Cartilage can be shaped by scoring. In an exploratory study in living adult animals, this phenomenon was demonstrated in cartilage of the nasal septum. Bending was observed immediately after superficial scoring of the cartilage surface, and the cartilage always warped in the direction away from the scored side. The scored piece of cartilage still showed its initially distorted shape 10 weeks after primary surgery. In ex vivo experiments, a clear relation between incision depth and bending of septal cartilage was observed. Under these controlled conditions, the variation between different septa was small. Deformation of the septal specimens was increased by introducing single superficial incisions deepening to half the thickness of the cartilage. A positive correlation between incision depth and bending was demonstrated. A model was used to accurately predict the degree of bending of the cartilage after making an incision of a particular depth. Hence, the effect of cartilage scoring can be predicted. Because the results of this controlled study showed excellent reproducibility for different septa, it is expected that this model can be extrapolated to human nasal septum cartilage. This would enable the surgeon to better predict the result of cartilage scoring, either preoperatively or perioperatively.,
Plastic and Reconstructive Surgery
Department of Orthopaedics

ten Koppel, P., van der Veen, J.-M., Hein, R., van Keulen, F., van Osch, G., Verwoerd-Verhoef, H., & Verwoerd, C. (2003). Controlling incision-induced distortion of nasal septal cartilage: A model to predict the effect of scoring of rabbit septa. Plastic and Reconstructive Surgery, 111(6), 1948–1957. doi:10.1097/01.PRS.0000055427.13139.35