Outcomes of Autologous Versus Irradiated Homologous Costal Cartilage Graft in Rhinoplasty

<b>Background:</b> Autologous costal cartilage (ACC) and irradiated homologous costal cartilage (IHCC) are commonly used in septorhinoplasty when there is insufficient septal cartilage for grafting. <b>Objective:</b> To assess the surgical outcomes of patients who underwent septorhinoplasty with either ACC or IHCC as measured by rates of infection, resorption, warping, and revision rate. <b>Methods:</b> A retrospective analysis of patients who underwent rhinoplasty with ACC or IHCC at a single academic institution was performed. Demographic data, surgical details, antibiotic use, and outcomes, including surgical duration, infection, resorption, warping, and revision rate, were analyzed using Fisher's exact test, chi-squared test, and logistic regression. <b>Results:</b> One hundred forty-three patients were identified. The median age was 48 years (interquartile range: 35-57.5) and 62.2% (<i>n</i> = 89) were female, 61 patients (42.7%) underwent ACC, and 82 (57.3%) IHCC. Revision rate in both groups was similar (ACC = 14.8%, IHCC = 14.6%; <i>p</i> = 0.98). There was no difference in infection rate (ACC = 4.9%, IHCC = 3.7%; <i>p</i> = 0.71). Postoperative deformity and nasal obstruction were the most common indications for revision surgery. Surgical time was shorter with IHCC (<i>p</i> < 0.01). Mean follow-up time was 26.5 months (±25) for ACC, and 16 months (±12) for IHCC. <b>Conclusions:</b> ACC and IHCC are similar in terms of effectiveness and safety in septorhinoplasty.