Age‐related histologic and biochemical changes in auricular and septal cartilage

• Published in: The Laryngoscope 2017-11, Vol.127 (11), p.E399-E407
• Main Authors: Riedler, Kiersten L., Shokrani, Alireza, Markarian, Alexander, Fisher, Laurel M., Pepper, Jon‐Paul
• Format: Article
• Language: English
• Subjects: Age; Age Factors; Aged; Aged, 80 and over; aging; Aging - physiology; basic research; Cadaver; Cartilage; cartilage grafts; Collagen; Cross-Sectional Studies; Ear Cartilage - metabolism; Ear Cartilage - pathology; facial plastic surgery; Glycosaminoglycans - metabolism; Humans; Middle Aged; Nasal Cartilages - metabolism; Nasal Cartilages - pathology; nasal reconstruction; rhinoplasty; septorhinoplasty; Staining and Labeling
• ISSN: 0023-852X; 1531-4995
• DOI: 10.1002/lary.26807

Objectives/Hypothesis To characterize the histologic and biochemical properties of auricular and septal cartilage and analyze age‐related changes in middle‐aged to older adults. Study Design Cross‐sectional study of auricular and septal cartilage from 33 fresh cadavers. Methods Auricular and septal cartilage specimens were stained using Safranin O for glycosaminoglycans, Verhoeff's stain for elastin, and Masson's trichrome for collagen. Percentage of tissue stained, cell density and size were quantified. Relationships between donor characteristics and histologic properties were evaluated using mixed model analyses. Results The average donor age was 75 years (standard deviation = 11 years; range, 55–93 years). In auricular cartilage, each 1‐year increase in age was associated with a 0.97% decrease in glycosaminoglycans (P < .001) and a 0.98% decrease in elastin (P < .001). In septal cartilage, glycosaminoglycans decreased 2.4% per year (P < .001). Age did not affect collagen content significantly in auricular (P = .417) or septal cartilage (P = .284). Cell density and cell size declined with age in auricular (both P < .001) and septal cartilage (P = .044, P = .032, respectively). Compared to septal cartilage in patients of all ages, auricular cartilage had more glycosaminoglycans, less collagen, higher cell density, and smaller cells. Conclusions In auricular and septal cartilage, glycosaminoglycans, elastin, cell density, and cell size decrease significantly with age in patients over 55 years of age. Glycosaminoglycan content declines faster with age in septal cartilage than auricular cartilage. These age‐related changes may affect biomechanical properties and tissue viability, and thereby have implications for graft choice in functional, aesthetic, and reconstructive nasal surgery. Level of Evidence NA. Laryngoscope, 127:E399–E407, 2017