Comparison of N-octyl-cyanoacrylate vs suture in the stabilization of cartilage grafts

P. N. Brown, H. S. McGuff and A. D. Noorily
Department of Otolaryngology-Head and Neck Surgery, University of Texas Health Science Center at San Antonio, USA.

OBJECTIVE: To compare N-octyl-cyanoacrylate and suture control to determine the efficacy of this tissue glue preparation in securing grafted cartilage with an acceptable inflammatory reaction. DESIGN: Four 5-mm circular auricular cartilage grafts were harvested, and 2 of these grafts were either glued together with N-octyl-cyanoacrylate or sewn together with nylon suture. These sandwich grafts were then glued or sewn to the periosteum of the calvaria. Histologic analysis for inflammation, necrosis, fibrosis, and foreign-body giant cell reaction was performed 2 and 6 weeks after implantation. We also measured cartilage graft migration from the original site of surgical implantation. SUBJECTS: Sixteen New Zealand white rabbits. The 2-week study group consisted of 7 rabbits (1 died of dehydration), and the 6-week group totaled 8. INTERVENTION: Each rabbit underwent auricular cartilage harvest and cartilage graft implantation to the parietal skull periosteum. RESULTS: We found no histological differences between the glue specimens and the suture controls. Similarly, our examination of graft migration yielded no differences between groups. CONCLUSIONS: N-octyl-cyanoacrylate was superior to standard suture technique by virtue of its speed, ease, and accuracy of application. No adverse inflammation was observed. Further studies, including clinical trials, are needed to assess the safety of N-octyl-cyanoacrylate in humans.