{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T18:22:14Z","timestamp":1788459734857,"version":"build-2803163510"},"reference-count":18,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T00:00:00Z","timestamp":1788220800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Facial Plastic Surgery &amp; Aesthetic Medicine"],"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>The adoption of homologous costal cartilage (HCC) in rhinoplasty is hindered by conflicting reports on resorption and warping. Current literature often conflates fresh-frozen and irradiated grafts, obscuring distinct biological profiles. The objective of this systematic review and meta-analysis was to evaluate the clinical and biomechanical outcomes of different preparations of cadaveric costal cartilage compared to autologous rib cartilage in rhinoplasty.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>A systematic review was conducted per PRISMA 2020 guidelines (PROSPERO ID: CRD42025603758). Studies comparing homologous grafts versus autologous costal cartilage were stratified into fresh-frozen and irradiated subgroups. Primary outcomes compared these homologous subgroups explicitly against autologous cohorts regarding resorption, warping, and infection. Risk of bias was assessed using the Newcastle-Ottawa Scale and ROBINS-I tools.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>Seven studies comprising 1,184 patients were included. Pooled analysis showed comparable infection rates between groups (risk ratios [RR] = 0.701; 95% CI: 0.284 to 1.731). Stratified subgroup analysis revealed that alcohol-preserved grafts demonstrated a significant reduction in warping risk (RR = 0.106; 95% CI: 0.012 to 0.934), while fresh-frozen and irradiated preparations showed comparable warping to autologous controls. Conversely, an elevated risk of resorption was driven exclusively by the irradiated subgroup (RR = 4.595; 95% CI: 1.279 to 16.503), whereas fresh-frozen (RR = 1.588; 95% CI: 0.489 to 5.164) and alcohol-preserved (RR = 1.479; 95% CI: 0.313 to 6.998) subgroups showed no significant difference. Operative time was significantly reduced in the homologous cohort (weighted mean differences = \u221266.56 min; 95% CI: \u221281.42 to \u221251.71).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>HCC represents a viable alternative to autologous rib in carefully selected cases, rather than a default substitute. While modern preservation methods offer promising short-term structural stability and eliminate donor-site morbidity, the decision of graft choice may be best made from individual patient and surgical factors, rather than the superiority of one source over the other.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/26893614261483359","type":"journal-article","created":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T04:25:00Z","timestamp":1788323100000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Different Preparations of Cadaveric Costal Cartilage Compared to Autologous Rib Cartilage in Rhinoplasty: A Systematic Review and Meta-Analysis"],"prefix":"10.1177","author":[{"ORCID":"https:\/\/orcid.org\/0009-0007-5413-1187","authenticated-orcid":false,"given":"Ahmed","family":"Wael Moftah","sequence":"first","affiliation":[{"name":"Faculty of Medicine, King Salman International University, South Sinai, Egypt."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4656-9000","authenticated-orcid":false,"given":"Ahmed","family":"Samy Gad","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Assiut University, Assiut, Egypt."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mouhammed","family":"Sleiay","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Hama University, Hama, Syria."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nourhan","family":"Eid Abdelaziz","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Zagazig University, Zagazig, Egypt."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,9,1]]},"reference":[{"key":"e_1_3_3_2_1","doi-asserted-by":"publisher","DOI":"10.1093\/asj\/sju117"},{"key":"e_1_3_3_3_1","doi-asserted-by":"publisher","DOI":"10.1001\/archfacial.2009.91"},{"key":"e_1_3_3_4_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamaoto.2019.4787"},{"key":"e_1_3_3_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bjps.2022.02.026"},{"key":"e_1_3_3_6_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamafacial.2016.1776"},{"key":"e_1_3_3_7_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.n71"},{"key":"e_1_3_3_8_1","volume-title":"Methods Guide for Effectiveness and Comparative Effectiveness Reviews","author":"Viswanathan M","year":"2008","unstructured":"7.Viswanathan M, , Ansari MT, , Berkman ND, et al. Assessing the risk of bias of individual studies in systematic reviews of health care interventions. In: Methods Guide for Effectiveness and Comparative Effectiveness Reviews. Agency for Healthcare Research and Quality (US): Rockville, MD; 2008."},{"key":"e_1_3_3_9_1","doi-asserted-by":"publisher","DOI":"10.3390\/publications14010004"},{"key":"e_1_3_3_10_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.i4919"},{"key":"e_1_3_3_11_1","doi-asserted-by":"publisher","DOI":"10.1002\/9781119099369.ch27"},{"key":"e_1_3_3_12_1","doi-asserted-by":"publisher","DOI":"10.1093\/asj\/sjae049"},{"key":"e_1_3_3_13_1","doi-asserted-by":"publisher","DOI":"10.1097\/GOX.0000000000005315"},{"key":"e_1_3_3_14_1","doi-asserted-by":"publisher","DOI":"10.1177\/0194599819866812"},{"key":"e_1_3_3_15_1","doi-asserted-by":"publisher","DOI":"10.1089\/fpsam.2023.0334"},{"key":"e_1_3_3_16_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00266-020-01986-7"},{"key":"e_1_3_3_17_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-0039-1677718"},{"key":"e_1_3_3_18_1","doi-asserted-by":"publisher","DOI":"10.1177\/0194599816683153"},{"key":"e_1_3_3_19_1","doi-asserted-by":"publisher","DOI":"10.1177\/00034894211058115"}],"container-title":["Facial Plastic Surgery &amp; Aesthetic Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/26893614261483359","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/26893614261483359","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/26893614261483359","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T17:57:51Z","timestamp":1788458271000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/26893614261483359"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,1]]},"references-count":18,"alternative-id":["10.1177\/26893614261483359"],"URL":"https:\/\/doi.org\/10.1177\/26893614261483359","relation":{},"ISSN":["2689-3614","2689-3622"],"issn-type":[{"value":"2689-3614","type":"print"},{"value":"2689-3622","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,1]]},"article-number":"26893614261483359"}}