Autologous vs allogeneic septal cartilage grafting in rhinologic surgery: current evidence, benefits, risks, and future directions (narrative review)

Abstract

Introduction. Septal cartilage grafting is a fundamental technique in rhinoplasty and rhino-septoplasty for restoring nasal structure, correcting contour defects, and improving airway function. When autologous septal cartilage is insufficient or unavailable—particularly after prior septal surgery— allogeneic cartilage from tissue banks may represent an alternative. This review summarizes current evidence on autologous and allogeneic septal cartilage transplantation in rhinologic surgery, focusing on clinical outcomes, safety, and future regenerative perspectives. Materials and methods. A narrative literature review was conducted using PubMed, Google Scholar, and ResearchGate. Publications from 2000 to 2024 were screened. Inclusion criteria comprised fulltext articles in English, Romanian, or Russian addressing rhinoplasty or rhino-septoplasty with autologous or allogeneic septal cartilage grafting. Original studies, reviews, editorials, and metaanalyses were analyzed. Additional relevant sources were identified through reference screening. Due to methodological variability, findings were synthesized qualitatively. Results. Autologous septal cartilage remains the preferred graft material in rhinologic surgery due to high biocompatibility, structural stability, and low immunologic risk. Clinical reports describe predictable integration and high patient satisfaction regarding both functional and aesthetic outcomes. Allogeneic cartilage is less frequently used but may be valuable when autologous tissue is limited. Reported risks include infection and rejection-like reactions, necessitating careful case selection and informed consent. Advances in harvesting and implantation techniques, including endoscopic approaches, improve visualization and postoperative recovery but require surgical expertise. Conclusions. Both autologous and allogeneic septal cartilage grafts are effective in rhinologic procedures. Autologous cartilage remains first-line due to its safety profile, while allogeneic grafts provide a viable alternative in selected cases with access to certified tissue banks. Future directions include refinement of surgical techniques, standardization of outcome assessment, and exploration of regenerative strategies to enhance graft integration and tissue remodeling.