Thermal Effects of Monopolar Electrocautery on Cartilage

Introduction Electrocautery is used for dorsal cartilage contouring in rhinoplasty, but its safe energy range and histological effects remain unclear. Objective and Hypothesis This study evaluated histological cartilage changes after monopolar electrocautery and compared postcautery and concomitant irrigation effects on chondrocyte viability. Study Design Experimental animal study. Methods Eight adult New Zealand rabbits were included. Auricular cartilage grafts were treated with monopolar electrocautery at 0, 8, 10, or 12 W for 4 seconds. Paired grafts received postcautery or concomitant irrigation with saline. Grafts were implanted subcutaneously and examined histopathologically at 60 days. Conclusion Chondrocyte viability decreased with increasing energy levels (0 W: 57.8 ± 27.9%; 8 W: 22.6 ± 16.8%; 10 W: 8.5 ± 9.9%; 12 W: 5.2 ± 5.5%; p < 0.001). Among the groups in which ossification was observed, the highest ossification rates were recorded at 8 W, with lower values at higher energy settings (p < 0.001). Postcautery irrigation preserved significantly higher chondrocyte viability than concomitant irrigation at all energy levels. Monopolar electrocautery causes an energy-dependent reduction in chondrocyte viability. Ossification was identified as an unanticipated finding independent of the applied energy level. Postcautery irrigation preserves higher chondrocyte viability than concomitant irrigation. When electrocautery is used for dorsal contouring, it should be applied within a limited safety range.