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. Objectives & Hypotheses: This study evaluated histological cartilage changes after monopolar electrocautery and compared post-cautery 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 s. Paired grafts received post-cautery or concomitant irrigation with saline. Grafts were implanted subcutaneously and examined histopathologically at 60 days. Conclusions: 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). Post-cautery 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. Post-cautery irrigation preserves higher chondrocyte viability than concomitant irrigation. When electrocautery is used for dorsal contouring, it should be applied within a limited safety range.