Copyright © 2018 Mutaz B. Habal, MD. Unauthorized reproduction of this article is prohibited. Creation of Experimental Human Nose Model With Lyophilized and Decellularized Bovine Cartilage Xenograft Can Ilker Demir, MD,  Emrah Kag˘an Yas ¸ar, MD, y Kivanc ¸ Davun, MD, y Aykut Go ¨k, MD, y Ceyhun Uzun, MD, y and Murat S ¸ahin Alago ¨z, MD y Abstract: The nose anatomy is a functional and aesthetically important organ because of its three-dimensional structure, visible location in the face region, and its connection with the respiratory tract. Aesthetic and reconstructive nasal surgery requires correction of deformations in cartilage and bone structures as well as preser- vation of the natural connections between all subunits. The minimal mistake made can result in functional or aesthetically bad results. In this study, the authors aimed to create an experimental nose model that help aesthetic and reconstructive nose surgery operations. Key Words: Experimental, model, nose, rat, rhinoplasty, xenograft (J Craniofac Surg 2018;00: 00–00) T he nose is a respiratory organ with many features such as regulating the temperature, clearing the air from foreign bodies, and helping with the phonation. 1–2 The nose is one of the most exposed organs to mechanical trauma. 3 For these reasons, aesthetic and reconstructive nose operations are often needed. In the Aes- thetic Plastic and Reconstructive Surgery Assistantship, this anat- omy has a fairly steep learning curve. 4 Intraoperative monitoring, anatomy atlases, textbooks, literature publications, and cadaver dissections are some of these methods. Each of these methods has advantages and disadvantages. Today, the most commonly used method of understanding this anatomy is intraoperative obser- vation. 4 In this study, we aimed to understand relations between nasal anatomy and subunits better, to make suture techniques to be learned more easily by especially for doctors in the first years of plastic surgery assistantship and have them developed, to make the 3 dimensional structure of nose to be resolved, and to make the interpretation of the relation between cartilage and skin to be more practical with human nose model which we have formed on the back of rats. In addition to these, we aimed to see the long-term effects of the techniques used and to make longer studies in the same subject. We used protocols of cellulization and antigenicity reduction for the long-term survival of the cartilage xenograft cartilage we used for this. METHODS Subjects In this study, piece of 10-, 12- to 14-week-old, healthy, adult, male, Wistar Albino rats weighing 350 to 360 g were used. The rats were followed up at a temperature of 228 to 268, with a ventilation system. The rats were fed with standard pellets, feed, and tap water. Neither additional nutrients nor diets were applied. All rats were anesthetized with ketamine hydrochloride (Ketalar Eczacibas ¸i, Turkey) with intraperitoneal 80 mg/kg intraperitoneally and xyla- zine hydrochloride (Rompun, Bayer, Turkey) with intraperitoneal 10 mg/kg. When the depth of anesthesia disappeared in rats, the dose was repeated at the ratio of 1/4. After a 1-month follow-up, complete anesthesia was administered by the same method followed by ether euthanasia. Death was confirmed by verifying the absence of heart rate. Creation of Cartilage Xenograft Cartilage taken from the bovine front leg shank was used to create the nose model. The adult bovine cartilage was taken immediately after the animal was cut and it was stored in 0.9% NaCl solution. Subsequently, pericondrium, tendons, and muscle structures around cartilage were removed under sterile conditions. Polypropylene-made storage bags were used to store the cartilage in sterile conditions. Large-sized cartilage was divided into 4 equal parts: 100 mL of methyl alcohol, 100 mL of chloroform solution was mixed, and the cartilage was left in solution for 48 hours at þ48. The solution was renewed every 24 hours. After chemical cellulization, lyophilization process was started. Carti- lage which frozen for 12 hours at 808 lyophilized for 12 hours at 458. As a last step, a total of 8 vials of cefatazol with 1 vial for each cartilage were placed in 100 mL 0.9% NaCl solution for 24 hour- s.At the same time, some antibiotics in the solution contributed to the sterilization. The cartilages were made ready to be used for modeling by putting them back on the polypropylene bags and they were kept ready at the room temperature to prepare the model. Creation of Nasal Model The base, septum, bone, lower lateral cartilage (LLC), and upper lateral cartilage (ULC) were created separately to form the model. The base width was planned to be 1.7 cm, parallel edges 2.2 cm, triangular edges at the top 1.3 cm, and thickness 1 to 2 mm. Septum sizes were planned to be 4 cm in base, 3.3 cm in dorsal, 2 cm in columella, 3 mm in supratip region, and 2 to 3 mm in thickness. The caudal caudate was elongated as an extension graft to allow creation columella. The bone is planned to be hexagonal. The From the  Bingo ¨l Public Hospital, Plastic Reconstructive Surgery, Bingo ¨l; and y Department of Plastic Reconstructive Surgery, Kocaeli University, Kocaeli, Turkey. Received January 22, 2018. Accepted for publication February 13, 2018. Address correspondence and reprint requests to Can Ilker Demir, MD, Oruc ¸ Reis Street, Ino ¨nu ¨ District, Bingo ¨l, Turkey; E-mail: canilkerdemir@gmail.com The authors report no conflicts of interest. Copyright # 2018 by Mutaz B. Habal, MD ISSN: 1049-2275 DOI: 10.1097/SCS.0000000000004546 SCIENTIFIC FOUNDATION The Journal of Craniofacial Surgery  Volume 00, Number 00, Month 2018 1