Evaluation of the Multiple Tissue Factors in the Cartilage of Primary and Secondary Rhinoplasty in Cleft Lip and Palate Patients

Cleft lip and palate (CLP) is one of the craniofacial defects. The objective of this study was
to identify the differences in appearance between the tissue factors in cartilage of CLP patients after
primary and secondary rhinoplasty. Immunohistochemistry was performed with MMP-2, MMP-8,
MMP-9, TIMP-2, IL-1α, IL-10, bFGF, and TGFβ1. The quantification of the structures was performed
using a semi-quantitative census method. MMP-2, -9, IL-1a, and bFGF demonstrated higher number
of positive cells in patients, while the number of MMP-8, IL-1a, -10 and TGFβ1 cells was higher
or equal in the control subjects. The only statistically significant difference between CLP-operated
patients was found in the TIMP-2 group, where the primary CLP patient group had a higher number
of TIMP-2 positive chondrocytes than the secondary CLP patient group (U = 53.5; p = 0.021). The
median value of the primary CLP group was ++ number of TIMP-2 positive chondrocytes compared
to +++ in the secondary CLP group. No statistically significant difference was found between primary
and secondary rhinoplasty patients for other tissue factors. Commonly, the rich expression of different
tissue factors suggests a stimulation of higher elasticity in cleft affected cartilage. The statistically
significant TIMP-2 elevation in primary operated cartilage indicates an impact of the selective tissue
remodeling for hard tissue.