No abstract available.
Costal Cartilage

The complexity of the auricle makes its reconstruction technically difficult, owing to the convexities and concavities of the underlying cartilage with its tightly adherent and thin overlying skin. This article gives an overview of the current practice in the field of auricular reconstruction. The majority of surgeons who perform auricular reconstruction continues to employ the well-established techniques developed by Brent and Nagata. Surgery takes between two and four stages, with the initial stage being construction of a framework of autogenous rib cartilage which is implanted into a subcutaneous pocket. Several modifications of these techniques have been reported. Understanding the various treatment options and having sufficient practice to increase the surgeon's skills are crucial to providing the patients with the best outcomes possible.
Cartilage ; Congenital Microtia ; Costal Cartilage ; Humans ; Ribs ; Skin ; Surgeons

Binder syndrome, also called the congenital flat nose syndrome, is a rare congenital malformation with a flat facial profile, intermaxillary hypoplasia and malocclusion. Rhinoplasty plays an important part in the multidisciplinary surgical protocol for this syndrome, for which weak nasal framework and soft tissue underdevelopment have been considered a great challenge. We present a case of Binder syndrome of a 27-year-old male. The nose was reconstructed with a caudal septum replacement graft and bilateral extended spreader grafts using costal cartilage.
Adult ; Costal Cartilage ; Humans ; Male ; Malocclusion ; Nose ; Rhinoplasty ; Transplants

OBJECTIVE: To review the advances in methods for reconstructing nipple projection based on tissue graft support. METHODS: The literature related to nipple projection reconstruction based on tissue graft support was reviewed and summarized in terms of the advantages and disadvantages of various tissue grafts and the improved nipple projection results. RESULTS: Loss of nipple projection is a common cause of decreased patient's satisfaction. Reconstructing nipple projection based on tissue graft support is a more common clinical method and can be done with autologous and allogeneic tissues. Autologous tissue grafts include dermis, adipose tissue with dermis, adipose tissue, ear cartilage, rib cartilage, and contralateral nipple tissue. Autologous tissue grafts are easy to obtain and have no immune rejection, but may lead to donor area damage and prolong the surgical time for tissue collection. Allogeneic tissue grafts include acellular dermal matrix, lyophilized rib cartilage, and extracellular matrix collagen, and decellularized nipple tissue. Allogeneic tissue grafts do not cause additional donor area damage, are highly malleable, and can be designed to be utilized according to the recipient area, but the high cost often limits the development of this technique. CONCLUSION There is no gold standard regarding tissue graft-assisted nipple projection reconstruction techniques, and there are advantages and disadvantages to both autologous and allogeneic tissue grafts. Surgeons should choose the appropriate graft based on the actual condition of the patient.
Humans ; Adipose Tissue ; Autografts ; Costal Cartilage ; Nipples/surgery* ; Transplants

Adolescent ; Adult ; Costal Cartilage ; surgery ; Female ; Humans ; Rhinoplasty ; methods ; Young Adult

OBJECTIVEAugmentation rhinoplasty is a commonly procedure in clinical work for a plastic surgeon. Autologous costal cartilage is widely used in aesthetic rhinoplasy because of the abundant in quality. However, the cartilage may warp, and it is not easy-handling for inexperienced plastic surgeons. We-used diced cartilage combined with thin strips as columellar struts, which can be easily shaped, and reduce the warping incidence.

METHODSFrom July 2012 to March 2014, 61 patients were performed diced costal cartilage for nasal augmentation via endonasal approach. Standardized photographs are obtained before and after surgery. Postoperative outcome is graded by patient's self-evaluation of the nasal appearance with a satisfaction scale.

RESULTSAmong the 61 cases, 25 were revision cases. The follow-up time was no less than 6 months, with an average time of 10.9 months. 28 patients reported improved or better nasal appearance. One patient required revision surgery because of overcorrection. Supratip step-off was observed in one patient and corrected by external reshaping. No warping, infection, irregularity, absorption, airway obstruction, or donor-site morbidity were observed. All patients were satisfied with the final appearance.

CONCLUSIONSDiced costal cartilage is a reliable option for nasal augmentation and revision rhinoplasty. Good outcomes can be achieved postoperatively, with aesthetically pleasing appearance and simple procedure.

Costal Cartilage ; transplantation ; Esthetics ; Humans ; Nasal Septum ; Reoperation ; Retrospective Studies ; Rhinoplasty ; methods

OBJECTIVETo explore the effect of the expanded capsule on biomechanics of the transplanted autologous costal cartilage.

METHODSTen New Zealand white rabbits aged 3 months were involved and four 15 ml tissue expanders were implanted symmetrically on the back of each rabbit. After 1 month, expanded capsules were removed (experimental group) on the left side and were reserved (control group) on the right side. Meanwhile, the 6th and 7th costal cartilage without the perichondrium were taken out and each cartilage was divided into two pieces and put under the expanded capsule symmetrically. The cartilage at the upper sides and lower sides were taken out at 4 weeks and 8 weeks later, respectively. All the cartilages were sculptured for the demand of the machine text. The tension and compression property of the cartilages were assessed by the material testing machine (Instron 5967) and the results were analyzed statistically.

RESULTS8 weeks lateral, the average ultimate tension strength was (4. 954 + 2. 8) MPa in experimental group and (2.939 + 0.842) MPa in control group. The average compressive strength was (58.74 ± 13.77) MPa in experimental group, and (47.61 ± 11.41) MPa in control group. The biomechanics property of the cartilages in the experimental group is better than the control group, and the differences were statistically significant.

CONCLUSIONSRemoving the expanded capsule is benefical to maintain the biomechanics of autologous costal cartilage.

Animals ; Autografts ; Biomechanical Phenomena ; Costal Cartilage ; physiology ; transplantation ; Humans ; Rabbits ; Ribs ; Tissue Expansion ; Tissue Expansion Devices

OBJECTIVETo investigate the correction of secondary nasal deformity of cleft lip with autogenous costal cartilage framework.

METHODS237 cases with secondary nasal deformity of unilateral cleft lip were treated. The rib cartilage was harvested through a mini-invasive incision, and was fabricated as a C-shaped framework, as well as some cartilage fragments. Through transcolumella incision, the C-shaped framework was implanted to support the depressed alar and the cartilage fragments were used to augment the nasal base.

RESULTSSatisfactory cosmetic and functional results were achieved in all the patients with primary healing. 93 patients were followed up one year after operation with good cosmetic results.

CONCLUSIONSAutogenous costal cartilage framework can be used for the correction of secondary nasal deformity of cleft lip with satisfactory results.

Cleft Lip ; surgery ; Costal Cartilage ; transplantation ; Humans ; Nose Deformities, Acquired ; surgery ; Rhinoplasty ; methods

OBJECTIVETo investigate the therapeutic effect of alar rotation flap for severe alar retraction.

METHODSPatients with severely retracted alar underwent ala reconstruction using alar rotation flaps and autogenous cartilage batten grafts. First, costal cartilage was used to reshape the nasal tip and nasal dorsum. Then cartilage patch was used to extend and thicken the retracted alar. Then the alar rotation flap was transferred to correct retracted alar.

RESULTSFourteen patients with severe alar retraction underwent alar reconstruction with alar rotation flap and alar batten grafts. The alar retraction was corrected in all cases, with improvements functionally and aesthetically. No recurrence of alar retraction was noted. The incision healed with acceptable cosmetic results, with obvious scar in only one patient (one side).

CONCLUSIONSThe alar rotation flap is an effective and reliable surgical option to correct severe alar retraction. Scar can be kept inconspicuous by precise placement of the incision within the junction of the ala and the nasal dorsum, following principles of the aesthetic nasal subunits.

Cartilage ; transplantation ; Cicatrix ; prevention & control ; Costal Cartilage ; transplantation ; Esthetics ; Humans ; Nose Deformities, Acquired ; surgery ; Rhinoplasty ; methods ; Rotation ; Surgical Flaps

A 71-year-old man was referred for an anterior chest wall mass. Chest computed tomography (CT) and positron emission tomography-CT suggested a malignant tumor. Surgical biopsy through a vertical subxiphoid incision revealed an extra-gastrointestinal stromal tumor (EGIST). En bloc resection of the tumor, including partial resection of the sternum, costal cartilage, pericardium, diaphragm, and peritoneum, was performed. Pathologic evaluation revealed a negative resection margin and confirmed the tumor as an EGIST. On postoperative day 17, the patient was discharged without any complications. At the 2-week follow-up, the patient was doing well and was asymptomatic.
Aged ; Biopsy ; Costal Cartilage ; Diaphragm ; Electrons ; Follow-Up Studies ; Gastrointestinal Stromal Tumors ; Humans ; Pericardium ; Peritoneum ; Sternum ; Thoracic Wall* ; Thorax*