Application of Trans-Areola Approach for Costal Cartilage Harvest in Asian Rhinoplasty and Comparison with Traditional Approach on Donor-Site Morbidity

2020 ◽  
Vol 40 (8) ◽  
pp. 829-835 ◽  
Author(s):  
Runlei Zhao ◽  
Bailin Pan ◽  
Hengju Lin ◽  
Yan Long ◽  
Yang An ◽  
...  
Keyword(s):  
Traditional Approach ◽  
Costal Cartilage ◽  
Donor Site ◽  
Donor Site Morbidity ◽  
Main Concern ◽  
Level Of Evidence ◽  
Traditional Group ◽  
Asian Patients ◽  
Areola Approach

Abstract Background The traditional approach of harvesting costal cartilage through a chest wall incision can result in significant donor-site morbidity and usually causes notable scars in Asian patients. This has become the main concern for Asian females seeking rhinoplasty with autologous costal cartilage. Objectives The aim of this study was to investigate the donor-site morbidity of the trans-areola approach for costal cartilage harvest in Asian rhinoplasty and to compare it with the traditional approach. Methods Patients’ records were reviewed to determine whether their rhinoplasties had been performed with either the trans-areola or the traditional approach to costal cartilage harvest. Donor-site morbidity was evaluated 1 year postoperatively via a visual analog scale and the Modified Vancouver Scar Scale. Long-term complications of the trans-areola group were assessed at least 6 months after surgery. Results There were 26 females in the trans-areola group and 35 females in the traditional group; both groups were of similar age and body mass index range. Compared with the traditional group, the trans-areola group had a significantly longer surgery time and a higher pneumothorax rate (7.7% vs 2.9%) but a significantly better scar quality and a higher overall satisfaction. Long-term outcomes and complications of the trans-areola group included significant scars (2/26, 7.7%), concavity of the breast (1/26, 3.8%), and local chest pain/discomfort (1/26, 3.8%). Conclusions Compared with the traditional approach to harvesting costal cartilage in Asian rhinoplasty, patients who underwent the trans-areola approach had less overall donor-site morbidity and higher overall satisfaction. We recommend this technique to patients who meet the inclusion criteria as well as those seeking a better cosmetic outcome. Level of Evidence: 4

LONG-TERM DONOR-SITE MORBIDITY IN COMPOSITE ANTEROLATERAL THIGH FREE FLAP FOR COMPLEX DEFECT OF LOWER LEG AND FOOT RECONSTRUCTION

2020 ◽  
pp. 85-91
Author(s):  
Phuc Le Hong ◽  
Son Tran Thiet ◽  
Thuy Nguyen Xuan
Keyword(s):  
Soft Tissue ◽  
Skin Graft ◽  
Free Flap ◽  
Donor Site ◽  
Lower Extremities ◽  
Lower Leg ◽  
Donor Site Morbidity ◽  
Thigh Circumference ◽  
Anterolateral Thigh

Background: In recent years, the composite anterolateral thigh free flap with tensor fasciae latae or vastus lateralis has been a new-applied type of flap that can provide very good reconstruction materials in complex defects of lower leg and foot. The study purpose is to evaluate the systematically complications of donor site, related factors to results of the donor area, in order to apply the result to improve the treatment, which have not been much reported in literature. Materials and Methods: Systematic donor site morbilidy evaluation in a prospective, uncontrolled clinical descriptive study of 33 composite anterolateral thigh free flaps in various forms to reconstruct anatomical structures or to resconstruct deep defects combined with covering the surfaces for complex soft tissue defects in lower extremities for 32 patients due to different causes in lower leg and foot area from 2014-2019 at Hue University of Medicine and Pharmacy. Examining and evaluating aesthetic and functional result of donor-site 3 months and 6 months up to 2 year after surgery; evaluating the correlation between the width and the type of the flaps and donor site closure methods. Result: In 33 composite flaps used, flap width to thigh circumference less than 20% in 27 cases (81.8%), more than 20% in 6 cases (18.20% ); There were 28 cases in which the donor site was directly closed, 5 cases required skin graft; All direct closed cases had flap width/ thigh circumference index below 20%; On the contrary, in cases having this index greater than 20%, the donor site required skin graft with p < 0.01. There are 11/33 (33.33%) of cases reported complications in donor site ; lateral thigh paresthesia is the most complicated complication with 8/33 cases (24.24%), followed by bad scarring 3/33 cases (9.09%). Conclusion: Long term follow up donor site morbility after composite anterior thigh free flap present 11/33 cases (33.33%): mostly complications of the donor site are thigh paresthesia with 8/33 cases (24.24%), and bad scarring 3/33 cases (9,09%), which improve time by time. Keywords: Composite anterior thigh free flap, lower extremities soft tissue defect, donor site morbidity

scholarly journals Long-Term Results of Autologous Auricular Cartilage Graft Applied in Anophthalmic Orbits Unable to Wear Prosthesis

2019 ◽  
Vol 2019 ◽  
pp. 1-6
Author(s):  
Yi-Lin Liao ◽  
Shu-Ya Wu ◽  
Yueh-Ju Tsai
Keyword(s):  
Donor Site ◽  
Donor Site Morbidity ◽  
Long Term Results ◽  
Chang Gung Memorial Hospital ◽  
Cartilage Graft ◽  
Auricular Cartilage ◽  
Prosthesis Fitting ◽  
Prosthesis Retention

In anophthalmic patients, shallow lower fornices make wearing ocular prostheses impossible and maintaining normal social activities difficult. This study retrospectively investigated the long-term surgical outcomes of autologous auricular cartilage grafting for contracted orbits. From 1995 to 2013, 29 anophthalmic contracture sockets with inadequate lower fornices and poor prosthesis retention presented to Chang Gung Memorial Hospital in Linkou, Taiwan, were treated using this surgical method. The success rate, aesthetic outcome, recurrence, and complications were analyzed. Among the 29 patients, 15 were women, 14 were men, their mean age was 45 years, and the mean follow-up time was 52 months (range = 6–159 months). Satisfactory lid position was achieved in 25 cases (86%), and lower fornix retraction recurred in four cases (14%). Neither donor site morbidity nor auricular deformity was noted during the follow-up period. Therefore, an auricular cartilage graft can be used successfully as a compatible spacer for anophthalmic patients with shallow lower fornices and prosthesis-fitting problems in long-term follow-up.

Gender Disparity between Donor Sites of the Trochlea Used for Autologous Osteoarticular Transfer: An MRI Analysis

2019 ◽  
Vol 33 (04) ◽  
pp. 357-364
Author(s):  
Kelly M. Rogers ◽  
Daniel C. Berman ◽  
Justin W. Griffin ◽  
Kevin F. Bonner
Keyword(s):  
Standard Deviation ◽  
Trochlear Dysplasia ◽  
Donor Site ◽  
Donor Site Morbidity ◽  
Gender Disparity ◽  
Measurement Tool ◽  
Level Of Evidence ◽  
Osteochondral Autograft Transfer ◽  
Males And Females ◽  
The Mean

AbstractThe purpose of this study was to assess potential gender differences in size of the lateral and medial trochlea of the male and female knee as well as the variation within gender of potential osteochondral autograft transfer (OAT) donor site area. Two hundred and twelve skeletally mature patients, 106 males and 106 females, who underwent a 3T magnetic resonance imaging of the knee for a variety of indications were utilized for analysis. Exclusion criteria included degenerative arthritis, trochlear dysplasia, and poor image quality. Medial and lateral femoral trochlear cartilage width was obtained using a linear radiologic measurement tool. Widths were measured from a reproducible anatomic location representing the maximal trochlear dimension in a region where donor plugs are commonly harvested. Trochlear width was also plotted as a function of patient height. Statistical analysis was performed using a two-sample t-test. The mean and standard deviation of the lateral trochlear cartilage width (mm) for males and females were 23.38 +/− 2.14 and 20.44 +/− 2.16, respectively (p < 0.00001). The mean and standard deviation of the medial trochlear cartilage width (mm) for males and females were 14.16 +/− 2.17 and 11.78 +/− 2.03, respectively (p < 0.00001). The overall range in trochlear width for both the lateral and medial sides was 22.22 and 19.73 mm for males and females, respectively. A graft measuring 10 mm could represent as little as 34% of the lateral trochlea in males versus as much as 65% in females. Our results indicate that donor OAT plug diameter relative to available trochlear cartilage width will vary significantly both between genders and individual patients. Trochlear width variability and its potential implications on donor site morbidity may be an important consideration when contemplating osteochondral plug harvest for OAT or other indications. The level of evidence is IV.

Long-term donor-site morbidity after vascularized free fibula flap harvesting: Clinical and gait analysis

2016 ◽  
Vol 69 (2) ◽  
pp. 262-269 ◽  
Author(s):  
Damien Feuvrier ◽  
Yoshimasa Sagawa ◽  
Samuel Béliard ◽  
Julien Pauchot ◽  
Pierre Decavel
Keyword(s):  
Gait Analysis ◽  
Donor Site ◽  
Donor Site Morbidity ◽  
Free Fibula Flap ◽  
Fibula Flap ◽  
Free Fibula

Modified Littler flap for sensory reconstruction of large thumb pulp defects

2018 ◽  
Vol 43 (5) ◽  
pp. 546-553 ◽  
Author(s):  
Hui Wang ◽  
Xiaoxi Yang ◽  
Chao Chen ◽  
Bin Wang ◽  
Wei Wang ◽  
...  
Keyword(s):  
Donor Site ◽  
Ring Finger ◽  
Middle Finger ◽  
Donor Site Morbidity ◽  
Digital Nerve ◽  
Level Of Evidence ◽  
Dorsal Branch ◽  
Ulnar Aspect ◽  
Monofilament Test

The Littler flap has been widely used to repair large pulp defects of the thumb; however, several complications have occurred frequently. In order to reduce these issues, the modified Littler flap innervated by the dorsal branch of the proper digital nerve and the proper digital nerve from the ulnar aspect of the middle finger or the radial aspect of the ring finger were devised in 16 consecutive cases. At the donor site, the defect of the proper digital nerve was repaired with a nerve graft from the proximal portion of the ipsilateral dorsal branch of the proper digital nerve. At the final follow-up, the scores for the static two-point discrimination test, Semmes–Weinstein monofilament test and total active motions in both recipient and donor fingers were nearly normal. This modified Littler flap provides a simple and reliable alternative for treatment of large defects of the thumb pulp with low donor-site morbidity. Level of Evidence: IV

Effects of Sterilization Techniques and Culture Time on the Creep of Collagenous Ligament Analogues

2002 ◽  
Author(s):  
Darryl A. Dickerson ◽  
Kay C. Dee ◽  
Glen A. Livesay
Keyword(s):  
Cruciate Ligament ◽  
Donor Site ◽  
Critical Role ◽  
The United States ◽  
Donor Site Morbidity ◽  
Joint Stability ◽  
Acl Injuries ◽  
Anterior Cruciate ◽  
Active Patients

Every year, approximately 200,000 anterior cruciate ligament (ACL) injuries occur in the United States; of these cases, 60,000–75,000 patients undergo ACL reconstruction [1]. The ACL plays a critical role in knee stability; however, it possesses little inherent capacity for healing. Although reconstruction is often used in active patients, issues such as donor site morbidity and long term joint stability have motivated interest in tissue-engineered ligament analogues.

Type IIIB and IV hypoplastic thumb reconstruction with non-vascularized fourth metatarsal

2020 ◽  
Vol 45 (7) ◽  
pp. 722-728 ◽  
Author(s):  
Bo Liu ◽  
Shanlin Chen ◽  
Esther Ching San Chow ◽  
Pengcheng Li ◽  
Kun Liu ◽  
...  
Keyword(s):  
Hand Function ◽  
Donor Site ◽  
Donor Site Morbidity ◽  
Pinch Strength ◽  
Reconstruction Method ◽  
Level Of Evidence ◽  
Type Iv ◽  
Type Iiib ◽  
Rotational Flap ◽  
Staged Reconstruction

We treated 16 patients with 17 hypoplastic thumbs (eight Type IIIB and nine Type IV) using a non-vascularized fourth metatarsal transfer with a rotational flap and multi-staged reconstruction. The average age at the first operation was 24 months. The average follow-up time was 46 months. All patients achieved reasonable hand function and were able to use the reconstructed thumb to grip small and large objects. The operated thumb achieved an average Kapandji score of 6.7 and average pinch strength of 0.9 kg. There were two cases of graft nonunion. All parents are satisfied with the function and appearance of the reconstructed thumb and donor foot. We conclude that non-vascularized fourth metatarsal transfer is a feasible reconstruction method for patients with Types IIIB and IV hypoplastic thumbs. The reconstruction allows for the preservation of a 5-digit hand with reasonable function and appearance and minimal donor site morbidity, although long-term growth of the metatarsals still need to be monitored. Level of evidence: IV

Evaluation of long‐term functional donor‐site morbidity after deep circumflex iliac crest artery bone flap harvest

Microsurgery ◽  
2018 ◽  
Vol 39 (4) ◽  
pp. 304-309 ◽  
Author(s):  
Carsten Rendenbach ◽  
Friedemann Goehler ◽  
Lara Hansen ◽  
Carsten Kohlmeier ◽  
Michael Amling ◽  
...  
Keyword(s):  
Iliac Crest ◽  
Donor Site ◽  
Donor Site Morbidity ◽  
Bone Flap

Y-Shaped En-Bloc Mortise-Tenon Rhinoplasty Technique

2019 ◽  
Vol 40 (1) ◽  
pp. NP8-NP20 ◽  
Author(s):  
Zheng Tan ◽  
Wentao Sun ◽  
Wenjing Yang ◽  
Xiaoling Zhu ◽  
Fan Dong ◽  
...  
Keyword(s):  
Costal Cartilage ◽  
Septal Cartilage ◽  
The Novel ◽  
En Bloc ◽  
Level Of Evidence ◽  
Cartilage Grafts ◽  
Asian Patients ◽  
Caudal Portion ◽  
Aesthetic Results ◽  
Nose Deformity

AbstractBackgroundNasal tip management is the most important and challenging aspect of rhinoplasty. Costal cartilage can be utilized in septal extension grafting to effectively correct nasal shape deformity.ObjectivesThe authors described their experience with costal cartilage grafting for septal extension utilizing a novel en-bloc mortise-tenon technique to correct primary or secondary nose deformity or to enhance nasal appearance in Asian patients.MethodsFrom July 2015 to December 2017, costal cartilage grafts were applied as septal extension biomaterials utilizing the novel en-bloc mortise-tenon technique in 278 consecutive Asian rhinoplasty patients with primary (n = 95), secondary (n = 173), and tertiary (n = 10) nose deformity or in patients needing nasal reshaping. The age of the patients ranged from 19 to 46 years. In all cases, the mucoperichondria of the nasal septum were dissected bilaterally from the septal cartilage. The prepared en-bloc costal cartilage graft was mounted onto the caudal portion of the septal cartilage and fixed to the septum with 5-0 polydioxanone sutures.ResultsThe follow-up duration ranged from 10 months to 2.5 years. Of the 278 patients treated, 5 were male and 273 were female. External lengthening of the nose from the nasal root to the tip ranged from 3 to 10 mm. All patients except 1 were satisfied with the shape of the nose.ConclusionsThe authors obtained good aesthetic results utilizing the novel en-bloc mortise-tenon method for connecting costal cartilage grafts as septal extension materials in patients with different types of nasal deformity and in patients needing nose reshaping.Level of Evidence: 4

Sign in / Sign up

Export Citation Format

Share Document