A New Method of Reconstruction for Pectus Excavatum That Preserves Blood Supply and Costal Cartilage

OBJECTIVES: Our goal was to describe a novel fascial flap of the temporal region and its use for reconstruction in otologic and neurotologic surgery. METHODS: The superficial temporalis fascia has an axial blood supply derived from the middle temporal artery and can be raised independently from the overlying temporoparietal fascia or the underlying deep temporalis fascia. This flap was used on 15 consecutive patients to solve a wide variety of reconstructive problems after otologic procedures. RESULTS: No additional morbidity was observed from the use of this flap. There were no complications related to the reconstruction. Adequate exposure for raising this flap was obtained using standard incisions for the otologic procedures. Follow-up ranges from 2 to 25 months. CONCLUSIONS: This fascial flap provides a wide surface area of tissue on a narrow-based pedicle capable of a wide arc of rotation. It provides thin, pliable tissue that can be adapted to the needs of various reconstructive otologic/neurotologic problems.

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The Arterial Blood Supply of the Distal Duodenum in Relation to a New Method of Duodenum-preserving Total Pancreatic Head Resection.

The Japanese Journal of Gastroenterological Surgery ◽

10.5833/jjgs.25.2502 ◽

1992 ◽

Vol 25 (10) ◽

pp. 2502-2506 ◽

Cited By ~ 1

Author(s):

Hideki Ryo ◽

Fujio Hanyu ◽

Takaho Watayo ◽

Toshihide Imaizumi ◽

Mitsuji Nakamura ◽

...

Keyword(s):

Blood Supply ◽

Pancreatic Head ◽

New Method ◽

Pancreatic Head Resection ◽

Arterial Blood Supply ◽

Arterial Blood

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Pectus excavatum repair using a costal cartilage graft for patients with tracheobronchomalacia

Journal of Pediatric Surgery ◽

10.1053/jpsu.2001.27941 ◽

2001 ◽

Vol 36 (11) ◽

pp. 1650-1652 ◽

Cited By ~ 1

Author(s):

Shinkichi Kamata ◽

Noriaki Usui ◽

Toshio Sawai ◽

Yuko Tazuke ◽

Keisuke Nose ◽

...

Keyword(s):

Pectus Excavatum ◽

Costal Cartilage ◽

Cartilage Graft ◽

Costal Cartilage Graft

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Semi-automatic 3D segmentation of costal cartilage in CT data from Pectus Excavatum patients

10.1117/12.2082531 ◽

2015 ◽

Author(s):

Daniel Barbosa ◽

Sandro Queirós ◽

Nuno Rodrigues ◽

Jorge Correia-Pinto ◽

J. Vilaça

Keyword(s):

Pectus Excavatum ◽

Costal Cartilage ◽

3D Segmentation ◽

Ct Data

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Deformities of the Thoracic Wall: Don't Forget the Plastic Surgeon

European Journal of Pediatric Surgery ◽

10.1055/s-0038-1668129 ◽

2018 ◽

Vol 28 (04) ◽

pp. 361-368 ◽

Cited By ~ 1

Author(s):

Anton Schwabegger

Keyword(s):

Pectus Excavatum ◽

Treatment Options ◽

Costal Cartilage ◽

Anterior Wall ◽

Thoracic Wall ◽

Reconstructive Procedures ◽

Chest Deformity ◽

Aesthetic Results ◽

Pectus Bar ◽

Single Method

AbstractSurgical procedures for pectus excavatum (PE) repair, such as minimally invasive repair of pectus excavatum or similar interventions (modified open videoendoscopically assisted repair of pectus excavatum), for remodeling the anterior thoracic wall may finally not always achieve sufficiently pleasing aesthetic results. Particularly in the asymmetric and polymorphic cases, remnant deformities may still be present after any sophisticated remodeling attempt. On the other hand, some cases despite optimal surgical management develop mild recurrences with partial concavity or rib cartilage distortion shortly after pectus-bar removal. Secondary treatment options then may include open access surgery, resection, or reshaping of deformed and prominent costal cartilage. Residual concave areas can be filled by autologous tissue, such as cartilage chips, liposhifting, or implantation of customized alloplastics. To provide the best options for a variety of primary or secondary postsurgical expressions of anterior wall deformities, any physician dealing with PE corrections should be familiar with various shaping and complementary reconstructive techniques or at least should have knowledge of such. However, among treating surgeons, there is an awareness that no single method can be applied for every kind of funnel chest deformity. Careful selection of appropriate techniques, either as a single approach for the ordinary deformities or in conjunction with ancillary procedures for the intricate cases, should be mandatory, based on the heterogeneity of symptoms, severity, expectations, and surgical and technical resources. A variety of such ancillary reconstructive procedures for PE repair are explained and illustrated herewith.

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