Application of One Piece Autologous Rib Cartilage Graft in Hollow Space of Complete Naso-Ethmoid-Orbital Fracture

Posterior glottic and subglottic stenosis from endotracheal intubation in children can be managed endoscopically with varying success. Open surgical treatment offers a better potential for correction with a single procedure in moderate and severe cases. The open method consists of splitting the scar and cricoid cartilage posteriorly to the level of the interarytenoid muscle, then stenting the incised cricoid open with a rib cartilage graft. Use of this method is described, and results in 12 cases are reported. Decannulation was achieved in ten patients. In all patients who were decannulated, good exercise tolerance, freedom from aspiration, and an adequate voice quality were achieved.

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Harvesting split thickness costal cartilage graft

Indian Journal of Plastic Surgery ◽

10.4103/ijps.ijps_124_16 ◽

2017 ◽

Vol 50 (01) ◽

pp. 079-081 ◽

Cited By ~ 4

Author(s):

Sunil Gaba ◽

Richa Gupta ◽

Bharat Mishra ◽

Daisy Sahni

Keyword(s):

Costal Cartilage ◽

Clinical Results ◽

Cartilage Graft ◽

Full Thickness ◽

Cartilage Grafts ◽

Rib Cartilage ◽

Post Operative Pain ◽

Costal Cartilage Graft

ABSTRACT Aim: There are few complications associated with harvesting of full thickness coastal cartilage grafts i.e., pneumothorax (0.9%), contour deformities and prolonged post-operative pain. To address these issues, authors devised special scalpel to harvest split-thickness costal cartilage grafts. Materials and Methods: Standard inframammary incision was used for harvesting rib. Incision was made directly over the desired rib. Specially designed scalpel was used to cut through the rib cartilage to the half of the thickness. The study was conducted in two parts – cadaveric and clinical. Results: There was significantly less pain and no pneumothorax in the patients in whom the split thickness graft was harvested. Wounds healed without any complication. Discussion: Thus, newly devised angulated scalpel used in the current study, showed the potential to supply the reconstructive surgeon with split thickness rib graft without risk of complications such as pneumothorax or warping contour deformities and post-operative pain.

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Computer-Aided Design and Rapid Prototyping–Assisted Contouring of Costal Cartilage Graft for Facial Reconstructive Surgery

Craniomaxillofacial Trauma & Reconstruction ◽

10.1055/s-0031-1300964 ◽

2012 ◽

Vol 5 (2) ◽

pp. 75-81 ◽

Cited By ~ 7

Author(s):

Shu Jin Lee ◽

Heow Pueh Lee ◽

Kwong Ming Tse ◽

Ee Cherk Cheong ◽

Siak Piang Lim

Keyword(s):

Rapid Prototyping ◽

Computer Aided Design ◽

Costal Cartilage ◽

Bone Grafts ◽

Autogenous Bone ◽

Cartilage Graft ◽

Facial Skeleton ◽

Rib Cartilage ◽

Computer Aided ◽

Aided Design

Complex 3-D defects of the facial skeleton are difficult to reconstruct with freehand carving of autogenous bone grafts. Onlay bone grafts are hard to carve and are associated with imprecise graft-bone interface contact and bony resorption. Autologous cartilage is well established in ear reconstruction as it is easy to carve and is associated with minimal resorption. In the present study, we aimed to reconstruct the hypoplastic orbitozygomatic region in a patient with left hemifacial microsomia using computer-aided design and rapid prototyping to facilitate costal cartilage carving and grafting. A three-step process of (1) 3-D reconstruction of the computed tomographic image, (2) mirroring the facial skeleton, and (3) modeling and rapid prototyping of the left orbitozygomaticomalar region and reconstruction template was performed. The template aided in donor site selection and extracorporeal contouring of the rib cartilage graft to allow for an accurate fit of the graft to the bony model prior to final fixation in the patient. We are able to refine the existing computer-aided design and rapid prototyping methods to allow for extracorporeal contouring of grafts and present rib cartilage as a good alternative to bone for autologous reconstruction.

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