Follow‐up of extensive calcified costal cartilage‐based rhinoplasty in Chinese People

2022 ◽  
Author(s):  
Xin Wang ◽  
Wenfang Dong ◽  
Huan Wang ◽  
Jianjun You ◽  
Ruobing Zheng ◽  
...  
Keyword(s):  
Costal Cartilage ◽  
Chinese People

Tracheocutaneous Fistula After Pediatric Open Airway Reconstruction

2021 ◽  
pp. 000348942098742
Author(s):  
Stephen R. Chorney ◽  
Joanne Stow ◽  
Luv R. Javia ◽  
Karen B. Zur ◽  
Ian N. Jacobs ◽  
...  
Keyword(s):  
Costal Cartilage ◽  
Case Series ◽  
Primary Objective ◽  
Multivariable Logistic Regression Analysis ◽  
Pediatric Airway ◽  
Surgical Closure ◽  
Laryngotracheal Reconstruction ◽  
Airway Reconstruction ◽  
Tracheocutaneous Fistula

Objectives: Tracheocutaneous fistula (TCF) is a common occurrence after pediatric tracheostomy decannulation. However, the persistence of TCF after staged reconstruction of the pediatric airway is not well-described. The primary objective was to determine the rate of persistent TCF after successful decannulation in children with staged open airway reconstruction. Methods: A case series with chart review of children who underwent decannulation after double-stage laryngotracheal reconstruction between 2017 and 2019. Results: A total of 26 children were included. The most common open airway procedure was anterior and posterior costal cartilage grafting (84.6%, 22/26). Median age at decannulation was 3.4 years (IQR: 2.8-4.3) and occurred 7.0 months (IQR: 4.3-10.4) after airway reconstruction. TCF persisted in 84.6% (22/26) of children while 15.4% (4/26) of stomas closed spontaneously. All closures were identified by the one-month follow-up visit. There was no difference in age at tracheostomy ( P = .86), age at decannulation ( P = .97), duration of tracheostomy ( P = .43), or gestational age ( P = .23) between stomas that persisted or closed. Median diameter of stent used at reconstruction was larger in TCFs that persisted (7.0 mm vs 6.5 mm, P = .03). Tracheostomy tube diameter ( P = .02) and stent size ( P < .01) correlated with persistence of TCF on multivariable logistic regression analysis. There were 16 surgical closure procedures, which occurred at a median of 14.4 months (IQR: 11.4-15.4) after decannulation. Techniques included 56.3% (9/16) by primary closure, 18.8% (3/16) by secondary intention and 25% (4/16) by cartilage tracheoplasty. The overall success of closure was 93.8% (15/16) at latest follow-up. Conclusions: Persistent TCF occurs in 85% of children who are successfully decannulated after staged open airway reconstruction. Spontaneous closure could be identified by 1 month after decannulation and was more likely when smaller stents and tracheostomy tubes were utilized. Surgeons should counsel families on the frequency of TCF and the potential for additional procedures needed for closure.

Nasal Reconstruction of a Frontonasal Dysplasia via Septal L-Strut Reconstruction Using Costal Cartilage

2021 ◽  
pp. 105566562110366
Author(s):  
Yong Bae Kim ◽  
Seung Min Nam ◽  
Eun Soo Park ◽  
Chang Yong Choi ◽  
Han Gyu Cha ◽  
...  
Keyword(s):  
Postoperative Complications ◽  
General Anesthesia ◽  
Retrospective Review ◽  
Costal Cartilage ◽  
Point Of View ◽  
Nasal Reconstruction ◽  
Open Rhinoplasty ◽  
Frontonasal Dysplasia ◽  
Congenital Condition

Objective Frontonasal dysplasia (FND) is a rare congenital condition. Its major features include hypertelorism, a large and bifid nasal tip, and a broad nasal root. We present our technique of septal L-strut reconstruction using costal cartilage. Design Retrospective review from June 2008 and August 2017. Methods Under general anesthesia, 6 patients with FND underwent septal reconstruction using costal cartilage via open rhinoplasty. We reconstructed the nasal and septal cartilaginous framework by placing columellar struts and cantilever-type grafts. Results The patients ranged in age from 6 to 13 years old. All were female. The follow-up period ranged from 8 months to 2 years; we encountered no postoperative complications (infection, nasal obstruction, or recurrence). All patients were satisfied with their nasal appearance. Conclusions Although the results were not entirely satisfactory from an esthetic point of view, we found that FND can be treated via septal reconstruction with costal cartilage and that the clinical outcomes are reliable and satisfactory. Our approach is a useful option for FND patients.

scholarly journals Different suturing techniques in thoracic incision: protocol for a feasibility randomised controlled trial

BMJ Open ◽  
2019 ◽  
Vol 9 (1) ◽  
pp. e021645
Author(s):  
Zonghui Liu ◽  
Xiangyu Liu ◽  
Lin He ◽  
Xueyuan Yu ◽  
Lu Wang ◽  
...  
Keyword(s):  
Randomised Controlled Trial ◽  
Controlled Trial ◽  
Costal Cartilage ◽  
Clinical Effectiveness ◽  
Suture Technique ◽  
Skin Closure ◽  
Mattress Suture ◽  
Vertical Mattress ◽  
Randomised Controlled

IntroductionBased on the principles of the ideal skin closure technique, we previously described a suture technique (wedge-shaped excision and modified buried vertical mattress suture (WE-MBVMS)) that could provide excellent outcomes for the most demanding surfaces. However, adequate clinical comparative evidence supporting improved outcomes is lacking. Thus, the purpose of this protocol is to establish the feasibility of conducting a fully randomised controlled trial (RCT) comparing the clinical effectiveness of WE-MBVMS with a buried intradermal suture (BIS) in closing thoracic incision.Methods and analysisThis study is a feasibility RCT of WE-MBVMS and BIS in patients undergoing surgery for costal cartilage harvesting. Seventy-eight participants are expected to participate in the study and will be randomised in a ratio of 1:1 to WE-MBVMS or BIS. Trial feasibility will be assessed by the number of participants assessed for eligibility, recruitment rates, reasons for ineligibility or non-participation, time for interventions, withdrawal and retention at all follow-up points (3, 6 and 12 months), follow-up rates and reasons for withdrawing from the trial. In addition, clinical data regarding the cosmetic results of scars will be collected to inform the sample size for a fully powered RCT.Ethics and disseminationThis study has been approved by The First Affiliated Hospital of Xi’an Jiaotong University Institutional Review Board (XJTU1AF2017LSK-120). The findings will be published in peer-reviewed journals.Trial registration numberChiCTR-INR-17013335; Pre-results.

scholarly journals Three component cartilage framework reconstruction for correction of post-traumatic nasal septal collapse

2017 ◽  
Vol 50 (03) ◽  
pp. 236-243 ◽  
Author(s):  
Uday Bhat ◽  
Tarush Gupta ◽  
Mahesh Nair ◽  
Mayur Mantri ◽  
Mangesh Pawar ◽  
...  
Keyword(s):  
Airway Obstruction ◽  
Costal Cartilage ◽  
Good Control ◽  
Support Materials ◽  
The Past ◽  
Natural Movement ◽  
Upper Lateral Cartilage ◽  
Dorsal Onlay ◽  
Post Traumatic

ABSTRACTBackground: Post-traumatic nasal septal collapse results in flat, broad, non-projecting nose due to mid-vault collapse. These patients may have airway obstruction due to poorly supported internal valve. Traditional techniques like ‘cantilever graft technique’ or conventional ‘L-graft technique’ produce a rigid lobule as the single unit framework extends to the tip. These grafts also lack in internal valve support. Materials and Methods: Twelve patients with post-traumatic nasal septal collapse were treated with three component cartilage framework technique in the past 3 years. The framework was reconstructed in three components-septal, columellar and dorsal onlay; using costal cartilage. If needed, upper lateral cartilage support grafts were also provided. Results: At 6 months’ follow-up, all 12 patients were satisfied with the outcome. The nasal projection and dorsal definition were aesthetically pleasing, and there was free natural movement of the lobular part of the nose. One graft was revised for further improvement in outcome. Airway obstruction, when present was also relieved. Conclusion: This technique has distinct advantages over the conventional techniques as the framework of separate components maintains pliability of the lobule, supports the internal valve and offers good control of aesthetic needs.

Combined Surgical and Endoscopic Approach for Ring–Sling Complex

2019 ◽  
Vol 68 (01) ◽  
pp. 051-058
Author(s):  
Giulio Porcedda ◽  
Alice Brambilla ◽  
Silvia Favilli ◽  
Bruno Murzi ◽  
Lorenzo Mirabile ◽  
...  
Keyword(s):  
Heart Defects ◽  
Vascular Ring ◽  
Costal Cartilage ◽  
Early Death ◽  
Left Pulmonary Artery ◽  
Postoperative Management ◽  
Tracheal Reconstruction ◽  
Slide Tracheoplasty ◽  
Main Determinants

Background Left pulmonary artery (LPA) sling (PAS) is a vascular ring, which is frequently associated with long-segment tracheal stenosis (TS). Mortality rate in operated children is still high, especially in cases of severe tracheal hypoplasia and/or associated congenital heart defects (CHDs). We report our experience of treatment and follow-up in a pediatric cohort of patients affected by PAS with severe tracheobronchial involvement. Methods From 2005 to 2017, we enrolled 11 children diagnosed with PAS and congenital TS requiring surgical intervention. Echocardiography, computed tomography, and bronchoscopy were performed in all patients. Associated CHD were present in 5 (45%) patients. Tracheal reconstruction techniques included slide tracheoplasty (7/11; 63%), slide tracheoplasty and costal cartilage graft (2/11; 18%), and Hazekamp technique (2/11; 18%).Nine patients underwent LPA direct reimplantation and concomitant tracheoplasty; concomitant surgical repair for CHD was performed in three children. Results Over a mean follow-up of 30 months (range: 3–75 months), a late mortality of 18% was registered; no early death occurred. Good flow through LPA could be documented in all patients. Ten children required operative bronchoscopies (mean: 16/patients) aimed at stent positioning/removal, treatment of granulomas, and tracheobronchial dilatation. Conclusions Severe tracheobronchial stenosis and associated CHD were the main determinants for hospitalization time, intensive assistance, and repeated endoscopic procedures.Patients affected by PAS/TS complex require a careful management at high-specialized centers providing multidisciplinary team.Respiratory endoscopy may play a central role both in preoperatory assessment and in postoperative management of patients showing severe tracheobronchial involvement.

Long-term Use and Follow-up of Irradiated Homologous Costal Cartilage Grafts in the Nose

2009 ◽  
Vol 11 (6) ◽  
Author(s):  
Russell W. H. Kridel ◽  
Faramarz Ashoori ◽  
Edmund S. Liu ◽  
Carol G. Hart
Keyword(s):  
Costal Cartilage ◽  
Cartilage Grafts

scholarly journals How to Prevent Costal Cartilage Graft Warping in Secondary Correction of Cleft Lip Nasal Deformity

2017 ◽  
Vol 26 (1) ◽  
pp. 55-60 ◽  
Author(s):  
Hung-Chang Chen ◽  
Cheng-I Yen ◽  
Shih-Yi Yang ◽  
Yen-Chang Hsiao
Keyword(s):  
Cleft Lip ◽  
Costal Cartilage ◽  
Donor Site ◽  
Cartilage Graft ◽  
Onlay Graft ◽  
Dorsal Onlay ◽  
Costal Graft ◽  
Onlay Grafts ◽  
Costal Cartilage Graft

Introduction: Autologous costal cartilage dorsal onlay graft is widely used for dorsum and radix augmentation in secondary cleft lip nasal rhinoplasty. The most common drawback of costal cartilage dorsal onlay graft is warping. The purpose of this article is to describe our chimeric autologous costal cartilage graft technique, which prevents warping significantly. “Chimeric” means the combination of 2 different tissues (bone and cartilage) to make a single dorsal onlay graft. Patients and Methods: From June 2011 to June 2014, 16 cleft lip patients who underwent rhinoplasty and needed dorsal onlay grafts with costal cartilage graft using the chimeric autologous costal graft method were identified. All patients were operated by the corresponding author. Patients’ nasal profiles were documented and photographed preoperatively and postoperatively. Result: There were 5 males and 11 females with ages ranging from 20 to 52 years (averaging 29.5 years). There were 14 unilateral and 2 bilateral cleft lips. The average follow-up time was 12.1 months. Six patients received revision surgery, including 1 (6%) warping and 5 (30%) revisions. All patients were harvested rib cartilage graft as cartilage donor and there was no complication with the donor site. Conclusion: From the clinical observation of all patients during the follow-up period, this technique is effective for preventing cartilage warping.

scholarly journals Reconstruction Of Noe Fracture With Immediate Diced Costal Cartilage Grafting: A Case Series

2019 ◽  
Vol 5 (2) ◽  
pp. 220-225
Author(s):  
Kristaninta Bangun ◽  
Muhammad Iqbal Maulana ◽  
Teuku Nanda Putra
Keyword(s):  
Demographic Data ◽  
Costal Cartilage ◽  
Case Series ◽  
Cartilage Graft ◽  
Nasal Tip ◽  
Syringe Needle ◽  
Cartilage Grafting ◽  
Diced Cartilage ◽  
Costal Cartilage Graft

Background : Naso-orbital-ethmoid (NOE) fracture is one of the common injury and the management remains difficult and controversial due to the anatomic complexity. Severe facial deformity and dysfunction are the results from the untreated injury. Moreover, the results from many procedures are not aesthetically satisfying. Meanwhile diced cartilage graft popularity is increasing in order to correct nasal deformity whether post trauma, revision (secondary) rhinoplasty or cleft nose. The procedure is less time consuming, easy to perform and also highly malleable. Methods : This study presents our experience in managing four patients with NOE fracture using costal cartilage graft technique immediately after injury. A columellar V-shaped incision was made, the finely diced cartilage harvested from the eight rib was injected to the glabella, dorsum and nasal tip using one cc syringe needle with cut tip. Demographic data were obtained from the patients’ medical record. Post-operative results were observed.  Result: The four surgeries were done, with average 5.75 (range, 2-9) days after injury. During the observation, nasal tip misalignment was observed in only one patient. Diced cartilage were not visible through the skin, although it could be palpable. No cartilage extrusion were occurred. After averange follow up 10.25 mo (range 8-12 mo) All patients were satisfied with their facial appearance. Conclusion: The fracture of NOE can be manage with immediate diced costal cartilage graft, since this treatment can achieve a normal facial function and appearance. The complications are low and manageable, making it as serious contender technique of choice in managing NOE fracture to other techniques. Keywords: NOE fracture, diced costal cartilage graft, facial fracture

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