Computed Tomography–Assisted Auricular Cartilage Graft for Depression of the Alar Base in Secondary Unilateral Cleft Lip Repair: A Preliminary Report

Objectives: To evaluate the feasibility, effectiveness, and safety of computed tomography–assisted auricular cartilage grafting for treating alar base depression secondary to unilateral cleft lip. Design and Setting: For patients with obvious depression of the alar base, the difference in heights of the alar base and the piriform margin between the cleft side and the noncleft side were measured with computed tomography. If both were >3.0 mm, the cartilage was harvested postauricularly and subdivided into 2 to 4 pieces. A multiple layer graft was inserted under the depressed alar base. The procedure was performed from 2006 to 2013, and the follow-up period was 3 to 15 months. Participants: Chinese patients with alar base depression secondary to unilateral cleft lip were selected. Intervention: Suture and cartilage graft techniques. Main Outcomes Measures: Differences in bilateral alar base heights and piriform apertures. Results: There was no wound dehiscence, exposure of bone, or donor site morbidity. The difference in heights in the bilateral alar bases and piriform apertures decreased. There were no obvious scars in any of the cases. Conclusions: This technique has several advantages including ease of operation, minimal trauma, satisfactory outcomes, and useful references for operation provided by computed tomography. It is a superior alternative for reconstruction of secondary alar depression.

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The addition of a conjunctival flap to a posterior lamella auricular cartilage graft: A technique to avoid corneal complications

European Journal of Ophthalmology ◽

10.1177/1120672121998914 ◽

2021 ◽

pp. 112067212199891

Author(s):

Constanza Barrancos ◽

Ignacio García-Cruz ◽

Beatriz Ventas-Ayala ◽

Marco Sales-Sanz

Keyword(s):

Donor Site ◽

Lower Eyelid ◽

Cartilage Graft ◽

Auricular Cartilage ◽

Inferior Margin ◽

Conjunctival Flap ◽

Absorbable Sutures ◽

Inferior Border ◽

Superior Portion ◽

Superior Border

Purpose: To present the benefits of the addition of a conjunctival flap when correcting lower eyelid retraction using an auricular cartilage graft. Methods: An auricular cartilage graft was obtained either from the concha o the scaphoid fossa. When preparing the receiving bed, the conjunctival incision was made 2 mm below the inferior margin of the lower eyelid tarsus, therefore, a conjunctival flap arising from the inferior border of the tarsus was obtained. The cartilage graft was placed in the lower eyelid. The inferior border of the graft was sutured to the retractors and conjunctiva using absorbable sutures. The superior border was sutured to the inferior tarsus, so that de conjunctival flap covered the superior portion of the graft. Results: Fourteen patients underwent the surgical technique. No corneal complications were observed in the early or late postoperative period. Donor site complications were not encountered. Conclusions: The confection of a conjunctival flap that lines the superior portion of an auricular cartilage graft in the lower eyelid provides protection against corneal postoperative complications until the graft is epithelized.

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Auricular Cartilage

Operative Plastic Surgery ◽

10.1093/med/9780190499075.003.0011 ◽

2019 ◽

pp. 91-94

Author(s):

Ali Sajjadian

Keyword(s):

Postoperative Pain ◽

Donor Site ◽

Graft Material ◽

Cartilage Graft ◽

Septal Perforation ◽

Auricular Cartilage ◽

Structural Support ◽

First Choice ◽

Graft Donor ◽

Ear Cartilage

The ear is generally not a first choice as a cartilage graft donor site for several reasons, none of which is valid. When the graft is harvested anteriorly, the scar is well-concealed as long as the incision is placed within the rim of the conchal bowl. And, although no site can provide as much cartilage as the rib, the auricle can provide a surprisingly large amount of graft material. There is also characteristically minimal morbidity with the harvest of auricular cartilage. This distinguishes it from rib cartilage harvest, which may be accompanied by significant postoperative pain and occasionally pneumothorax. In addition, septal harvest may cause bleeding, saddling of the nose symptomatic of septal perforation, and other airflow disturbances. The most important and major problem with ear cartilage is the flaccidity inherent in its structure. This makes it a poor choice when significant structural support is mandatory.

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

Journal of Ophthalmology ◽

10.1155/2019/7197063 ◽

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.

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Cartilage Graft Donor Site Morbidity following Rhinoplasty and Nasal Reconstruction

Craniomaxillofacial Trauma & Reconstruction ◽

10.1055/s-0037-1607065 ◽

2018 ◽

Vol 11 (4) ◽

pp. 278-284 ◽

Cited By ~ 1

Author(s):

Thuy-Van Tina Ho ◽

Kevin Sykes ◽

J.David Kriet ◽

Clinton Humphrey

Keyword(s):

Donor Site ◽

Donor Site Morbidity ◽

Nasal Reconstruction ◽

Cartilage Graft ◽

Nasal Surgery ◽

Auricular Cartilage ◽

Donor Site Pain ◽

Graft Donor ◽

Ear Cartilage ◽

Site Pain

Although surgical techniques for rhinoplasty and nasal reconstruction are well established, prospective research on postoperative morbidity remains limited. The aim of this pilot study was to assess costal and auricular cartilage donor site pain and morbidity in patients undergoing rhinoplasty and nasal reconstruction. In this prospective cohort study, we enrolled 55 patients undergoing nasal surgery that required costal or auricular cartilage harvest from February 2015 through May 2016. Each patient was given a symptom-specific patient survey that assessed general pain, nasal pain, graft donor site pain, graft donor site itching, color variation, skin stiffness and thickness, and graft donor site appearance at 1, 4, and 12 weeks after surgery. Our patient group was 55% female ( n = 30); the mean age was 47 years. Rib cartilage graft patients had significantly greater nasal pain than cartilage donor site pain. There was no significant difference in rib versus ear cartilage donor site pain. Nearly all patients reported that they were not at all concerned about their scar appearance or ear shape and appearance. No prior studies compare cartilage donor site morbidity in patients undergoing nasal surgery. Our findings challenge the conventional wisdom that utilizing auricular and costal cartilage results in high levels of donor site pain. Surgeons should have a low threshold to harvest rib or ear cartilage when it can improve surgical outcome.

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

Plastic Surgery ◽

10.1177/2292550317740690 ◽

2017 ◽

Vol 26 (1) ◽

pp. 55-60 ◽

Cited By ~ 1

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.

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Unilateral cleft lip closure by use of Dermabond (N-octyle-2-cyanoacrylate)

International Journal Of Medical Science And Clinical Invention ◽

10.18535/ijmsci/v7i09.02 ◽

2020 ◽

Vol 7 (09) ◽

pp. 4944-4950

Author(s):

Dr santosh Mishra ◽

Dr Madhuri Shukla ◽

Dr Amit Kumar Sahu ◽

Dr Sushma Mishra

Keyword(s):

Statistical Analysis ◽

Cleft Lip ◽

New Technologies ◽

Primary Repair ◽

Wound Dehiscence ◽

Advancement Flap ◽

Tissue Adhesive ◽

Cleft Lip Palate ◽

The Difference ◽

Comparison Of The Results

Background: Facial cosmetic results are one of the most concerning issues for the parents who get their children operated for cleft lip. Moreover, the postoperative care of the surgical site, the discomfort associated with the suture removal, and additional visit for suture removal are other reasons which encourages one to use any new technologies that may replace the need for suture placement. In this study, we used octyl-2-cyanoacrylate, a tissue adhesive which offers a viable alternative to traditional techniques without compromising optimal wound closure. Objective: To perform a comprehensive comparison of the outcomes from the use of Dermabond in patients undergoing primary repair of congenital cleft lip ± palate anomalies. Materials and Methods: Twenty patients, in the age group of 3–18 months were treated surgically for unilateral cleft lip deformity using Millard rotation-advancement flap. Pre- and post-operative photographs of the patients were taken at 1 week, 2 week, 1 month, 6 months, and 1 year postoperatively and were evaluated using Vancouver scar scale which was given by Sullivan in 1990. Paired t-test was used for statistical analysis. Results: Increased vascularity (hyperemia) was seen in the 1st and 2nd week in 35% and 30% patients, respectively which gradually reduced to normal in subsequent follow-ups. The scar was flat in 85% of patients in 1st week, and the number decreased to 10% at the end of 1 year. No wound dehiscence was found in any patients. Statistical analysis showed that among all the follow-ups, only the difference between the first and second follow-ups. Comparison of the results of 1 week with all other follow-ups yielded no significant results. Conclusion: Octyl-2-cyanoacrylate can be used for cleft lip closure effectively. The procedure is relatively painless and quick. Added to this are benefits of protection from wound infection since the material is bacteriostatic.

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Evaluation of dehiscence and fenestration in adolescent patients affected by unilateral cleft lip and palate: A retrospective cone beam computed tomography study

The Angle Orthodontist ◽

10.2319/042715-289.1 ◽

2016 ◽

Vol 86 (3) ◽

pp. 431-436 ◽

Cited By ~ 8

Author(s):

Suleyman Kutalmis Buyuk ◽

Esra Ercan ◽

Mevlut Celikoglu ◽

Ahmet Ercan Sekerci ◽

Mukerrem Hatipoglu

Keyword(s):

Computed Tomography ◽

Cone Beam Computed Tomography ◽

Cleft Lip ◽

Cleft Lip And Palate ◽

Cone Beam ◽

Control Group ◽

Anterior Teeth ◽

The Difference ◽

Student’S T ◽

Student’S T Test

ABSTRACT Objective: To evaluate the presence of dehiscence and fenestration defects around anterior teeth in the cleft region and to compare these findings with the noncleft side in the same patients using cone beam computed tomography (CBCT). Materials and Methods: CBCT scans of 44 patients (26 males, 18 females; mean age, 14.04 ± 3.81 years) with unilateral cleft lip and palate (UCLP) were assessed to define dehiscences and fenestrations of the anterior teeth in both cleft and noncleft sides of the UCLP patients and a control group of noncleft patients (51 patients; 21 males, 30 females; mean age, 14.52 ± 1.16 years). Data were analyzed using Pearson’s χ2 and Student’s t-test. Results: The prevalence of dehiscences at the maxillary central incisors, lateral incisors, and canines teeth were 43.2%, 70.6%, and 34.1% on the cleft side and 22.7%, 53.1%, and 27.3% on the noncleft side of UCLP patients, and 13.7%, 7.8%, and 13.7% in controls, respectively (statistically no difference between the sides of cleft patients). The cleft patients had a statistically significantly higher prevalence of dehiscences than did the controls on both the cleft and noncleft sides (P < .05), except for the maxillary central incisors. Fenestrations for these teeth were significantly more common on the cleft side in UCLP patients compared with controls (P < .05), whereas the difference for maxillary lateral incisors was not statistically significant. Conclusions: Patients with UCLP showed a higher prevalence of dehiscence and fenestration defects around the maxillary anterior teeth.

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