scholarly journals Reconstructive rhinoplasty with costal cartilage grafting: A case report of relapsing polychondritis

2019 ◽  
Vol 20 (5) ◽  
pp. 341-344
Author(s):  
Yunhae Lee ◽  
Hyungon Choi
Keyword(s):  
Case Report ◽  
Costal Cartilage ◽  
Relapsing Polychondritis ◽  
Cartilage Grafting

scholarly journals P32 Relapsing polychondritis with anterior scleritis in young female

2021 ◽  
Vol 5 (Supplement_1) ◽  
Author(s):  
Umair Arain ◽  
Abimbola Phillips ◽  
Ben Burton ◽  
Damodar Makkuni
Keyword(s):  
Rheumatoid Arthritis ◽  
Case Report ◽  
Visual Fields ◽  
Delayed Diagnosis ◽  
Relapsing Polychondritis ◽  
Young Female ◽  
Blurred Vision ◽  
Ocular Findings ◽  
Anterior Scleritis ◽  
The Right

Abstract Case report - Introduction Relapsing polychondritis (RP) was first recognized as a clinical entity in 1923 by Jaksch-Wartenhorst (1923) and reported by him under the title "polychondropathia". The term "relapsing polychondritis" was first used by Pearson, Kline, and Newcomer (1960). Because the ocular findings can be the initial findings of RP, ophthalmologists should know the major ocular findings of this disease. Isaak et al reported that the most common ocular finding is episcleritis (39%) and the second is scleritis (14%). Other signs are iritis (9%), retinopathy (9%), muscle paresis (5%), and optic neuritis (5%). Case report - Case description A 45-year-old female with known rheumatoid arthritis referred by rheumatology in eye clinic due to blurred vision and dry eye. The patient was on hydroxychloroquine and sulfasalazine. No retinal toxicity was found on examination, OCT and Visual Fields. The vision was 6/6 both eyes. Follow-up was in 12 months. She presented 6 months later in casualty with severe pain in her right eye. Examination showed diffuse anterior scleritis with secondary conjunctival inflammation. Anterior chamber cells present. Posterior segment showed no inflammation. Left eye was unremarkable. She was started on Froben 100mg tds with omeprazole. She was seen after a week and condition was improving. She was asked to taper off the meds. Inflammation resolved with 6/5 vision in both eyes and the next appointment was made in a year to monitor for hydroxychloroquine toxicity. In November 2020 she was seen by ENT with inflammation of the right ear cartilage. The pictures showed that the pinna was spared and cartilage was only involved. There was nasal crusting and stuffy nose but without any respiratory symptoms. She was prescribed 50mgs of prednisolone and this helped with her inflammation. She was seen by rheumatology later on and hydroxychloroquine and sulfasalazine was stopped, and she was started on methotrexate 10mgs weekly and folic acid 5mg weekly. Pulmonary function test and echocardiogram was ordered. The case was discussed in MDT rheumatology and it was decided that if joint symptoms got worse than biologics could be started. Methotrexate increased to 15mg subcut. Echocardiogram was normal with satisfactory blood tests. Her next appointment is in October 2021. Case report - Discussion Initially the patient was diagnosed with rheumatoid arthritis with ocular inflammation (anterior scleritis) and was given the standard treatment of steroids to which the patient responded as well. Later when she developed the ear inflammation which involved only the cartilage the diagnosis was revised by rheumatology and changed to RP. As this is a rare life-threatening disease management was switched to immunosuppressive therapy to which she is currently responding well. Case report - Key learning points It is important to consider the possibility that a rheumatology patient may have more than one diagnosis or be open to the idea of revising the diagnosis as the clinical picture evolves over the time. Given the nature of the disease all the systemic features should be examined thoroughly as any one missed area can lead to delayed diagnosis.

Pediatric Airway Reconstruction at Great Ormond Street: A Ten-Year Review

1992 ◽  
Vol 101 (6) ◽  
pp. 465-468 ◽  
Author(s):  
James W. Ochi ◽  
John N. G. Evans ◽  
C. Martin Bailey
Keyword(s):  
Costal Cartilage ◽  
Laryngotracheal Stenosis ◽  
Pediatric Airway ◽  
Airway Reconstruction ◽  
Cartilage Grafting

One hundred eight consecutive patients with pediatric laryngotracheal stenosis requiring airway reconstruction over a 10-year period were reviewed. One hundred forty-nine operations consisting of 75 laryngotracheoplasties and 74 laryngotracheal reconstructions with costal cartilage grafting were performed. The Cotton grading scheme of preoperative stenosis was useful in predicting likelihood of decannulation. In all, 90 patients (83%) were decannulated.

scholarly journals Ileocecal ulcers accompanied by relapsing polychondritis: a case report

SpringerPlus ◽  
2014 ◽  
Vol 3 (1) ◽  
Author(s):  
Yoko Kawakami ◽  
Katsuya Endo ◽  
Tomonori Ishii ◽  
Sho Haneda ◽  
Fumiyoshi Fujishima ◽  
...  
Keyword(s):  
Case Report ◽  
Relapsing Polychondritis

Arthroplasty of the Interphalangeal Joint of the Great Toe Using Costal Osteochondral Grafting

2006 ◽  
Vol 96 (6) ◽  
pp. 508-512 ◽  
Author(s):  
Hisashi Motomura ◽  
Kensuke Nose ◽  
Masao Fujiwara ◽  
Toshiyuki Ozawa ◽  
Teruichi Harada ◽  
...  
Keyword(s):  
Motor Vehicle ◽  
Motor Vehicle Accident ◽  
Costal Cartilage ◽  
Effective Means ◽  
Interphalangeal Joint ◽  
Great Toe ◽  
Osteochondral Grafts ◽  
Vehicle Accident ◽  
Latissimus Dorsi Myocutaneous Flap ◽  
Cartilage Grafting

Although many reports have been published on the usefulness of costal cartilage grafting in the reconstruction of interphalangeal joints of fingers, there are only a few published reports on the reconstruction of interphalangeal joints of toes. We describe a 21-year-old woman with a tissue defect of the dorsum pedis and a partial defect of the interphalangeal joint of the great toe caused by a motor-vehicle accident. We attempted arthroplasty using a free latissimus dorsi myocutaneous flap and a costal osteochondral graft. The grafted rib and cartilage survived, allowing the patient to resume functional ambulation for day-to-day activities. Arthroplasty using costal osteochondral grafts seems to be an effective means of reconstructing the interphalangeal joints of toes. (J Am Podiatr Med Assoc 96(6): 508–512, 2006)

scholarly journals Optimal Costal Cartilage Graft Selection According to Cartilage Shape: Anatomical Considerations for Rhinoplasty

2017 ◽  
Vol 33 (06) ◽  
pp. 670-674 ◽  
Author(s):  
Adam Bender-Heine ◽  
Michelle Russell ◽  
Allen Rickards ◽  
J. Holmes ◽  
Mark Armeni ◽  
...  
Keyword(s):  
Costal Cartilage ◽  
Nasal Dorsum ◽  
En Bloc ◽  
Reconstruction Procedure ◽  
Geometric Morphometric ◽  
Recipient Site ◽  
Columellar Strut ◽  
Columellar Strut Graft ◽  
Geometric Morphometric Analysis ◽  
Cartilage Grafting

AbstractCostal cartilage grafting is a commonly used reconstruction procedure, particularly in rhinoplasty. Although costal cartilage is broadly used in reconstructive surgery, there are differing opinions regarding which costal cartilage levels provide the most ideal grafts. Grafts are typically designed to match the shape of the recipient site. The shapes of costal cartilage grafts have been described as “boat-shaped,” “C-shaped,” “canoe-shaped,” “U-shaped,” “crescent-shaped,” “L-shaped,” “semilunar,” “straight,” and “Y-shaped.” The shapes of costal cartilages are thought to lend themselves to the shapes of certain grafts; however, there has been little study of the shapes of costal cartilages, and most reports have been anecdotal. Therefore, this study is aimed to detail the average shapes of the most commonly grafted cartilages (i.e., the fifth to seventh cartilages). A total of 96 cadaveric costal cartilages were analyzed through geometric morphometric analysis. The fifth costal cartilage was determined to have the straightest shape and would therefore be particularly suitable for nasal dorsum onlay grafting. The lateral portions of the sixth and, particularly, the seventh costal cartilages have the most acute curvature. Therefore, they would lend themselves to the construction of an en bloc “L”-shaped or hockey stick-shaped nasal dorsum-columellar strut graft.

scholarly journals Epididymo-Orchitis as a Presenting Feature of Relapsing Polychondritis: A Case Report

2011 ◽  
Vol 2011 ◽  
pp. 1-3 ◽  
Author(s):  
Kuljeet Bhamra ◽  
Rachel Weerasinghe ◽  
Alan Steuer
Keyword(s):  
Weight Loss ◽  
Case Report ◽  
Blood Vessels ◽  
Diagnostic Test ◽  
Relapsing Polychondritis ◽  
Immunosuppressive Drugs ◽  
Bronchial Tree ◽  
Multisystem Disease ◽  
Systemic Symptoms ◽  
Recurrent Inflammation

Relapsing polychondritis (RP) is a rare multisystem disease. It is characterized by recurrent inflammation of cartilaginous structures including the ears, nose, tracheo-bronchial tree and peripheral joints. Proteoglycan-rich structures such as the heart, eyes and blood vessels can also be affected. Systemic symptoms including fever, weight loss and lethargy are common. RP is difficult to diagnose as it presents in a wide variety of ways and there is no diagnostic test. Corticosteroids are the mainstay of treatment but other immunosuppressive drugs can be used in combination with steroids. We present an unusual presentation of RP.

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