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Ultrasonographic evaluation of calcification patterns in costal cartilage: implications for rib graft harvesting
Alessandro Bozzato1, Klaus Bumm, Victoria Hertel
1Department of Otorhinolaryngology-Head and Neck Surgery, University of Homburg Medical School, Homburg, Germany.
Importance:
Complex augmentation rhinoplasty often requires the use of cartilaginous grafts, especially in revision surgery. When using costal cartilage, the possibility of inadequate cartilage material because of excessive calcification must always be kept in mind. Furthermore, cartilage may be harvested but found to be not ideal, causing unsatisfying results.
Objective:
To report our experience with the use of preoperative ultrasonographic (US) examinations for quality analysis of costal cartilage.
Design, Setting, And Participants:
In an academic research setting, US imaging of the anterior rib cage was performed before 83 revision rhinoplasties requiring costal cartilage grafting.
Main Outcomes And Measures:
Cartilage volume, quality, sex-specific calcification patterns, and the location of hidden calcification islands within viable cartilage were recorded.
Results:
Two different calcification patterns, 1 central and 1 peripheral, were identified.
Conclusions And Relevance:
We found this cost-effective technique to be a valuable tool for easy preoperative cartilage assessment. Furthermore, US screening guides the surgeon to areas of harvestable cartilage and to cartilage that is best suited for rhinoplasty in terms of distribution patterns of calcification areas.
Level Of Evidence:
NA.
