Costochondral grafting in craniofacial microsomia

Area of Science:

• Plastic Surgery
• Pediatric Surgery
• Craniofacial Surgery

Background:

• Craniofacial microsomia presents with mandibular hypoplasia, asymmetry, and potential airway issues.
• Pruzansky/Kaban types 2B and 3 involve significant mandibular underdevelopment.
• Costochondral rib grafting is a reconstructive option for these complex cases.

Purpose of the Study:

• To evaluate the senior author's experience with costochondral rib grafting for mandibular reconstruction.
• To assess outcomes and complications in pediatric patients with severe craniofacial microsomia.
• To analyze the efficacy of this technique for Pruzansky/Kaban type 2B and 3 deformities.

Main Methods:

• Retrospective chart review of patients undergoing costochondral rib grafting (1998-2013).
• Inclusion criteria: craniofacial microsomia with Pruzansky/Kaban type 2B or 3 mandibular hypoplasia.
• Data collected: demographics, surgical details, complications, outcomes; imaging reviewed.

Main Results:

• 22 patients (12 male, 10 female) underwent 33 grafts (11 unilateral, 11 bilateral).
• No intraoperative complications or graft resorption; 81.8% required no secondary procedures.
• One case of postoperative ankylosis; no malunion or nonunion reported.

Conclusions:

• Costochondral rib grafting provides reliable and good results for mandibular reconstruction in type 2B and 3 craniofacial microsomia.
• The described surgical approach is effective in addressing significant mandibular hypoplasia.
• This technique offers a viable solution with a low complication rate for complex pediatric cases.