Using Rib Bone Turnover Technique, Prevention of Chest Wall Depression after Microtia Reconstruction

Park, Chan Young; Lee, Yoon Ho

Abstract

PURPOSE: Reconstruction of microtia using costal cartilage graft is commonly used technique nowadays. The chest wall depression at the donor site after the graft, however, has been noticed in many articles. Prevention or correction technique for the depression at the donor site also has been reported and we also have been concerned about the problem. This article is a case report about a new technique preventing chest wall depression after costal cartilage graft.
METHODS
We selected total 15microtia patients who visited our clinic, from December 2005 to July 2007. They were 10 male and 5 female patients and the mean age was 11.9 years. The average follow up period was 9.2months(2 to 15months). We used 6, 7, and 8th costal cartilage for microtia reconstruction. And then we turned over pivot of cartilage resection margin, after bihalving costal cartilage involving about 5-6cm of 6th and 7th rib bone. After microtia reconstruction, chest donor sites were evaluated by physical examination and radiography.
RESULTS
Postoperative depression at the donor site was much less when the costal cartilage turnover technique was performed. Postoperative physical examination and three dimensional reconstruction CT showed that the rest part of rib bone was turned over and it supported the soft tissue defect during respiration.
CONCLUSION
We expect that the turnover rib bone will not be absorbed after graft, as well as offering mechanical support, compared to the other reports.