title: Rib reconstruction of the absent mandibular condyle in children.
abstract: OBJECTIVE
  To describe pediatric costochondral graft reconstruction of the absent mandibular condyle and to report the short-term and long-term outcomes and complications associated with performing this procedure in young children.
  
  
  METHODS
  Case series with a retrospective chart review.
  
  
  METHODS
  Pediatric otolaryngology clinic and tertiary children's hospital in a metropolitan area.
  
  
  METHODS
  All children treated for an absent mandibular condyle with a costochondral graft at Children's Hospitals and Clinics of Minnesota were identified from 2002 through 2011, and a retrospective chart review was performed.
  
  
  RESULTS
  Ten patients aged 3 to 11 years were identified. The most common diagnosis, in 8 of 10 patients, was oculo-auriculo-vertebral syndrome. Three of the patients had a tracheostomy, of which 1 was decannulated following condylar reconstruction. Functional improvement, defined as improved symmetry, chewing, or better oral opening, was observed in 8 of 10 patients. Five patients have required no further surgeries to date, with a mean follow-up time of 3.9 years. Severe overgrowth of the graft was noted in 1 case, and partial or complete resorption of the graft was also noted in 3 cases. Overgrowth occurred after 5.7 years, whereas resorption occurred after an average of 2.5 years.
  
  
  CONCLUSIONS
  Costochondral grafts are an excellent surgical treatment option for children with severe mandibular malformations. Short-term results show particular improvement in function and mandibular alignment. The mean follow-up time with no revision surgery was substantial and indicates that rib grafting is a good addition to the armamentarium of treatment for this patient population.
authors.affiliation: University of Minnesota Medical School, Minneapolis, Minnesota, USA.
authors.forename: Derek
authors.initials: D
authors.lastname: Goerke
authors.forename: Daniel E
authors.initials: DE
authors.lastname: Sampson
authors.forename: Robert J
authors.initials: RJ
authors.lastname: Tibesar
authors.forename: James D
authors.initials: JD
authors.lastname: Sidman
mesh_terms: D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D008297:Male; D008335:Mandibular Condyle / Q000002:abnormalities* / Q000601:surgery*; D019647:Oral Surgical Procedures / Q000379:methods*; D011183:Postoperative Complications; D019651:Plastic Surgery Procedures / Q000379:methods*; D012189:Retrospective Studies; D012272:Ribs / Q000637:transplantation*; D014139:Tracheostomy; D016896:Treatment Outcome
keywords: Goldenhar syndrome; Hemifacial microsomia; costochondral graft; mandibular defect; oculo-auriculo-vertebral syndrome; pediatric; reconstruction