title: A novel technique for sculpting costal cartilage in microtia repair and rhinoplasty.
abstract: OBJECTIVE
  Transforming a block of costal cartilage into a complex 3-dimensional framework that reflects the contours of a normal ear or nasal bridge requires the creation of many subtle curves, concavities, and convexities. Thus, specialized instruments for microtia repair and rhinoplasty, with specifically curved sharp blades, are used for delicate carving without the need for excessive force, which can damage the framework. Several challenges are associated with these specialized instruments.
  
  
  OBJECTIVE
  To describe a novel alternate technique using disposable skin punch biopsy instruments for sculpting cartilage, which have the potential to decrease cost, ensure consistently sharp blades, and provide a variety of sizes to allow precise, controlled contour changes.
  
  
  METHODS
  Surgical technique adapting a commercially available skin punch tool for costocondral sculpting.
  
  
  METHODS
  Academic tertiary care medical center.
  
  
  METHODS
  Patients undergoing microtia repair and rhinoplasty requiring sculpting of costocondral cartilage.
  
  
  METHODS
  Feasibility and reliability of cartilage contouring.
  
  
  RESULTS
  This novel technique has been used in microtia repair and rhinoplasty with excellent results.
  
  
  CONCLUSIONS
  This alternate technique of costocondral sculpting should be included as an additional tool in the reconstructive surgeon's armamentarium.
  
  
  METHODS
  NA.
authors.affiliation: Division of Facial Plastic and Reconstructive Surgery, Department of Otolaryngology-Head and Neck Surgery, The Johns Hopkins University School of Medicine, Baltimore, Maryland.
authors.forename: Linda N
authors.initials: LN
authors.lastname: Lee
authors.forename: Kofi D
authors.initials: KD
authors.lastname: Boahene
mesh_terms: D002356:Cartilage / Q000637:transplantation*; D000013:Congenital Abnormalities / Q000601:surgery*; D065817:Congenital Microtia; D004423:Ear / Q000002:abnormalities* / Q000601:surgery; D005240:Feasibility Studies; D006801:Humans; D019651:Plastic Surgery Procedures / Q000295:instrumentation / Q000379:methods; D015203:Reproducibility of Results; D012225:Rhinoplasty / Q000295:instrumentation / Q000379:methods*; D012272:Ribs; D016896:Treatment Outcome