Ultrasonographic evaluation of calcification patterns in costal cartilage: implications for rib graft harvesting.
OBJECTIVE
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.


METHODS
In an academic research setting, US imaging of the anterior rib cage was performed before 83 revision rhinoplasties requiring costal cartilage grafting.


METHODS
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
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.


METHODS
NA.
Department of Otorhinolaryngology-Head and Neck Surgery, University of Homburg Medical School, Homburg, Germany.
Alessandro
A
Bozzato
Klaus
K
Bumm
Victoria
V
Hertel
Jochen
J
Wurm
D000293:Adolescent; D000328:Adult; D000368:Aged; D002114:Calcinosis / Q000000981:diagnostic imaging* / Q000473:pathology; D002356:Cartilage / Q000000981:diagnostic imaging / Q000473:pathology / Q000637:transplantation*; D002357:Cartilage Diseases / Q000000981:diagnostic imaging* / Q000473:pathology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011300:Preoperative Care / Q000379:methods*; D012225:Rhinoplasty / Q000379:methods*; D012272:Ribs / Q000000981:diagnostic imaging* / Q000473:pathology; D014463:Ultrasonography; D055815:Young Adult