title: Management of chest deformity caused by microtia reconstruction: Comparison of autogenous diced cartilage versus cadaver cartilage graft partial filling techniques.
abstract: BACKGROUND
  Efforts to prevent chest wall deformity after costal cartilage graft are ongoing. In this study, we introduce a new method to prevent donor site deformation using irradiated cadaver cartilage (ICC) and compare this method to the autogenous diced cartilage (ADC) technique.
  
  
  METHODS
  Forty-two pediatric patients comprised the ADC group (n = 24) and the ICC group (n = 18). After harvesting costal cartilage, the empty perichondrial space was filled with autologous diced cartilage in the ADC group and cadaver cartilage in the ICC group. Digital photographs and rib cartilage three-dimensional computed tomography (CT) data were analyzed to compare the preventive effect of donor site deformity. We compared the pre- and postoperative costal cartilage volumes using 3D-CT and graded the volumes (grade I: 0%-25%, grade II: 25%-50%, grade III: 50%-75%, and grade IV: 75%-100%).
  
  
  RESULTS
  The average follow-up period was 20 and 24 months in the ADC and ICC groups, respectively. Grade IV maintenance of previous costal cartilage volume was evident postoperatively in 22% of patients in the ADC group and 82% of patients in the ICC group. Intercostal space narrowing and chest wall depression were less in the ICC group. There were no complications or severe resorption of cadaver cartilage.
  
  
  CONCLUSIONS
  ICC support transected costal ring and prevented stability loss by acting as a spacer. The ICC technique is more effective in preventing intercostal space narrowing and chest wall depression than the ADC technique.
  
  
  BACKGROUND
  Samsung Medical Center Institution Review Board, Unique protocol ID: 2009-10-006-008. This study is also registered on PRS (ClinicalTrials.gov Record 2009-10-006).
authors: Department of Plastic Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Irwon-ro 81, Gangnam-gu, Seoul, 06351, South Korea.
authors: Ju Young
authors: JY
authors: Go
authors: Department of Plastic Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Irwon-ro 81, Gangnam-gu, Seoul, 06351, South Korea.
authors: Bo Young
authors: BY
authors: Kang
authors: Department of Plastic Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Irwon-ro 81, Gangnam-gu, Seoul, 06351, South Korea.
authors: Jin Hee
authors: JH
authors: Hwang
authors: Department of Plastic Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Irwon-ro 81, Gangnam-gu, Seoul, 06351, South Korea. Electronic address: kapsung.oh@samsung.com.
authors: Kap Sung
authors: KS
authors: Oh
mesh_terms: D000293:Adolescent; D002102:Cadaver; D002648:Child; D015331:Cohort Studies; D065817:Congenital Microtia / Q000601:surgery*; D066186:Costal Cartilage / Q000637:transplantation*; D005260:Female; D006801:Humans; D008297:Male; D011183:Postoperative Complications / Q000000981:diagnostic imaging / Q000209:etiology / Q000517:prevention & control*; D019651:Plastic Surgery Procedures / Q000009:adverse effects / Q000379:methods*; D035441:Thoracic Wall / Q000000981:diagnostic imaging / Q000473:pathology; D020858:Tissue and Organ Harvesting / Q000009:adverse effects*; D014057:Tomography, X-Ray Computed; D060053:Transplant Donor Site / Q000000981:diagnostic imaging / Q000601:surgery*
keywords: Auricular reconstruction; Autogenous diced cartilage; Chest wall deformity; Irradiated cadaver cartilage