Download PDF
CC BY-NC-ND 4.0 · Indian J Radiol Imaging 2021; 31(03): 586-595
DOI: 10.1055/s-0041-1735866
Original Article

Utility of 3D CT Rib Study in Presurgical Planning of Autologous Ear Graft for Pinna Reconstruction in Microtia

Sneha S. Zanje
1   Department of Radiodiagnosis, Jupiter Scan Centre, Mumbai, Maharashtra, India
,
Nikhil V. Kamat
1   Department of Radiodiagnosis, Jupiter Scan Centre, Mumbai, Maharashtra, India
,
Kunal K. Taware
1   Department of Radiodiagnosis, Jupiter Scan Centre, Mumbai, Maharashtra, India
,
M L. Rokade
1   Department of Radiodiagnosis, Jupiter Scan Centre, Mumbai, Maharashtra, India
,
Ashesh C. Bhumkar
2   Bhumkar ENT Hospital, Mumbai, Maharashtra, India
› Author Affiliations Financial Support and Sponsorship Nil.
› Further Information
Also available at
   Permissions and Reprints

Abstract

Purpose The aim of this study was to demonstrate the utility of three-dimensional computed tomography (3D) CT rib study in presurgical planning to select the autologous rib cartilage graft for pinna reconstruction.

Materials and Methods Total of 35 patients of microtia for autologous rib graft from April 2017 to February 2020 were evaluated in this study. All patients had a plain low-dose multislice CT chest. The length of costal cartilages of sixth to ninth ribs bilaterally and width and height of sixth and seventh rib costal cartilage synchondrosis were measured in 3D reconstructed true size coronal images with best possible length displayed. All patients had high-resolution computed tomography (HRCT) temporal studies done to evaluate for associated anomalies in external canal, middle ear cavities, and inner ear structures. Eleven patients had simultaneous HRCT temporal bone done after plain CT chest and rest who had done recent prior study were reviewed without repetition of study.

Results There were 19 males and 16 females for 3D CT rib study. Average age of the participants was 16.5 years. The average width of synchondrosis of sixth and seventh rib was 15.4 mm on right side and 14.7 mm on left side, average height of synchondrosis was 28.5 mm on right side and 30.7 mm on left side. Average length of the eighth rib costal cartilage was 88.6 mm on the right side and 90.5 mm on the left side. Average length of the ninth rib was 63.2 mm on the right side and 58.2 mm on the left side. Costal cartilage calcifications were present in 9 patients.

Conclusion Preoperative 3D CT rib study provides accurate measurements of rib stock for sculpting autologous ear graft.

Keywords

3D CT VRT - autologous rib graft - microtia

Source(s) of Support

Nil.


Presentation at a Meeting

No.




Publication History

Article published online:
06 October 2021

© 2021. Indian Radiological Association. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

Thieme Medical and Scientific Publishers Pvt. Ltd.
A-12, 2nd Floor, Sector 2, Noida-201301 UP, India

 

  • References

  • 1 Harris J, Källén B, Robert E. The epidemiology of anotia and microtia. J Med Genet 1996; 33 (10) 809-813
    CrossrefPubMedGoogle Scholar
  • 2 Luquetti DV, Heike CL, Hing AV, Cunningham ML, Cox TC. Microtia: epidemiology and genetics. Am J Med Genet A 2012; 158A (01) 124-139
    CrossrefPubMedGoogle Scholar
  • 3 Matsuka K, Hata Y, Yano K. et al. Comparative study of auricular dimensions for the normal auricles of microtia patients, their parents, and normal individuals. Ann Plast Surg 1994; 32 (02) 135-140
    CrossrefPubMedGoogle Scholar
  • 4 Steffen A, Wollenberg B, König IR, Frenzel H. A prospective evaluation of psychosocial outcomes following ear reconstruction with rib cartilage in microtia. J Plast Reconstr Aesthet Surg 2010; 63 (09) 1466-1473
    CrossrefPubMedGoogle Scholar
  • 5 Baluch N, Nagata S, Park C. et al. Auricular reconstruction for microtia: a review of available methods. Plast Surg (Oakv) 2014; 22 (01) 39-43
    CrossrefPubMedGoogle Scholar
  • 6 Tanzer RC. Total reconstruction of the external ear. Plast Reconstr Surg Transplant Bull 1959; 23 (01) 1-15
    CrossrefPubMedGoogle Scholar
  • 7 Nagata S. A new method of total reconstruction of the auricle for microtia. Plast Reconstr Surg 1993; 92 (02) 187-201
    CrossrefPubMedGoogle Scholar
  • 8 Brent B. Auricular repair with autogenous rib cartilage grafts: two decades of experience with 600 cases. Plast Reconstr Surg 1992; 90 (03) 355-374 , discussion 375–376
    CrossrefPubMedGoogle Scholar
  • 9 Nagata S. Modification of the stages in total reconstruction of the auricle: Part I. Grafting the three-dimensional costal cartilage framework for lobule-type microtia. Plast Reconstr Surg 1994; 93 (02) 221-230 , discussion 267–268
    CrossrefPubMedGoogle Scholar
  • 10 Nagata S. Modification of the stages in total reconstruction of the auricle: Part II. Grafting the three-dimensional costal cartilage framework for concha-type microtia. Plast Reconstr Surg 1994; 93 (02) 231-242 , discussion 267–268
    CrossrefPubMedGoogle Scholar
  • 11 Nagata S. Modification of the stages in total reconstruction of the auricle: Part III. Grafting the three-dimensional costal cartilage framework for small concha-type microtia. Plast Reconstr Surg 1994; 93 (02) 243-253 , discussion 267–268
    CrossrefPubMedGoogle Scholar
  • 12 Nagata S. Modification of the stages in total reconstruction of the auricle: Part IV. Ear elevation for the constructed auricle. Plast Reconstr Surg 1994; 93 (02) 254-266 , discussion 267–268
    CrossrefPubMedGoogle Scholar
  • 13 Zim SA. Microtia reconstruction: an update. Curr Opin Otolaryngol Head Neck Surg 2003; 11 (04) 275-281
    CrossrefPubMedGoogle Scholar
  • 14 Ohara K, Nakamura K, Ohta E. Chest wall deformities and thoracic scoliosis after costal cartilage graft harvesting. Plast Reconstr Surg 1997; 99 (04) 1030-1036
    CrossrefPubMedGoogle Scholar
  • 15 Brent B. Microtia repair with rib cartilage grafts: a review of personal experience with 1000 cases. Clin Plast Surg 2002; 29 (02) 257-271 , vii
    CrossrefPubMedGoogle Scholar
  • 16 Thomson HG, Kim TY, Ein SH. Residual problems in chest donor sites after microtia reconstruction: a long-term study. Plast Reconstr Surg 1995; 95 (06) 961-968
    CrossrefPubMedGoogle Scholar
  • 17 Andreoli SM, Mills JC, Kilpatrick LA, White DR, Patel KG. CT measured normative cartilage growth in children requiring costochondral grafting. Otolaryngol Head Neck Surg 2013; 149 (06) 924-930
    CrossrefPubMedGoogle Scholar
  • 18 Moon IY, Oh KS, Lim SY, Pyon JK, Mun GH, Bang SI. Estimation of eighth costal cartilage in surgical timing of microtia reconstruction. J Craniofac Surg 2015; 26 (01) 48-51
    CrossrefPubMedGoogle Scholar
  • 19 Kang SS, Guo Y, Zhang DY, Jiang DY. Rib cartilage assessment relative to the healthy ear in young children with microtia guiding operative timing. Chin Med J (Engl) 2015; 128 (16) 2208-2214
    CrossrefPubMedGoogle Scholar
  • 20 Kim H, Hwang JH, Lim SY. et al. Preoperative rib cartilage imaging in 3-dimensional chest computed tomography for auricular reconstruction for microtia. Ann Plast Surg 2014; 72 (04) 428-434
    CrossrefPubMedGoogle Scholar
  • 21 Wang Y, He L, Liu L, Chen W, Jiang H, Shang Q. [Evaluation of multi-slice spiral ct scan and image reconstruction technology in estimating costal cartilage volume]. Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi 2014; 28 (10) 1266-1269
    PubMedGoogle Scholar
  • 22 Costal Cartilage Injuries [Internet]. Radsource. 2020 [cited 2020 Nov 07]. Accessed August 18, 2021 from: https://radsource.us/costal-cartilage-injuries
    Google Scholar
  • 23 Subhas N, Kline MJ, Moskal MJ, White LM, Recht MP. MRI evaluation of costal cartilage injuries. AJR Am J Roentgenol 2008; 191 (01) 129-132
    CrossrefPubMedGoogle Scholar