Moon Il Yung, Oh Kap Sung, Lim So Young, Pyon Jai-Kyong, Mun Goo-Hyun, Bang Sa-Ik
From the Department of Plastic Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
J Craniofac Surg. 2015 Jan;26(1):48-51. doi: 10.1097/SCS.0000000000001177.
There is controversy over the optimal timing of microtia reconstruction. The eighth costal cartilage, which is used to shape the helix framework, can be one of the key factors determining surgical timing of microtia reconstruction. Nevertheless, it is difficult to predict the length of the eighth costal cartilage preoperatively. The aim of the present study was to suggest clinical predictors of the length of the eighth cartilage by assessing the correlation between the actual length of the eighth cartilage and preoperative measurements of the cartilage length using three-dimensional rib-cage computed tomography (3D rib-cage CT). A retrospective analysis was performed on a total of 97 patients who underwent preoperative 3D rib-cage CT and auricular reconstruction using a rib cartilage graft between January 2010 and February 2013. The length of the eighth costal cartilage on 3D rib-cage CT was measured preoperatively, and the length of the harvested eighth rib cartilage was measured intraoperatively. We analyzed the association between the preoperative and intraoperative measured length of the eighth rib, with patient age, height, weight, and body mass index. Preoperative measurement using 3D rib-cage CT showed a high correlation with actual cartilage length. Height and weight correlated more strongly with length than with age. This study describes the usefulness of 3D rib-cage CT for preoperative measurement of the length of the eighth costal cartilage. The measurement of the eighth rib cartilage on 3D rib-cage CT could be a useful aid for reconstructive surgeons in planning microtia reconstruction.
关于小耳畸形重建的最佳时机存在争议。用于塑造耳轮框架的第八肋软骨可能是决定小耳畸形重建手术时机的关键因素之一。然而，术前很难预测第八肋软骨的长度。本研究的目的是通过评估第八肋软骨的实际长度与术前使用三维胸廓计算机断层扫描（3D胸廓CT）测量的软骨长度之间的相关性，提出第八肋软骨长度的临床预测指标。对2010年1月至2013年2月期间共97例行术前3D胸廓CT及肋软骨移植耳廓重建术的患者进行回顾性分析。术前测量3D胸廓CT上第八肋软骨的长度，术中测量所取第八肋软骨的长度。我们分析了第八肋术前和术中测量长度与患者年龄、身高、体重和体重指数之间的关联。术前使用3D胸廓CT测量与实际软骨长度高度相关。身高和体重与长度的相关性比年龄更强。本研究描述了3D胸廓CT在术前测量第八肋软骨长度方面的实用性。3D胸廓CT上第八肋软骨的测量可为重建外科医生规划小耳畸形重建提供有用的帮助。
