Rujira-Arporn Thitithip, Sriswadpong Papat, Jirawatnotai Supasid
Plastic and Reconstructive Surgery, Lerdsin Hospital, 190 Silom Road, Bangrak 10500, Bangkok, Thailand.
Plastic and Reconstructive Surgery, Lerdsin Hospital, 190 Silom Road, Bangrak 10500, Bangkok, Thailand.
J Plast Reconstr Aesthet Surg. 2022 Sep;75(9):3462-3468. doi: 10.1016/j.bjps.2022.04.065. Epub 2022 Apr 30.
Autologous costal cartilage graft (ACC) is considered a gold standard in complex rhinoplasty. Costal cartilage calcification remains a problematic issue, causing not only difficulties during the harvesting, carving, and fixation procedures but also worsening the long-term outcome with resorption.
This study aims to establish diagnostic accuracy of hand-held ultrasonography in not only detecting the degree and pattern of costal cartilage calcification but also assessing its ability to predict the volume of the harvestable cartilage graft.
The study was performed on 50 fresh cadavers with an age range between 17 and 80 years (mean 53.4 ± 16.2 years). An ultrasonographic examination of the costal cartilage of 5th, 6th, and 7th ribs of both hemithoraces was performed. The presence of calcification of the cartilages and the pattern, length, width, cross-sectional area, and depth of calcification were observed and recorded. These results were compared against direct visualization and measurement via surgical dissection.
Hand-held ultrasonography has a sensitivity of 94% and a specificity of 96% in detecting calcification with 96% positive predictive value and 93% negative predictive value. The positive likelihood ratio was 20.81 and the negative likelihood ratio was 0.06. Overall, the modality has demonstrated the ability to determine dimensions of the costal cartilage to within millimeters. The pattern of calcification was also correctly predicted in all 300 specimens.
Hand-held ultrasonography is an affordable and accessible choice of demonstrating the presence and pattern of calcification as well as the general dimensions of the harvestable rib cartilage.
自体肋软骨移植（ACC）被认为是复杂鼻整形术中的金标准。肋软骨钙化仍然是一个有问题的问题，不仅在采集、雕刻和固定过程中造成困难，而且会因吸收而使长期效果恶化。
本研究旨在确定手持式超声检查在检测肋软骨钙化程度和模式方面的诊断准确性，以及评估其预测可采集软骨移植物体积的能力。
对50具年龄在17至80岁（平均53.4±16.2岁）的新鲜尸体进行研究。对双侧胸腔第5、6和7肋的肋软骨进行超声检查。观察并记录软骨钙化的存在情况以及钙化的模式、长度、宽度、横截面积和深度。将这些结果与通过手术解剖的直接可视化和测量结果进行比较。
手持式超声检查在检测钙化方面的灵敏度为94%，特异度为96%，阳性预测值为96%，阴性预测值为93%。阳性似然比为20.81，阴性似然比为0.06。总体而言，该方法已证明能够将肋软骨尺寸确定在毫米范围内。在所有300个标本中，钙化模式也被正确预测。
手持式超声检查是一种经济实惠且易于获得的方法，可用于显示钙化的存在和模式以及可采集肋软骨的大致尺寸。
