Concentric and Eccentric Carved Costal Cartilage
A Comparison of Warping
David W. Kim, MD;
Anil R. Shah, MD;
Dean M. Toriumi, MD
Arch Facial Plast Surg. 2006;8:42-46.
Objective To determine if a systematic, concentric graft-carving technique results in less warping than eccentric carving.
Methods Costal cartilage from ribs 3 through 9 were harvested from fresh human cadavers. Concentric dorsal grafts were carved from cartilage obtained from one side of the cadaver (n = 7) and eccentric grafts were carved from the opposite side (n = 11). After carving, grafts were placed in saline sponges (isotonic sodium chloride) for 1 hour, and photographs were then taken from a lateral and a frontal view. Identical photographs were taken after 2 weeks of incubation in saline (36.7°C). The angle of curvature was measured from the photographs.
Results More warping occurred in the eccentric group than the concentric group on lateral view at 1 hour (4.4° vs 0.4°; P<.001) and at 2 weeks (5.8° vs 1.4°; P = .003). Eccentric grafts progressively warped between the 1-hour and 2-week points.
Conclusion Meticulous concentric carving of costal cartilage grafts may minimize the complication of graft warping.
Author Affiliations: Division of Facial Plastic and Reconstructive Surgery, Department of Otolaryngology–Head and Neck Surgery, University of California, San Francisco (Dr Kim); and Division of Facial Plastic and Reconstructive Surgery, Department of Otolaryngology–Head and Neck Surgery; University of Illinois at Chicago (Drs Shah and Toriumi).
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