Donor-site morbidity of ear cartilage autografts.

BACKGROUND: The external ear provides a versatile cartilage source for reconstructive procedures, especially for augmentative rhinoplasty. The authors evaluated the short- and long-term morbidity associated with ear cartilage harvest using concha, tragus, and scapha as donor sites. METHODS: The study included 52 patients in whom a cartilage graft from the external ear was harvested between February of 2001 and June of 2005. Donor-site morbidity was assessed in the early postoperative follow-up period. Twenty-eight patients were examined within a follow-up time of 3 to 168 months. Long-term morbidity assessment included documentation of patients' subjective complaints, clinical examination of the donor site, and anthropometric measurements. RESULTS: The relevant morbidity factors in the early postoperative period were hematoma formation (6.7 percent) and sensory impairment (3.3 percent). In long-term follow-up, sensory impairment was the most frequent condition objectively assessed and subjectively complained of (12.9 percent). Overall, sensory impairment was confined to concha as the donor site. Anthropometric measurements showed a mean difference in the length of the affected ear compared with the contralateral ear of 1.8 mm, a width difference of 2.5 mm, a difference in tragus/lateral canthus distance of 1.4 mm, and a difference in protrusion angle of 2.4 degrees. Statistically significant differences between values obtained from operated and nonoperated ears could not be detected for every evaluated parameter using the paired t test. Aesthetically relevant complications were rare and their occurrence restricted to single cases. CONCLUSION: Cartilage graft harvest from the auricle can be considered as a relatively safe procedure with a favorable aesthetic outcome.

Vertical distraction osteogenesis of fibula transplants for mandibular reconstruction--a preliminary study.

INTRODUCTION: When reconstructing the mandible after tumour resection with a fibular graft, the mandible is often vertically deficient, making placement of dental implants impossible. PATIENTS: Segmental vertical distraction of the reconstructed mandible was performed in nine patients following tumour surgery between February 1998 and 2001. Their age was 14-65 years (average 46.3); all underwent radiotherapy with a dose of up to 55.6 Gy prior to tumour resection. Mandibular discontinuity was repaired with a microvascular fibular bone graft. All grafts had a vertical bone deficit ranging from 9 to 12 mm when compared with the non-resected part of the mandibles. METHODS: All patients underwent segmental vertical distraction of the transplants. The distraction devices were applied intraorally. Distraction of 1.0 mm/day was performed using a Martin distractor (TRACK 1.5) followed by 12 weeks retention time. RESULTS: The increase of vertical bone height was stable and enabled placement of dental implants without any complications. CONCLUSION: Vertical distraction osteogenesis may become a common procedure in the treatment of alveolar ridge deficiency resulting from transplanting fibulae for mandibular reconstruction following tumour surgery.