CT measured normative cartilage growth in children requiring costochondral grafting

• Published in: Otolaryngology-head and neck surgery Vol. 149; no. 6; p. 924
• Main Authors: Andreoli, Steven M, Mills, Jared C, Kilpatrick, Lauren A, White, David R, Patel, Krishna G
• Format: Journal Article
• Language: English
• Published: England 01.12.2013
• Subjects: Adolescent; Adult; Cartilage - diagnostic imaging; Cartilage - growth & development; Cartilage - surgery; Cartilage - transplantation; Child; Child, Preschool; Congenital Abnormalities - surgery; Congenital Microtia; Ear - abnormalities; Ear - surgery; Ear, External - surgery; Female; Hospitals, Pediatric; Hospitals, University; Humans; Male; Otologic Surgical Procedures - methods; Reference Values; Ribs - diagnostic imaging; Ribs - growth & development; Ribs - surgery; Ribs - transplantation; South Carolina; Thoracic Wall - diagnostic imaging; Tomography, X-Ray Computed; Transplantation, Autologous; Treatment Outcome; microtia; growth curve; costochondral grafting
• ISSN: 1097-6817
• DOI: 10.1177/0194599813504071

Careful operative timing is required for children undergoing microtia repair using autologous costochondral grafting. This operation is performed as early as age 6 in efforts to treat children before school matriculation while allowing for sufficient rib growth. There remains a paucity of data regarding cartilaginous growth of the ribs and synchondrosis routinely harvested during microtia repair. This study employs CT imaging to generate normative costochondral growth characteristics in children. A population-based study was performed. Tertiary care children's hospital. Chest CTs were reviewed in 360 children ages 3 to 20 years. Measurements included: length of ribs 6, 7, and 8 and the height and width of the synchondrosis between ribs 6 and 7. Growth charts are presented for gender and laterality. At age 6: ribs 6, 7, and 8 measure 5.96 ± 0.69, 7.79 ± 0.84, and 6.33 ± 1.01 cm, respectively. In adulthood the mean length of ribs 6, 7, and 8 are 8.29 ± 1.00, 11.10 ± 1.19, and 8.95 ± 1.99 cm, respectively. The vertical height of the synchondrosis at years 6 and 20 are 2.42 ± 0.39 and 3.59 ± 0.53 cm, respectively. Ribs 6, 7, and 8 as well as the synchondrosis grow in a nearly linear fashion. Cartilaginous growth of ribs 6 to 8 during early childhood is nearly linear. Synchondrosis height approaches adult auricle width at 8 years. Rib size is consistently larger in males and on the left side. These data are useful for the pediatric otolaryngologist and facial plastics and reconstructive surgeon performing microtia surgery.