Rib reconstruction of the absent mandibular condyle in children

Derek Goerke, Daniel E. Sampson, Robert J. Tibesar, James D Sidman

Research output: Contribution to journalArticlepeer-review

13 Scopus citations

Abstract

Objectives. To describe pediatric costochondral graft reconstruction of the absent mandibular condyle and to report the short-term and long-term outcomes and complications associated with performing this procedure in young children. Study Design. Case series with a retrospective chart review. Setting. Pediatric otolaryngology clinic and tertiary children's hospital in a metropolitan area. Subjects and Methods. All children treated for an absent mandibular condyle with a costochondral graft at Children's Hospitals and Clinics of Minnesota were identified from 2002 through 2011, and a retrospective chart review was performed. Results. Ten patients aged 3 to 11 years were identified. The most common diagnosis, in 8 of 10 patients, was oculo-auriculo- vertebral syndrome. Three of the patients had a tracheostomy, of which 1 was decannulated following condylar reconstruction. Functional improvement, defined as improved symmetry, chewing, or better oral opening, was observed in 8 of 10 patients. Five patients have required no further surgeries to date, with a mean follow-up time of 3.9 years. Severe overgrowth of the graft was noted in 1 case, and partial or complete resorption of the graft was also noted in 3 cases. Overgrowth occurred after 5.7 years, whereas resorption occurred after an average of 2.5 years. Conclusions. Costochondral grafts are an excellent surgical treatment option for children with severe mandibular malformations. Short-term results show particular improvement in function and mandibular alignment. The mean follow-up time with no revision surgery was substantial and indicates that rib grafting is a good addition to the armamentarium of treatment for this patient population.

Original languageEnglish (US)
Pages (from-to)372-376
Number of pages5
JournalOtolaryngology - Head and Neck Surgery (United States)
Volume149
Issue number3
DOIs
StatePublished - Sep 1 2013

Keywords

  • Goldenhar syndrome
  • Hemifacial microsomia
  • costochondral graft
  • mandibular defect
  • oculo-auriculo-vertebral syndrome
  • pediatric
  • reconstruction

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