Open AccessRib Reconstruction of Absent Mandibular Condyles in Children
Author(s) -
Goerke Derek,
Sampson Daniel E.,
Tibesar Robert,
Sidman James D.
Publication year - 2012
Publication title -
otolaryngology–head and neck surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.232
H-Index - 121
eISSN - 1097-6817
pISSN - 0194-5998
DOI - 10.1177/0194599812451426a355
Subject(s) - medicine , condyle , surgery , outpatient clinic , retrospective cohort study , population , resorption , mandible (arthropod mouthpart) , dentistry , botany , environmental health , pathology , biology , genus
Objective 1) Describe pediatric costochondral graft reconstruction of the absent mandibular condyle. 2) Report the short‐term and long‐term outcomes and complications associated with performing this procedure in young children. Method All children treated for an absent mandibular condyle with a costochondral graft from 2002 to 2011 at Children’s Hospitals and Clinics of Minnesota were identified and a retrospective chart review was performed. Outpatient charts, hospital records, and operative reports were reviewed. Results Ten patients aged 3 to 11 years old were identified. The most common diagnosis in 7 out of 10 patients was oculo‐auriculo‐vertebral syndrome. Three of the patients had a tracheostomy, of which one was decannulated following condylar reconstruction. Functional improvement, defined as improved symmetry, chewing, or better oral opening, was observed in 8 out 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. Conclusion 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.