The Use of Autogenous Rib Graft in Craniofacial Reconstruction: Case Series Study

Yassir Ryadh Al-khannaq; Haider Majid Altimmimi; Adel Sahib Aubed

doi:10.54133/ajms.v7i1.1158

Authors

Yassir Ryadh Al-khannaq Department of Oral and Maxillofacial Surgery, College of Dentistry, University of Baghdad, Baghdad, Iraq
Haider Majid Altimmimi Department of Oral and Maxillofacial Surgery, Ghazi Al-Hariri Hospital, Medical City, Baghdad, Iraq https://orcid.org/0009-0003-2946-5637
Adel Sahib Aubed Department of Oral and Maxillofacial Surgery, Alkadumia Medical City, Baghdad, Iraq

DOI:

https://doi.org/10.54133/ajms.v7i1.1158

Keywords:

Bone Graft, Craniofacial deformity, Craniofacial reconstruction, Rib Graft

Abstract

Background: Hard tissue defects in the maxillofacial region due to trauma or ablative surgery result in functional and cosmetic problems. The method of choice in the treatment of facial defects is autogenous bone grafts. Objectives: To evaluate the use of rib grafts in the reconstruction of craniofacial deformities. Methods: This prospective study was presented for the reconstruction of craniofacial deformity using a rib bone graft. These cases were collected from the Maxillofacial Surgery Unit from October 2011 to November 2020. The sample consisted of 16 patients (14 males and 2 females, with a mean age of 34 years). The patients were divided according to the site of the defect. In all cases, a single rib was harvested. The fifth rib was taken. Bone graft fixation by bone plate, direct screws, and transosseous wiring. The success of the bone grafting was assessed by clinical and radiological examination. Results: The overall success rate in this study was 87.5%, while we had bone graft resorption in two cases (12.5%) of mandibular reconstruction. Only one case experienced donor site complications, a pleural tear, which successfully underwent suturing and chest tube insertion. Conclusions: Free autogenous rib was successfully used to reconstruct defects in the maxillofacial regions. It gives the best result when minimum loading is needed. Stabilization of the graft by rigid internal fixation and good adaptation to the recipient site helped to minimize complications.

Downloads

Download data is not yet available.

References

Donkor P, Bankas DO, Boakye G, Ansah S, Acheampong A. The use of free autogenous rib grafts in maxillofacial reconstruction. Ghana Med J. 2006;40(4):127-131. doi: 10.4314/gmj.v40i3.55266.

Taggard DA, Menezes AH. Successful use of rib grafts for cranioplasty in children. Pediatr Neurosurg. 2001;34(3):149-155. doi: 10.1159/000056010.

Gurtner GC, Evans GR: Advances in head and neck reconstruction. Plast Reconstr Surg 2000; 106: 672-682. In septorhinoplasty. Arch Facial Plast Surg. 2002; 4:172–176.

Koch WM, Yoo GH, Goodstein ML. Advantages of mandibular reconstruction with the Titanium hollow screw osseo-integrating reconstruction plate (THORP). Laryngoscope. 1994;104:545-552. doi: 10.1002/lary.5541040507.

Josan VA, Sgouros S, Walsh AR, Dover MS, Nishikawa H, Hockley AD. Cranioplasty in children. Childs Nerv Syst. 2005;21(3):200-204. doi: 10.1007/s00381-004-1068-2.

Cakmak O, Ergin T. The versatile autogenous costal cartilage graft in septorhinoplasty. Arch Facial Plast Surg. 2002;4(3):172-176. doi: 10.1001/archfaci.4.3.172.

Wee JH, Park MH, Oh S, Jin HR. Complications associated with autologous rib cartilage use in rhinoplasty: a meta-analysis. JAMA Facial Plast Surg. 2015;17(1):49-55. doi: 10.1001/jamafacial.2014.914.

Carvalho TB, Cancian LR, Marques CG, Piatto VB, Maniglia JV, Molina FD. Six years of facial trauma care: an epidemiological analysis of 355 cases. Braz J Otorhinolaryngol. 2010;76(5):565-574. doi: 10.1590/S1808-86942010000500006.

Costan VV, Drochioi IC, Nicolau A, Sulea D, Doscas A, Marius Dabija M. Correction of sequelae following orbito-zygomatic. Rom J Oral Rehabil. 2018;10(4):198–206.

Collyer J, McKinzie J, Sneddon Ken J. Screw and ‘‘washer’’ fixation for onlay rib grafts to the mandible. Br J Oral Maxillofac Surg. 2008;46:609. doi: 10.1016/j.bjoms.2008.03.029.

Dastgir R, Coffey J, Quereshy H, Baur DA, Quereshy FA. Nonvascularized bone grafts: how successful are they in reconstruction of segmental mandibular defects? Oral Surg Oral Med Oral Pathol Oral Radiol. 2024;137(5):e63-e72. doi: 10.1016/j.oooo.2023.10.010.

Jiang M, Huo H, Zhang L. Current practice in autologous rib and costal-cartilage harvest for rhinoplasty: A systematic review. Chinese J Plast Reconstr Surg. 2024;6(1):41-48. doi: 10.1016/j.cjprs.2024.02.002.

Schwabegger AH, Rainer C, Laimer I, Huemer GM. Hemispheric brain volume replacement with free latissimus dorsi flap as first step in skull reconstruction. Microsurgery. 2005;25(4):325-328. doi: 10.1002/micr.20117.

Cabbad NC, Stalder MW, Arroyave A, Wolfe EM, Wolfe SA. Autogenous bone cranioplasty: Review of a 42-year experience by a single surgeon. Plast Reconstr Surg. 2019;143(6):1713-1723. doi: 10.1097/PRS.0000000000005677.

Moreira-Gonzalez A, Jackson IT, Miyawaki T, Barakat K, DiNick V. Clinical outcome in cranioplasty: critical review in long-term follow-up. J Craniofac Surg. 2003;14(2):144-153. doi: 10.1097/00001665-200303000-00003.

Cypher TJ, Jordan P. Grossman JP. Biological principles of bone graft healing. J Foot Ankle Surg.1996;35(5): 413-417. doi: 10.1016/S1067-2516(96)80061-5.

Singh AK, Mohapatra DP, Kumar V. Spectrum of primary bone grafting in cranio maxillofacial trauma at a tertiary care centre in India. Indian J Plast Surg. 2011;44(1):29-35. doi: 10.4103/0970-0358.81444.

Saluja H, Sachdeva S, Shah S, Dadhich A, Tandon P, More V. Autogenous grafts for orbital floor reconstruction: A review. Int J Oral Craniofac Sci. 2017;3(2):046-052. doi: 10.17352/2455-4634.000031.

Elsalanty ME, Genecov DG. Bone grafts in craniofacial surgery. Craniomaxillofac Trauma Reconstr. 2009;2(3):125-134. doi: 10.1055/s-0029-1215875.

Schön R, Schmelzeisen R, Shirota T, Ohno K, Michi K. Tissue reaction around miniplates used for the fixation of vascularized iliac crest bone grafts. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 1997;83(4):433-440. doi: 10.1016/s1079-2104(97)90141-4.

Valentini V, Cassoni A, Marianetti TM, Romano F, Terenzi V, Iannetti G. Reconstruction of craniofacial bony defects using autogenous bone grafts: a retrospective study on 233 patients. J Craniofac Surg. 2007;18(4):953-958. doi: 10.1097/scs.0b013e3180690123.

Sugg KB, Rosenthal AH, Ozaki W, Buchman SR. Quantitative comparison of volume maintenance between inlay and onlay bone grafts in the craniofacial skeleton. Plast Reconstr Surg. 2013;131(5):1014-1021. doi: 10.1097/PRS.0b013e31828e217a.

Castro-Núñez J, Van Sickels JE. Secondary reconstruction of maxillofacial trauma. Curr Opin Otolaryngol Head Neck Surg. 2017;25(4):320-325. doi: 10.1097/MOO.0000000000000368.

Morton L, Flood T. Rib graft cartilage harvest for cleft septorhinoplasty donor site morbidity and patient perception of their scar. Br J Oral Maxillofac Surg. 2018;56(10):36. doi: 10.1016/j.bjoms.2018.10.044.

Özücer B, Dinç ME, Paltura C, Koçak I, Dizdar D, Çörtük O, et al. Association of autologous costal cartilage harvesting technique with donor-site pain in patients undergoing rhinoplasty. JAMA Facial Plast Surg. 2018;20(2):136-140. doi: 10.1001/jamafacial.2017.1363.

James DR, Irvine GH. Autogenous rib grafts in maxillofacial surgery. J Maxillofac Surg. 1983;11(5):201-203. doi: 10.1016/s0301-0503(83)80048-4.