OBJECTIVES: Autologous
costal cartilage is a promising alternative for
mastoid obliteration. However,
donor -site
morbidities of the
chest wall limit the use of this
graft . To
address this issue, we have developed a minimally-invasive
technique of
harvesting costal cartilage and
report donor site
morbidity associated with the
procedure .
METHODS: Donor site
morbidities were evaluated for 151
patients who underwent
costal cartilage harvest, canal wall down
mastoidectomy , and
mastoid obliteration.
Pain and cosmetic concern were evaluated via visual analogue scale (VAS).
Scars were evaluated via the modified Vancouver
Scar Scale (VSS) and the
Patient and Observer
Scar Assessment Scale (POSAS).
Postoperative complications were assessed during the follow-up period.
RESULTS: The mean duration of noticeable
pain was 5.3 days post operation. The mean VAS score for
pain was 3.0 of 10 on the first day after the operation and gradually declined. At the 6 months post operation, the mean VAS cosmetic score at the
costal cartilage harvest site was 0.6 of 10. The mean VSS score was 9.5 out of 10 total, and the mean POSAS score was 23.27 out of 110 total.
CONCLUSION: The minimally-invasive chopped
costal cartilage harvest
technique resulted in acceptable
pain , cosmetic concern, and
postoperative complications for most
patients . There were no major
postoperative complications .
Costal cartilage is an acceptable
donor for
mastoid obliteration in canal wall down
mastoidectomy , especially in the context of the extremely low
donor site
morbidity of the minimally-invasive
technique presented in the study.