Irradiated homograft costal cartilage reportedly warps less than autologous cartilage based on clinical observation; however, no controlled, experimental studies on the warping characteristics of irradiated homograft costal cartilage have been done. Fresh cadaver costal cartilage (ribs 5 through 8) was prepared and irradiated using a standardized technique. A specially designed cartilage-cutting device was used to cut the cartilage into a reproducible size. The irradiated (n = 23) and nonirradiated (n = 20) groups were incubated in vitro and assessed over a 4-week period. There was no significant difference in warping between the irradiated and nonirradiated groups (p = 0.1). The centrally cut pieces of cartilage in each group warped less than peripherally cut blocks in each group. Peripherally cut pieces of both the irradiated and nonirradiated groups warped at a faster rate compared with the nonirradiated groups. All cartilage exhibited continued warping over the 4-week study period. We concluded that there was no difference in warping characteristics between irradiated and nonirradiated homograft rib cartilage. Furthermore, unlike previous studies, cartilage grafts continued warping over time for at least 4 weeks, and this phenomenon may be extrapolated as a causative factor in delayed postoperative nasal deviation after rhinoplasty and nasal reconstruction where rib grafts are used.
The anatomy of the internal mammary vessels is poorly understood and thought to be unreliable clinically for use as a recipient vein in free-tissue-transfer breast reconstruction. This study of 10 fresh cadaver thoracic cavities demonstrated by anatomic and dye resection studies that the internal mammary veins become smaller (< or = 2 mm) distally (fourth rib) and bifurcate [left (90 percent) > right (40 percent)], becoming unsuitable for consistent venous anastomoses at or below the fourth interspace. Furthermore, this study suggests that the most consistent interval is the third rib, which offers an appropriate recipient vein (40 percent > or = 3 mm on the left and 70 percent > or = 3 mm on the right). However, at the fourth interspace, 20 percent of the cadaver specimens had a vein on one side that was 1 mm or less and therefore unsuitable as a recipient. This enhanced understanding of the anatomy (size, location, and consistency) of the internal mammary recipient veins offers our patients another recipient option to enhance the safety and technical ease of microvascular breast reconstruction.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.