A new method of costal cartilage harvest for total auricular reconstruction: Part I. Avoidance and prevention of intraoperative and postoperative complications and problems

Background: The occurrence of chest wall deformity is not dependent on the amount of costal cartilage harvested but results from the method of costal cartilage harvest. Therefore, the authors developed a new method of costal cartilage harvest where the perichondrium is left completely intact at the donor site and the remaining costal cartilage after fabrication of the three-dimensional costal cartilage framework is returned to the perichondrial pocket to fill the dead space formed. By leaving the perichondrium completely intact, the most ideal environmental condition for regeneration of cartilage is attained. Methods: The costal cartilages are harvested en bloc with the perichondrium left completely intact at the donor site. After fabrication of the three-dimensional frame, the remaining costal cartilage is cut into small blocks that act as spacers to fill the dead space formed in the perichondrial pocket. Results: The findings of the authors' study involving over 270 cases performed with the new method of costal cartilage harvest revealed that there were absolutely no postoperative chest wall deformities identified, and there was a significant decrease in intraoperative complications. Conclusion: The authors' study revealed that the new method of costal cartilage harvest plays an important role in the regeneration of cartilage and in the prevention and avoidance of postoperative chest wall deformity.