Comparative analysis of small-incision and traditional techniques in costal cartilage harvesting: Outcomes on thoracic deformities and scar appearance

Abstract

Objective

This study aims to compare the postoperative thoracic deformity and scar aesthetic outcomes of auricular reconstruction between the conventional large-incision technique and small-incision technique with perichondrium preservation for costal cartilage harvesting.

Methods

A retrospective analysis was performed on 134 patients who underwent auricular reconstruction using tissue expanders and autologous costal cartilage harvested from the right chest wall between January 2021 and September 2023. Patients were divided into two groups according to the harvesting technique: the traditional large-incision group (n = 64) and the small-incision group with perichondrium preservation (n = 70). Preoperative and postoperative chest CT scans were reviewed for thoracic deformities by measurements of the modified Haller Index (mHI) and modified correction index (mCI). Thoracic scar dimensions were measured in postoperative follow-up.

Results

In the conventional group, significant difference were observed between the left and right hemithorax in anterior-posterior diameter, maximum transverse diameter, cross-sectional area, and mHI values (p < 0.05), showing thoracic deformities. In contrast, within the small-incision group, there were no significant differences between hemithoraces. Additionally, postoperative thoracic scars were significantly smaller in the small-incision group, with shorter scar length (5.63 ± 1.33 cm vs. 11.44 ± 1.31 cm) and width (1.41 ± 0.55 cm vs. 3.75 ± 1.54 cm; p < 0.001).

Conclusion

The small-incision technique with perichondrium preservation significantly reduces postoperative thoracic deformities and results in smaller, less conspicuous scars compared to the traditional large-incision method. This approach minimizes disruption to the chest wall structure and reduces donor-site morbidity, offering improved patient outcomes.