Anatomy of the Tenth Costal Cartilage for a Columella Strut in an Asian Rhinoplasty

Abstract

The aim of this study was to elucidate the precise radiological and surface anatomy of the 10th costal cartilage for the usage of a columella strut in an Asian rhinoplasty. Three hundred abdominal computed tomography scans were reviewed and measured (166 males, 134 females), and the location of the 10th costochondral junction (CCJ) was measured in reference to the anterior superior iliac spine (ASIS) and umbilicus. Sixteen 10th costal cartilages were harvested from 10 Korean adult cadavers (7 males, 3 females), and the length, width, and thickness of each cartilage were measured. Distance from the anterior ASIS to the umbilicus was 155.4 +/- 15.1mm (male: 157.9 +/- 15.5mm, female: 152.2 +/- 14.1mm). Distance from the umbilicus to the 10th CCJ was 170.7 +/- 23.0mm (male: 179.2 +/- 22.8mm, female: 160.3 +/- 18.7mm). Distance from the ASIS to the 10th CSJ angle was 181.8 +/- 21.8mm (male: 184.7 +/- 21.3mm, female: 178.2 +/- 22.1mm). The ASIS-umbilicus 10th CSJ angle was 56.3 +/- 5.6 degrees (male: 55.1 +/- 5.5 degrees, female: 57.8 +/- 5.3 degrees). The average length of the cartilage was 64.1 +/- 19.7mm. The average curved length of the cartilage was 69.6 +/- 21.0mm. The average greatest width was 11.0 +/- 2.1mm, and the width at its mid-length was 8.3 +/- 1.7mm. The average thickness of the cartilage was 5.7 +/- 0.9mm. In a 33-year-old woman, the 10th costal cartilage was used for columella strut. It is thought that the 10th costal cartilage can provide a sufficient amount and shape for a columella strut and tip in an onlay graft.