Ultrasonic Criteria for the Selection of Rib Graft for Laryngotracheal Reconstruction

Mohamed Abdulaziz Farah, Resident of Otorhinolaryngology, Head and Neck Surgery, Faculty of Medicine, Mansoura University, EgyptFollow
Hazem Emam Amer, Professor of Otorhinolaryngology, Head and Neck Surgery, Faculty of Medicine, Mansoura University, EgyptFollow
Ahmed Abdelfattah Elsobki, Professor of Otorhinolaryngology, Head and Neck Surgery, Faculty of Medicine, Mansoura University, EgyptFollow
Mahitab M. Rashad Ghoneim, Assistant Professor of Diagnostic Radiology, Faculty of Medicine, Mansoura University, EgyptFollow
Ahmed abdoo Elzhzahy, Lecturer of Otorhinolaryngology, Head and Neck Surgery, Faculty of Medicine, Mansoura University, EgyptFollow

Subject Area

Otolaryngology

Article Type

Original Study

Abstract

Background Laryngotracheal reconstruction (LTR) is a well-established surgical procedure for the management of pediatric subglottic stenosis, with rib cartilage grafts. This study was conducted to evaluate preoperative and intraoperative discrepancies of rib graft used in laryngotracheal reconstruction using ultrasonic criteria in terms of their height, thickness, and length. Methods This prospective cohort study was conducted on 10 pediatric patients who underwent LTR at Mansoura University Hospitals. Preoperative ultrasonography was performed on the right 4th, 5th, and 6th rib cartilages, measuring height, thickness, and length. These measurements were then directly compared with intraoperative dimensions of the harvested cartilage. Results There was no statistically significant difference between preoperative and intraoperative measurements in terms of rib cartilage height and thickness. However, a statistically significant difference was detected in rib cartilage length, particularly for rib 5. Excellent agreement was observed for height (ICC=0.921) and thickness (ICC=0.970), while poor agreement was noted for length (ICC=-0.148). Conclusion Preoperative ultrasound is an accurate and reproducible imaging modality for evaluating rib cartilage dimensions in pediatric patients undergoing LTR, particularly in assessing cartilage height and thickness. Despite discrepancies in cartilage length, ultrasound remains a valuable, non-invasive, and radiation-free tool to guide graft selection.

Recommended Citation

Farah, Mohamed Abdulaziz; Amer, Hazem Emam; Elsobki, Ahmed Abdelfattah; Ghoneim, Mahitab M. Rashad; and Elzhzahy, Ahmed abdoo (2025) "Ultrasonic Criteria for the Selection of Rib Graft for Laryngotracheal Reconstruction," Mansoura Medical Journal: Vol. 54 : Iss. 4 , Article 10.
Available at: https://doi.org/10.58775/2735-3990.1473