Costal Cartilage Calcification in a Caucasian Population: Machine Learning Recommendations for Chest CT-guided Rhinoplasty Planning.

Journal: Facial plastic surgery : FPS
Published Date: Oct 27, 2025

Abstract

INTRODUCTION: Autologous costal cartilage calcification (CCC) can impact the course and long-term results of rhinoplasty. Preoperative information about the presence, severity, and pattern of CCC helps to assess donor site suitability and rhinoplasty planning. OBJECTIVE: To use machine learning to identify a sex-specific age threshold beyond which a preoperative chest CT is likely to reveal CCC relevant for rhinoplasty planning. STUDY DESIGN: Cross-sectional retrospective study of 662 Caucasian adults. METHODS: Prevalence, severity, and patterns of CCC in ribs five to eight were assessed by three independent reviewers. A machine learning algorithm was used to predict the age threshold beyond which a chest CT scan is beneficial to rhinoplasty planning. RESULTS: The prevalence of CCC in Caucasian adults was 89.6%. Nearly all individuals over the age of 50 exhibited some form of CCC. In young females CCC was more severe and prevalent in the central core of ribs five to eight compared with age-matched males. CONCLUSION: A chest CT is recommended in females over 23 years and males over 40 years. No data-driven recommendations regarding an upper age limit for costal cartilage use could be determined from the data.

Authors

  • Victor S van Dam
    Department of Otolaryngology and Head & Neck Surgery, Erasmus Medical Center, Rotterdam, Netherlands.
  • Diako Berzenji
    Department of Otolaryngology and Head & Neck Surgery, Erasmus MC University Medical Center Rotterdam, Rotterdam, Netherlands.
  • Aaike S Berg van den
    Department of Radiology, Erasmus MC University Medical Center Rotterdam, Rotterdam, Netherlands.
  • Aaike S van den Berg
    Department of Radiology, Erasmus Medical Center, Rotterdam, The Netherlands.
  • Floris Vwj van Zijl
    Department of Otolaryngology and Head & Neck Surgery, Erasmus Universiteit Rotterdam, Rotterdam, Netherlands.
  • Floris V W J van Zijl
    Department of Otorhinolaryngology, Erasmus Medical Center, Rotterdam, The Netherlands.
  • Andries P Nagtegaal
    Otorhinolaryngology and Head & Neck Surgery, Erasmus MC University Medical Center Rotterdam, Rotterdam, Netherlands.
  • Bernd Kremer
    Department of Otolaryngology and Head & Neck Surgery, Erasmus MC, Rotterdam, Netherlands.
  • Frank R Datema
    Department of Otolaryngology and Head & Neck Surgery, Erasmus Medical Center Rotterdam, Rotterdam, Netherlands.

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