Prevalence of Thoracic Complications Following Costochondral Grafting: A Nationwide Estimate in the United States

Abstract

The costochondral graft (CCG) is a well-established reconstruction modality for the temporomandibular joint (TMJ), particularly for the growing patient. Donor site complications such as pneumothorax have been reported, but only in isolated reports or small case series or single-center studies, precluding understanding of the true risks. This retrospective cross-sectional study used the National Inpatient Sample database, a large-scale database of hospitalizations in the United States, for the years 2020 to 2022, to calculate the estimated nationally representative frequency of thoracic complications in the United States. Between 2020 and 2022, there were 235 weighted hospitalizations related to CCG (57.4% female; mean age: 16.9 y). The mean hospital length of stay and hospital charges were 11.5 days and $177,235 (2022 US dollars), respectively. There were 15 weighted hospitalizations with thoracic complications, with a weighted frequency of 6.4%. Within the limitations of the analysis of a 3-year nationally representative sample, the estimated frequency of thoracic complications in the United States was nontrivial, at 6.4%. Knowledge of the risk can guide the clinician during clinical decision-making, from consideration of viable alternatives to implementing risk mitigation strategies.

The authors' abstract, as published at the source. Journal of Craniofacial Surgery, 2026 · DOI ↗