Experimental study of the influence of expanded capsule on biomechanics of autograftedcostal cartilage / 中华整形外科杂志

<p><b>OBJECTIVE</b>To explore the effect of the expanded capsule on biomechanics of the transplanted autologous costal cartilage.</p><p><b>METHODS</b>Ten New Zealand white rabbits aged 3 months were involved and four 15 ml tissue expanders were implanted symmetrically on the back of each rabbit. After 1 month, expanded capsules were removed (experimental group) on the left side and were reserved (control group) on the right side. Meanwhile, the 6th and 7th costal cartilage without the perichondrium were taken out and each cartilage was divided into two pieces and put under the expanded capsule symmetrically. The cartilage at the upper sides and lower sides were taken out at 4 weeks and 8 weeks later, respectively. All the cartilages were sculptured for the demand of the machine text. The tension and compression property of the cartilages were assessed by the material testing machine (Instron 5967) and the results were analyzed statistically.</p><p><b>RESULTS</b>8 weeks lateral, the average ultimate tension strength was (4. 954 + 2. 8) MPa in experimental group and (2.939 + 0.842) MPa in control group. The average compressive strength was (58.74 ± 13.77) MPa in experimental group, and (47.61 ± 11.41) MPa in control group. The biomechanics property of the cartilages in the experimental group is better than the control group, and the differences were statistically significant.</p><p><b>CONCLUSIONS</b>Removing the expanded capsule is benefical to maintain the biomechanics of autologous costal cartilage.</p>

Preliminary clinical research with thoracic deformities in microtia / 中华整形外科杂志

<p><b>OBJECTIVE</b>To investigate the characteristics and incidence of the thoracic deformities in patients with microtia.</p><p><b>METHODS</b>In Plastic Surgery Hospital, we conducted a retrospective study of the clinical and radiographical data of 300 patients with microtia from March 2013 to October 2014. Pearson χ2 test was used to analyze the relationship among deformities of ribs and spine, as well as microtia.</p><p><b>RESULTS</b>A total of 78 (26.0%) patients were documented with rib deformities, 26 patients (8.7%) had spinal deformities, and 17 patients (5.7% )had both. The incidence of rib deformities in microtia I, II, and III was 7.1% (2/28), 26.7% (62/232) and 35.0% (14/40) respectively. The incidence of spinal deformities in microtia I, II, and III was 3.6% (1/28), 6.5% (15/232) and 25.0% (10/40 respectively. The patients with microtia III were found to have a higher incidence of ribs and spinal deformities than those with microtia II, patients with microtia II were found to have a higher incidence of ribs and spinal deformities than those with microtia I (P < 0.05).</p><p><b>CONCLUSIONS</b>The incidence of ribs and spinal deformities is high in patients with microtia. The poorer one auricle developed, the higher the incidence of thoracic deformities.</p>

Clinical analysis on characteristics of rib cartilage calcification in congenital microtia patients / 中华整形外科杂志

<p><b>OBJECTIVE</b>To explore the incidence, degree, and pattern of rib cartilage calcification in congenital microtia patients, in order to provide reference for harvesting the rib cartilage, sculpturing cartilage framework.</p><p><b>METHODS</b>From Jun. 2013 to Nov. 2014, 383 patients (age range, 6-45 years) underwent CT scans of the chest. 11 patients with bony diseases or traumatic history were excluded. The remaining 372 patients were divided by age into four groups as 6-15, 16-25, 26-35, 36-45 years old. Twenty patients (10 male and 10 female) were selected by the order of patient identification number in each age group, thus selecting a total of 80 patients (40 male and 40 female). Retrospective study of CT scans of the chest in 80 patients and the incidence, degree, and pattern of cartilage calcification of the sixth to eighth ribs were noted. A chi-square test is conducted to test whether there are significant difference between the variables through the SPSS 19.0 software.</p><p><b>RESULTS</b>Overall, 40.4% (194/480) cartilage was calcified; female patients (47.50%, 114/240) showed higher frequency of calcification than male patients (33.33%, 80/240, P = 0. 025). Calcification rates of all age groups are 1.7% (2/120), 46.7% (56/ 120), 49.2% (59/120), 64.2% (77/120). Calcification rate of 6-15 years group is lowest in all groups (P < 0.05) while other three groups have no statistical significance (P > 0.05). Calcification rates of the sixth and sevent rib cartilage were higher than those of the eighth rib cartilage in all age groups except 6-15 years group, who had a similar rate of all three ribs. Calcification rate of all three rib cartilage was significantly increased with age. Calcification rates of the amle's rib cartilage and the female's in all age groups are 3.3% (2/60) and 0.0% (0/60) (6-15 years): 33.3% (20/60) and 60.0% (36/60) (16-25 years): 40.0% (24/60) and 58.3% (35/60) (26-35 years), 56.7% (34/60) and 71.2% (43/60) (36-45 years). In 6-15 years group calcification rates of male and female had a similar rate, while female's rates were higher than male's rates in other three groups. Male and females mainly had the granular type of calcification [70.0% (56/80), 63.2% (72/114)].</p><p><b>CONCLUSIONS</b>Females who are over 16 years old should pay more attention to the possibility of middle-severe calcification before harvesting rib cartilage. These patients should take CT examination if necessary. In addition, the patients who had previous operation, or traumatic history, rib deformity, or spine deformity should select the CT examination.</p>

Expanded post-auricular skin flap combined with autologous rib cartilage framework for correction of concha-type microtia / 中华整形外科杂志

<p><b>OBJECTIVE</b>To explore the clinical effect of the method by using an expanded post-auricular skin flap combined with autologous rib cartilage framework for correction of concha-type microtia.</p><p><b>METHODS</b>The operation were performed in three stages. The expander was implanted under post-auricular skin at the first stage and expanded skin flap was formed. At the second stage, the expander was taken out and the expanded skin flap was transferred with autologous rib cartilage framework and skin graft for correction of microtia. At the third stage, the reconstructed ear was revised and new concha was formed.</p><p><b>RESULTS</b>From August 2008 to August 2011, 108 cases with 113 concha-type microtia were corrected by this method. All patients healed primarily and were followed up for 6 months to 3 years. The reconstructed ears had a good appearance and position, and were symmetric to ear on the healthy sides.</p><p><b>CONCLUSIONS</b>Using expanded post-auricular skin flap combined with autologous rib cartilage framework is a reliable method for concha-type microtia.</p>