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Objective:To investigate the surgical method and clinical outcome of using nasal septal cartilage combined with auricular cartilage for management of nasal tip shape.Methods:A clinical study was conducted from April 2014 to June 2019, in which we managed nasal tip shape with nasal septal cartilage and auricular cartilage, and these materials were used as septal extension graft, spreader graft and cap graft. In total, 622 patients (28 males, 594 females; age from 18 to 42 years, mean age 27.47 years) were assessed for eligibility.Results:The follow-up period was from 6 months to 6 years. Nasal shape of all 622 patients was improved significantly after the operation. The nasal tip was natural and round, and there were no complications such as damage of nasal septum mucosa, exposure of prosthesis and infection of surgical site. Only 12 patients were found downward rotation of nasal tip, and 610 patients achieved satisfactory aesthetic results.Conclusions:Using septal cartilage combined with auricular cartilage is a safe, effective and suitable method for management of nasal tip shape.
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Objective:To introduce a modified stent technique of nasal septal extension graft (SEG) with auricle cartilage, and to explore its effect on rhinoplasty.Methods:For 116 patients that underwent rhinoplasty, the cartilage of bilateral auricula was sutured with shell alignment and the dovetail was modified to prepare SEG stent; PTFE or silicone prosthesis was used for nasal dorsal graft. The patients were follow up for 6-18 months after surgery. A number of indicators including length of nose, tip projection, nasal tip and nasolabial angle morphology were used to assess surgical outcomes.Results:The 116 patients obtained satisfactory appearance immediately after operation. Length of nasal extension was 3-6 mm, tip projection was extended by 2-5 mm. Following up for 6-18 months showed stable effect (0.5-1.5 mm retraction) and satisfactory nose tip and nasolabial angle. The skin color was normal. No deformity occured in the ear cartilage donor area existed with no obvious scar.Conclusions:The modified SEG stent of auricle cartilage has good support and stability. It has a good effect on the slight and moderate extension of the short nose. In addition, the elevation of the nasal tip and the severe short nose of the first rhinoplasty and secondary rhinoplasty with mild contracture are also improved.
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Introdução: As orelhas proeminentes, popularmente chamadas de "orelhas em abano", representam a deformidade congênita mais comum da orelha externa, atingindo cerca de 5% da população. Métodos: Estudo primário, prospectivo e de intervenção comparando os resultados de pacientes submetidos ao procedimento cirúrgico de correção de orelhas proeminentes por meio da técnica de Converse e de Mustardé, realizado no Serviço de Cirurgia Plástica do Hospital das Clínicas da Universidade Federal de Pernambuco (HC-UFPE). Resultados: Foram avaliados 20 pacientes, 10 por meio da técnica de Converse e 10 por meio de Mustardé, no período de junho de 2016 a dezembro de 2017. Ambos os grupos mostraram diminuição das distâncias mastoideas auriculares ao final do período de observação, variando de 6.67 a 14.6 mm, a depender da técnica cirúrgica e do ponto de avaliação, mas sem significância estatística. Quanto às distâncias mastoideas auriculares médias ao final do período de observação, observou-se diferença de no máximo 6.3mm entre os grupos avaliados, mas sem significância estatística. Em relação a simetria das orelhas dentro do mesmo grupo, o nível máximo de assimetria média nos grupos Mustardé e Converse foi de respectivamente 0.9mm e 0.5mm. A porcentagem da perda de correção das medidas obtidas cirurgicamente ao longo do período de observação em ambos os grupos variaram de 15-19%, no entanto, sem significância estatística. No que se refere as complicações, houve 1 (10%) caso de hematoma no grupo Mustardé. Conclusão: As técnicas de Converse e Mustardé demostraram não ter diferença estatística nos resultados.
Introduction: prominent ears, popularly called "flappy ears," represent the most common congenital deformity of the external ear, affecting approximately 5% of the population. Methods: Primary, prospective and intervention study comparing the results of patients undergoing the surgical procedure to correct prominent ears using the Converse and the Mustardé techniques, performed at the Plastic Surgery Service of the Hospital das Clínicas, Federal University of Pernambuco (HC) -UFPE). Results: Twenty patients were evaluated, 10 with the Converse technique, and 10 with the Mustardé technique, from June 2016 to December 2017. Both groups showed a decrease in auricular mastoid distances at the end of the observation period, ranging from 6.67 to 14.6 mm, depending on the surgical technique and the evaluation point, but without statistical significance. Regarding the average auricular mastoid distances at the end of the observation period, a difference of a maximum of 6.3 mm was observed between the evaluated groups, but without statistical significance. Regarding the symmetry of the ears within the same group, the maximum mean level of asymmetry in the Mustardé and Converse groups was 0.9 mm and 0.5 mm, respectively. However, the percentage of loss of correction of the measures obtained surgically during the observation period in both groups ranged between 15 and 19%, without statistical significance. Regarding complications, there was 1 (10%) case of hematoma in the Mustardé group. Conclusion: Converse and Mustardé techniques did not show statistical differences in the results.
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Objective: To explore the anthropometric changes of the auricle after auricular cartilage unfolding in moderate concha-type microtia patients, so as to provide the basis to help evaluate surgical timing and prognostic. Methods: A total of 33 children with moderate concha-type microtia, who were treated with auricular cartilage unfolding between October 2016 and September 2018 and met the inclusive criteria, were included in the study. There were 24 boys and 9 girls with an average age of 1.4 years (range, 1-3 years). Sixteen cases were left ears and 17 cases were right ears. The follow-up time was 12-23 months (mean, 17.5 months). The affected auricular detailed structures were observed and quantitatively analyzed before operation and at immediate after operation. The width, length, and perimeter of auricle before operation and at immediate after operation and at last follow-up were noted with three dimensional-scanning technology. The normal auricle was noted as control. Results: There were (7.5±1.0) and (11.3±0.8) structures of the affected auricle at pre- and post-operation, respectively, showing significant difference between pre- and post-operation ( t=23.279, P=0.000). The length, width, and perimeter of the affected auricle constantly increased after operation, and there were significant differences between pre-operation and immediately after operation and between immediately after operation and last follow-up ( P0.05). Conclusion: The auricular cartilage unfolding in treatment of the moderate concha-type microtia can receive more ear structures and increase auricle sizes, which make it possible for free composite tissue transplantation. In addition, the affected and the contralateral normal auricles have a very similar growth rate and it offers the theoretical foundation for the early treatment for moderate concha-type microtia.
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Objective@#To investigate the tissue structure, chondrocyte characteristics, and the differential expression of related genes and cell surface markers of auricular cartilage of patients in different ages, in order to provide a basis for the age selection of tissue engineered cartilage repair defects.@*Methods@#The auricular cartilage tissue was obtained from 22 patients with microtia in the Plastic Surgery Hospital, Chinese Academy of Medical Science, ranged from 6 to 28 years old, and divided into the child group (6-12 years old), the adolescent group (13-18 years old) and the adult group (21-28 years old). The proliferation and differentiation features of chondrocytes which from different-aged patients were detected. Furthermore, quantitative real-time PCR was used to detect the differences in the expression of genes related to cell proliferation and chondrocyte extracellular matrix. Flow cytometry, immunofluorescence and immunohistochemistry were used to detect the differences in the expression of mesenchymal stem cell markers CD90, CD44, CD73 and CD105 in chondrocytes. SPSS Statistics 21.0 software was used to process statistics.@*Results@#The proliferation capability of auricular chondrocytes of children was stronger than adolescents and adults, the child group vs the adult group P<0.05, the child group vs the adolescent group P<0.01. The expression of cartilage extracellular matrix related gene COL2A1 increased with age, the child group vs the adult group P<0.01, the adolescent group vs the adult group P<0.01. While the capability of cell osteogenic differentiation decreased with age(P<0.05). However, there was no significant difference in the capability of adipogenic differentiation when considering the ages of patients. The results of both flow cytometry and real-time PCR showed that the expression of mesenchymal stem cell markers decreased with age, with the most significant decrease in CD90(P<0.01).@*Conclusions@#The biological characteristics and stem cell content of cells derived from auricular cartilage tissue was influenced by the patients′age.
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Objective To discuss clinical curative effects of using Forehead skin expansion combine with auricular cartilage for repairing nose alar full-thickness defects.Methods From August 2010 to August 2010,36 patients with nose alar full-thickness defects in the second affiliated hospital of kunmin medical university,The defect range exceed 1.5 cm× 1.2 cm.50-80 ml expander was implanted in forehead and injected saline water to expand in order to acquire extra skin.We Turn around the skin of defect as the lining of nose,harvest ipsilateral auricular cartilage for nose ala framework,Expanded forehead pedicle flap was transferred to cover framework.The donor area was sutured directly.The pedicle of flap was cut and trimmed after 2 months.Results Follow-up time of 3-18 months after the operation,All flaps are survive,nose alar defects are repaired successfully.Some cases were performed second surgery,postoperative,nose alar color,thickness,nostril size and shape the same with the contralateral side.Donor site healed with linear scar.Conclusions This method could be easy to obtain excess skin,for repairing large sides nose alar full-thickness defect.Frontal scar is not obvious,It is a practical.
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OBJECTIVE To investigate and evaluate the effects of intact-bridge tympanoplasty using auricular cartilage in treating chronic otitis media. METHODS A retrospective review of 86 cases undergoing an intact-bridge tympanomastoidectomywas performed from July,2013 to May,2016.The auricular cartilage was placed on the attic and tympanic antrum entrance to reconstruct the attic. RESULTS The outcome of dry ear and well-epithelialized mastoid cavities was achieved after 4-6 weeks. After 6-month follow-up no recurrence occurred. The pure-tone average threshold improved by (25.4±6.3) dB HL after operation,and the mean air bone gap was elevated. CONCLUSION On the basis of combination of closed and open techniques,the IBM technique is a optimal cure strategy for chronic otitis media,which can not only remove the pathological changes thoroughly to prevent disease recurrence but also maximally improve the hearing of the diseased ear.The closure of attic with auricular cartilage can ensure the space of the ossicular chain.
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Objective To investigate the application of auricular cartilage in nasal plastic surgery and its clinical effects of the different tip graft and reconstructed domal graft (RDG).Methods From October 2009 to May 2015,the surgical procedure was performed on 286 patients,through the application of cymba and conchae cartilages into various tip graft and RDG in nasal tip plasty.Results A total of 286 patients were followed up post-operatively for 3 months to 5 years,245 patients (85.7％ achieved expected stability tip,the tip down to 1-2 mm after one year.Tip skin thinning was observed in 10 patients after one year,nasal tip down occurred in 89 patients;the columella skew and asymmetric nostrils occurred in 31 patients.Conclusions The ear cartilage can be made into various tip graft for rhinoplasty,with satisfactory clinical outcomes.
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Costal cartilage, auricular cartilage and nasal septal cartilage are widely used in plastic operation. Costal cartilage is used in ear reconstruction and augmentation rhinoplasty, while the auricular cartilage and nasal septal cartilage are applied in the nasal plastic operation. The maintenance of postoperative form is closely related to the biomechanical characteristics of the cartilage. Meanwhile, ultrastructure, especially extracellular matrix, determines the mechanical properties of cartilage. This review mainly focuses on the biomechanical properties and ultrastracture of the cartilages and summarizes the basic data of different cartilages in biomechanical testing, including tissue engineered-auricular cartilage. However, the procedure of biomechanical testing on cartilages currently needs further standardization, and the use of the finite element method should be promoted, so as to offer a better clinical diagnosis and treatment.
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Esthetic reconstruction of cleft lip nose deformity is a challenging task in surgical management of patients with orofacial cleft. The author reconstructed cleft lip nose deformity effectively using autogenous auricular cartilage and a relatively new graft material of porcine dermal collagen, Permacol(TM). After correction of the deformed lower third of the nose with patient's auricular cartilage, we applied Permacol(TM) to augment the entire nasal dorsum. Three patients were treated and followed for up to five years. All patients improved in nose aesthetics without any inflammatory or immunogenic reaction. The author suggests that the use of Permacol(TM) for nasal profile augmentation in the treatment of cleft lip nose deformity is an alternative surgical strategy with minimal surgical invasiveness. The author report long-term experience with combined use of auricular cartilage and Permacol(TM) in nasal reconstruction for cleft lip nose deformity.
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Humans , Cleft Lip , Collagen , Congenital Abnormalities , Ear Cartilage , Esthetics , Nose , Rhinoplasty , TransplantsABSTRACT
Objective To explore the clinical effect of auricle reconstruction with expanded auricle posterior flap on mastoidea and auto rib cartilage bracket for repair of congenital microtia.Methods Twenty-one eligible patients with congenital auricle malformation and defect were recruited into this study and three-stage operation was performed.A 50 ml kidney-shaped expander was implanted at mastoid process area to expand skin in stage Ⅰ surgery,followed by a regular affusion to expand skin for 3 to 4 months.The average total waterflood was (80.51 ± 3.87) ml.The volume remained stable for 1 month,once up to the predetermined amount.In stage Ⅱ surgery autogenous costal cartilage was taken and carved into inverted conch shape.Auricle was reconstructed with the expanded flap to cover the auto rib cartilage bracket.The stage Ⅲ surgery was performed for details dressing of the auricle after 3 months.Results All 21 cases underwent operation successfully.Reconstructed ear auricles were similar to uninjured sides in size and shape.Both doctors and patients were contented with the auricles.Conclusions Expanded auricle posterior flap on mastoidea can cover the auto rib cartilage bracket.Autologous costal cartilage can be carved to four layers cartilage bracket that likes an inverted conch,and followed by realistic postoperative auricular shape and strong three-dimensional sense after operation.
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Objective To investigate the feasibility, rationality and efficacy of the autologous dermal-fat composite tissue used as filling materials in the repair of nasal dorsum collapse.Methods The dermal fat composite tissue block (7.0 cm× 1.0 cm × 1.0 cm) was removed from the buttocks or abdoman as filling materials. 13 cases of nasal dorsum and nasal-shaped misfits were treated by using an umbrella graft of the auricular cartilage plus dermal-fat composite tissue graft to reconstruct natual shape of nasal dorsum and tip. Results The nasal dorsum and tip were repaired in 13 patients with collapsed nasal dorsum. The dermal-fat composite tissue survived well, and the incisions were healed in stage Ⅰ and the incision trace was not obvious. After follow-up for one year, the shape of nose was much satisfactory. Conclusion It is a well-accepted and easy-going procedure to repair collapsed nasal dorsum with autologous dermal-fat or a combination of composite ear cartilage tissue graft, with satisfactory effect and no rejection reactions.
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Avaliou-se a reconstrução da pálpebra inferior de coelhos, com cartilagem auricular alógena, conservada em solução saturada de NaCl em 12 coelhos, adultos, de ambos os sexos. Os animais receberam acepromazina (0,5mg/kg/IM) e tiletamina e zolazepam (7,0mg/kg/IM), após o que removeu-se um fragmento de 1,0x0,5cm das pálpebras inferiores, esquerda e direita. A pálpebra esquerda foi reparada pela técnica de blefaroplastia em H (GC) e a direita por um retalho de cartilagem auricular associado a blefaroplastia em H (GE). Aos sete dias de pós-operatório (PO), as feridas cirúrgicas dos animais do GC apresentavam retração cutânea. Aos 15 dias de PO, observou-se que as feridas nos coelhos do GE estavam cicatrizadas, mas 30 por cento das do GC apresentavam deiscência e retração cicatricial. Aos 30 dias de PO, as feridas nos animais do GE e GC apresentavam-se cicatrizadas, mas, 30 por cento nos do GC não apresentavam as bordas das feridas coaptadas. O enxerto de cartilagem auricular diminuiu a retração cicatricial, possibilitando reparo anatômico à pálpebra
The rabbit inferior eyelid repair was evaluated using NaCl satured-stored alogenous auricular cartilage. Twelve adult male and female rabbits had a 1.0x0.5cm fragment removed from the left and right inferior eyelids after pre-medication with acepromazine (0.5mg/kgIM) and tiletamine-zolazepan (7.0mg/kgIM) anesthesia. The "H" plasty technique was used to the left eyelid repair (CG) and the right one was repaired with auricular cartilage associated with the "H" plasty technique (GG). The CG wounds presented cutaneous retraction at day 7th of the post-operative period. The GG wounds were healed on the day 15th, while the CG wounds presented 30 percent of deiscence and cicatricial retraction. The GG and CG wounds were healed at day 30th of the post-operative period, but 30 percent of the CG wounds did not present the edges lined up. It was concluded that the auricular cartilage graft decreases cicatricial retraction and improves anatomical eyelid repair
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Animals , Adult , Blepharoplasty/adverse effects , Blepharoplasty/methods , Blepharoplasty/veterinary , Ear Cartilage/surgery , Ear Cartilage/physiology , Rabbits/surgery , Postoperative Care/veterinary , Eyelids/surgery , Transplantation, Homologous/adverse effectsABSTRACT
PURPOSE: Correction of saddle nose remains problematic both in the technique of reconstruction and in the choice of implant material for nasal augmentation. A large variety of graft materials have been used for the reconstruction of the saddle nose deformity. The purpose of this study is to determinate an algorithm for deciding alternative graft materials used in correction of saddle nose deformity. METHODS: Six patients with saddle nose who were corrected using by auricular cartilage and costal cartilage at Chosun university hospital were analyzed. RESULTS: After a mean interval of 12 months, all patients were satisfied with the esthetic and functional result. CONCLUSION: Auricular cartilage is an excellent graft material for esthetic and functional reconstruction of mild to moderate saddle nose deformity.
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Humans , Cartilage , Congenital Abnormalities , Ear Cartilage , Nose , TransplantsABSTRACT
PURPOSE: Correction of saddle nose remains problematic both in the technique of reconstruction and in the choice of implant material for nasal augmentation. A large variety of graft materials have been used for the reconstruction of the saddle nose deformity. The purpose of this study is to determinate an algorithm for deciding alternative graft materials used in correction of saddle nose deformity. METHODS: Six patients with saddle nose who were corrected using by auricular cartilage and costal cartilage at Chosun university hospital were analyzed. RESULTS: After a mean interval of 12 months, all patients were satisfied with the esthetic and functional result. CONCLUSION: Auricular cartilage is an excellent graft material for esthetic and functional reconstruction of mild to moderate saddle nose deformity.