scholarly journals Donor Site Calcification and Deformation Following Microtia Repair in a Pediatric Patient With Mosaic Trisomy 22

2019 ◽  
Vol 5 ◽  
pp. 2513826X1983172
Author(s):  
Paul Yen ◽  
Cynthia Verchere
Keyword(s):  
Costal Cartilage ◽  
Donor Site ◽  
Anterior Chest Wall ◽  
Young Female ◽  
Clinical Syndrome ◽  
Autologous Reconstruction ◽  
Ear Reconstruction ◽  
External Ear ◽  
Wall Deformation ◽  
Mosaic Trisomy

A microtia, or small or abnormally formed pinna, is an uncommon congenital abnormality of the external ear which can present as an isolated defect or as part of an underlying clinical syndrome. External ear reconstruction is a possibility, with either an autologous or non-autologous framework. The Nagata type of autologous reconstruction is a multistage process whereby costal cartilage, temporoparietal fascia, and a full thickness skin graft are used to form a new pinna. Here, we present the unique case of a young female born with mosaic trisomy 22, an extremely rare genetic condition, and a right-sided microtia. Between the first and second stages of her reconstruction, an anterior chest wall deformation was observed, coupled with unusual dystrophic calcifications over the cartilage near the ribs and sternum.

Human-engineered auricular reconstruction (hEAR) by 3D-printed molding with human-derived auricular and costal chondrocytes and adipose-derived mesenchymal stem cells

2021 ◽  
Author(s):  
Shira Landau ◽  
Ariel A. Szklanny ◽  
Majd Machour ◽  
Ben Kaplan ◽  
Yulia Shandalov ◽  
...  
Keyword(s):  
Costal Cartilage ◽  
Donor Site ◽  
Autologous Reconstruction ◽  
Clinical Grade ◽  
Donor Site Pain ◽  
Custom Made ◽  
3D Printed ◽  
Artistic Skill ◽  
Site Pain

Abstract Microtia is a small, malformed external ear, which occurs at an incidence of 1-10 per 10,000 births. Autologous reconstruction using costal cartilage is the most widely accepted surgical microtia repair technique. Yet, the method involves donor-site pain and discomfort and relies on the artistic skill of the surgeon to create an aesthetic ear. This study employed novel tissue engineering techniques to overcome these limitations, by developing a clinical-grade, 3D-printed biodegradable auricle scaffold that formed stable, custom-made, neocartilage implants. The unique scaffold design combined strategically reinforced areas to maintain the complex topography of the outer ear and micropores to allow cell adhesion for the effective production of stable cartilage. The auricle construct was CT scan-based composed of a 3D-printed clinical-grade polycaprolactone (PCL) scaffold loaded with patient‐derived chondrocytes produced from either auricular cartilage or costal cartilage biopsies combined with adipose-derived MSCs. Cartilage formation was measured within the construct in vitro, and cartilage maturation and stabilization were observed 12 weeks after its subcutaneous implantation into a murine model. The proposed technology is simple and effective and is

Microtia Repair

2019 ◽  
pp. 461-470
Author(s):  
Melissa Kanack ◽  
Catherine Tsai ◽  
Amanda Gosman
Keyword(s):  
Skin Graft ◽  
Costal Cartilage ◽  
Ear Reconstruction ◽  
External Ear ◽  
Cartilage Graft ◽  
Associated Anomalies ◽  
Ear Canal ◽  
Genetic Syndrome ◽  
Definition Of ◽  
Costal Cartilage Graft

Microtia may occur as an isolated finding or in conjunction with other associated anomalies or a genetic syndrome. Ear reconstruction for these patients is typically performed no earlier than 6 years of age. In this chapter, a staged autogenous method of ear reconstruction is described using costal cartilage. In the first stage, a costal cartilage graft is harvested and placed. The next stages involve lobule transposition, detachment of the auricle with placement of a posterior skin graft, and further refinement of the external ear landmarks with tragus creation and definition of the conchal bowl and ear canal.

scholarly journals Burned Ear Reconstruction Using a Superficial Temporal Fascia Flap

2020 ◽  
pp. 014556132093762 ◽  
Author(s):  
Peipei Guo ◽  
Haiyue Jiang ◽  
Qinghua Yang ◽  
Leren He ◽  
Lin Lin ◽  
...  
Keyword(s):  
Costal Cartilage ◽  
Good Choice ◽  
Ear Reconstruction ◽  
External Ear ◽  
Temporal Fascia ◽  
Therapeutic Regime ◽  
Fascial Flap ◽  
Temporal Fascial Flap ◽  
Fascia Flap ◽  
Superficial Temporal Fascia

Objectives: Ear deformity caused by burns is one of the most difficult types of deformity to treat with plastic surgery, and the reconstruction of burned ears undoubtedly remains a substantial challenge. This study aims to report the therapeutic regime of using a superficial temporal fascial flap to cover the framework in burned ear reconstruction. Methods: Autologous costal cartilage was used to form the ear framework in all of the reconstruction cases. A superficial temporal fascial flap was used as soft tissue to cover the ear scaffold. Results: Five patients with 6 ears were included in our study. The external ear healed well and the location, size, and shape of both ears were generally symmetrical. No complication was observed in any of the patients. Conclusions: The superficial temporal fascial flap is a good choice for covering the autogenous cartilage framework when treating ear deformities after burns.

1150 A Painless Anterior Chest Wall Mass Post Coronary Artery Bypass Grafting Surgery

2021 ◽  
Vol 108 (Supplement_6) ◽  
Author(s):  
R Reid ◽  
F Alakhras Aljanadi ◽  
R Beattie ◽  
A Graham
Keyword(s):  
Coronary Artery ◽  
Coronary Artery Bypass ◽  
Chest Wall ◽  
Artery Bypass ◽  
Costal Cartilage ◽  
Bypass Graft ◽  
Anterior Chest Wall ◽  
Chronic Obstructive ◽  
Wall Mass ◽  
Chest Wall Mass

Abstract Aim We aim to present here a case of a painless anterior chest wall mass which was first noted during routine follow up post coronary artery bypass graft surgery Case presentation An 80-year-old male developed an asymptomatic slow growing pronounced swelling over the right anterior chest wall post CABG. His other past medical history includes chronic obstructive pulmonary disease, pulmonary fibrosis, ischaemic heart disease, an AICD for complete heart block, hypertension, hyperlipidaemia and osteoarthritis. A CT scan demonstrated a 10 x 12 x 6.5 cm subcutaneous lesion at the mid-line of the lower chest wall adjacent to the xiphisternum and the previous sternotomy site. On clinical examination there was a large non-tender cystic swelling with peripheral calcifications, but overlying skin was normal. Fluid was aspirated from the lesion and cytology showed a paucicellular specimen with features in keeping with seroma. Due to the progressive increase in size patient underwent surgical resection. A gelatinous bloody fluid was aspirated from the lesion and it was then resected enbloc. The tumour base appeared to arise from 6/7th costal cartilage and tumour was shaved away. The mass was confirmed histologically to be chondrosarcoma. Conclusions Given the uncommon prevalence of malignant primary chest wall tumours this case highlights the importance of high clinical suspicion even after developing post CABG.

External Ear Reconstruction in Hemifacial Microsomia

2009 ◽  
Vol 20 (Suppl 2) ◽  
pp. 1787-1793 ◽  
Author(s):  
Akira Yamada ◽  
Koichi Ueda ◽  
Reiko Yorozuya-Shibazaki
Keyword(s):  
Ear Reconstruction ◽  
External Ear ◽  
Hemifacial Microsomia

scholarly journals Ear Reconstruction Simulation: From Handcrafting to 3D Printing

2019 ◽  
Vol 6 (1) ◽  
pp. 14 ◽  
Author(s):  
Elisa Mussi ◽  
Rocco Furferi ◽  
Yary Volpe ◽  
Flavio Facchini ◽  
Kathleen S. McGreevy ◽  
...  
Keyword(s):  
Costal Cartilage ◽  
Surgical Reconstruction ◽  
Ear Reconstruction ◽  
Autologous Tissue ◽  
Aesthetic Appearance ◽  
History Of ◽  
Common Clinical Practice ◽  
The Aesthetic ◽  
Manufacturing Technologies ◽  
High Level

Microtia is a congenital malformation affecting one in 5000 individuals and is characterized by physical deformity or absence of the outer ear. Nowadays, surgical reconstruction with autologous tissue is the most common clinical practice. The procedure requires a high level of manual and artistic techniques of a surgeon in carving and sculpting of harvested costal cartilage of the patient to recreate an auricular framework to insert within a skin pocket obtained at the malformed ear region. The aesthetic outcomes of the surgery are highly dependent on the experience of the surgeon performing the surgery. For this reason, surgeons need simulators to acquire adequate technical skills out of the surgery room without compromising the aesthetic appearance of the patient. The current paper aims to describe and analyze the different materials and methods adopted during the history of autologous ear reconstruction (AER) simulation to train surgeons by practice on geometrically and mechanically accurate physical replicas. Recent advances in 3D modelling software and manufacturing technologies to increase the effectiveness of AER simulators are particularly described to provide more recent outcomes.

scholarly journals Fabrication and evaluation of an optimized xenogenic decellularized costal cartilage graft: preclinical studies of a novel biocompatible prosthesis for rhinoplasty

2021 ◽  
Author(s):  
Shuang Lin ◽  
Yuanjia He ◽  
Meihan Tao ◽  
Aijun Wang ◽  
Qiang Ao
Keyword(s):  
Costal Cartilage ◽  
Donor Site ◽  
Rabbit Model ◽  
Operation Time ◽  
Promising Alternative ◽  
Ionic Detergent ◽  
Cellular Components ◽  
First Time

Abstract On account of the poor biocompatibility of synthetic prosthesis, millions of rhinoplasty recipients have been forced to choose autologous costal cartilage as grafts, which suffer from limited availability, morbidity at donor site and prolonged operation time. Here, as a promising alternative to autologous costal cartilage, we developed a novel xenogeneic costal cartilage and explored its feasibility as a rhinoplasty graft for the first time. Adopting an improved decellularization protocol, in which the ionic detergent was substituted by trypsin, the resulting decellularized graft was confirmed to preserve more structural components and better mechanics, and eliminate cellular components effectively. The in vitro and in vivo compatibility experiments demonstrated that the decellularized graft showed excellent biocompatibility and biosecurity. Additionally, the functionality assessment of rhinoplasty was performed in a rabbit model, and the condition of grafts after implantation was comprehensively evaluated. The optimized graft exhibited better capacity to reduce the degradation rate and maintain the morphology, in comparison to the decellularized costal cartilage prepared by conventional protocol. These findings indicate that this optimized graft derived from decellularized xenogeneic costal cartilage provides a new prospective for future investigations of rhinoplasty prosthesis and has great potential for clinical application.

scholarly journals Autologous Costal Cartilage Graft—A New Method to Treat Articular Cartilage Defects: Case Report and Note of Surgical Technique

Joints ◽  
2018 ◽  
Vol 06 (04) ◽  
pp. 246-250
Author(s):  
Antonio Gigante ◽  
Marco Cianforlini ◽  
Luca Farinelli ◽  
Riccardo Girotto ◽  
Alberto Aquili
Keyword(s):  
Articular Cartilage ◽  
Femoral Condyle ◽  
Costal Cartilage ◽  
Donor Site ◽  
Standard Technique ◽  
Cartilage Defects ◽  
Cartilage Graft ◽  
Full Thickness ◽  
Articular Cartilage Defects ◽  
Costal Cartilage Graft

AbstractFull-thickness articular cartilage defects do not heal spontaneously. Several techniques have been developed to address this issue, but none resulted in the restitutio ad integrum of the articular cartilage. The most frequent sites of chondral lesion in the knee are medial femoral condyle and patella. The patellofemoral lesions are characterized by outcomes that are generally worse than those of tibiofemoral ones. To date, it has been well recognized the chondrogenic potential of rib perichondrium, and costal cartilage grafts have been extensively used in reconstructive surgery. Considering the need to find a gold standard technique to restore articular defect, we developed and here described a new technique to repair cartilage lesions of the knee using autologous costal cartilage graft with its perichondrium. This innovative surgical approach can be used to treat full thickness articular defects using autologous hyaline cartilage, making it possible to cover wide defects. This one step technique is low invasive, not technically demanding with minimal donor site morbidity and it has low costs. The long-term clinical efficacy of the method remains to be evaluated.

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