A clinical study of external ear reconstruction: a study of 20 cases

Background: Auricular defects pose one of the most difficult challenges in reconstructive surgery of the head and neck. The reason is the unique three-dimensional anatomical architecture of the auricle, with its multiple concavities and convolutions of the cartilage and the thin, delicate skin cover. Acquired auricular deformities commonly result from traumatic injuries, burn trauma or tumour extirpation. These vary in severity from simple lacerations to complete auricular avulsions. Congenital ear deformity (microtia) occurs in every 1 out of 6000 live births. The goal of reconstruction is the precise duplication of the missing anatomical part with regard to size, orientation and anatomical landmarks.Methods: Range from healing by secondary intention to complete replacement with autologous rib cartilage and/or auricular prosthesis. Total auricular reconstruction was done by two methods: (1) Nagata and (2) Brent’s method. Nagata’s technique is commonly performed in this study. The present study aimed to evaluate the reconstruction of auricular defects using autologous rib cartilage graft with or without temperoparietal fascia flap covered by split-thickness skin graft.Results: Excellent cosmetic result can be obtained with adequate skills and training in carving the cartilage for auricular framework. This improves confidence and gives psychological support to microtia patients.Conclusions: With training and method, results in ear reconstruction using autologous rib cartilage are excellent and reproducible.

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Study on esthetic appearance of reconstructed pinna in microtia

International Surgery Journal ◽

10.18203/2349-2902.isj20185023 ◽

2018 ◽

Vol 5 (12) ◽

pp. 3940

Author(s):

G. Gopalan ◽

M. K. Rajendran ◽

R. Shankar

Keyword(s):

Hearing Loss ◽

Three Dimensional ◽

Dimensional Structure ◽

Ear Reconstruction ◽

Prospective Longitudinal Study ◽

Female Ratio ◽

Rib Cartilage ◽

Maxillary Surgery ◽

The Mean ◽

Prospective Longitudinal

Background: The normal external ear is a complex three-dimensional structure and, as such, reconstruction of the ear is a demanding undertaking. A new era in ear reconstruction began in 1959 when Tanzer introduced his multistage autologous rib cartilage technique and it gained wide acceptance from the surgeons. The aim of the present study was reconstruction of pinna in microtia cases using esthetic component and to study its surgical outcome.Methods: A prospective longitudinal study was conducted in the department of plastic, reconstructive and facio-maxillary surgery, Government Mohan Kumaramangalam Medical College, Salem, for a period of 2 years. A total of 26 patients with microtia were included in our study. The reconstruction of microtia was done by the following steps; a. first stage – removal of the rib cartilage and framework implantation; b. second stage - rotation of the ear lobule by Z plasty incision; c. third stage– creation of cephaloauricular sulcus; d. fourth stage - tragus construction and concha excavation. All the socio-demographic details and the clinical parameters related to the reconstructed ear were measured and tabulated.Results: The mean age of the study subjects was 14.3 years with a male: female ratio of 2:1. Based on the Tanzer classification all the patients were either in grade IIA or grade III of microtia with 35% of the patients had the hearing loss exceeding 40db. The mean length, breadth, degree of protrusion and degree of inclination of the reconstructed ear were 58.5mm, 34.6mm, 25o and 13o respectively. The most common complication reported in present study subjects was malposition of the reconstructed pinna (21.7%) followed by hematoma infection (8.6%) and hidden helix. Post-operatively the mean hearing loss was only 25db.Conclusions: The esthetic results of each of these techniques can be excellent when performed by an experienced surgeon in appropriately selected patients.

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A New Continuous Suture Technique in Ear Reconstruction With Full-Thickness Skin Grafts

Journal of Craniofacial Surgery ◽

10.1097/scs.0b013e31824e2cca ◽

2012 ◽

Vol 23 (4) ◽

pp. 1196-1197

Author(s):

Russell James Bramhall ◽

Mark Gorman ◽

Muhammad Adil Abbas Khan ◽

Muhammad Riaz

Keyword(s):

Suture Technique ◽

Ear Reconstruction ◽

Skin Grafts ◽

Full Thickness ◽

Continuous Suture ◽

Full Thickness Skin ◽

Thickness Skin

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Three-dimensional video scanning, planning and printing to optimise autologous ear reconstruction

Journal of Plastic Reconstructive & Aesthetic Surgery ◽

10.1016/j.bjps.2021.03.087 ◽

2021 ◽

Author(s):

Li Yenn Yong ◽

Luca Lancerotto ◽

Scott Inglis ◽

Kerr Clapperton ◽

Jonathan J Cubitt ◽

...

Keyword(s):

Three Dimensional ◽

Ear Reconstruction

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Development of a Novel Pre-Vascularized Three-Dimensional Skin Substitute Using Blood Plasma Gel

Cell Transplantation ◽

10.1177/0963689718797570 ◽

2018 ◽

Vol 27 (10) ◽

pp. 1535-1547 ◽

Cited By ~ 7

Author(s):

Niann-Tzyy Dai ◽

Wen-Shyan Huang ◽

Fang-Wei Chang ◽

Lin-Gwei Wei ◽

Tai-Chun Huang ◽

...

Keyword(s):

Wound Healing ◽

Human Plasma ◽

Three Dimensional ◽

Skin Substitute ◽

Strength Analysis ◽

Full Thickness ◽

Skin Substitutes ◽

Full Thickness Skin ◽

Post Surgery ◽

Thickness Skin

Skin substitutes with existing vascularization are in great demand for the repair of full-thickness skin defects. In the present study, we hypothesized that a pre-vascularized skin substitute can potentially promote wound healing. Novel three-dimensional (3D) skin substitutes were prepared by seeding a mixture of human endothelial progenitor cells (EPCs) and fibroblasts into a human plasma/calcium chloride formed gel scaffold, and seeding keratinocytes onto the surface of the plasma gel. The capacity of the EPCs to differentiate into a vascular-like tubular structure was evaluated using immunohistochemistry analysis and WST-8 assay. Experimental studies in mouse full-thickness skin wound models showed that the pre-vascularized gel scaffold significantly accelerated wound healing 7 days after surgery, and resembled normal skin structures after 14 days post-surgery. Histological analysis revealed that pre-vascularized gel scaffolds were well integrated in the host skin, resulting in the vascularization of both the epidermis and dermis in the wound area. Moreover, mechanical strength analysis demonstrated that the healed wound following the implantation of the pre-vascularized gel scaffolds exhibited good tensile strength. Taken together, this novel pre-vascularized human plasma gel scaffold has great potential in skin tissue engineering.

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Anatomical Variability of Fascial-Muscle Formations of the Thorax in 4-6-Month Human Fetuses

Ukraïnsʹkij žurnal medicini bìologìï ta sportu ◽

10.26693/jmbs06.05.134 ◽

2021 ◽

Vol 6 (5) ◽

pp. 134-140

Author(s):

T. V. Khmara ◽

◽

I. I. Okrym ◽

M. Yu. Leka ◽

I. D. Kiiun ◽

...

Keyword(s):

Pectoralis Major Muscle ◽

Three Dimensional ◽

Spinal Column ◽

Vertical Direction ◽

Posterior Wall ◽

Pectoralis Major ◽

Human Embryos ◽

Human Fetuses ◽

Surgical Interventions ◽

Rib Cartilage

The development of rational accesses and methods of surgical interventions to the chest walls, muscles and vascular-nerve formations of the chest involves clarifying data on the topography of fascia, superficial and deep muscles of the chest at different stages of human ontogenesis. The purpose of the study. Identification of macromicroscopic structure and topography of fascia and chest muscles in 4-6-month human fetuses. Materials and methods. The study was performed using microscopy of a series of consecutive histological sections of 29 human embryos of 81.0-230.0 mm parietal-coccygeal length, production of three-dimensional reconstruction models and morphometry. Results and discussion. In some early fetuses, and in isolated cases in the same fetus, there is anatomical variability of the pectoralis major muscle, characterized by asymmetry of shape, size and topography of individual parts of the right and left pectoralis major muscles. The underdevelopment of the individual muscle bundles of the sternocostal part of the pectoralis major muscle, hypoplasia of the internal intervertebral muscles, aplasia of the external intercostal membrane, internal intercostal and subcostal muscles, transverse muscles of the chest is described. Conclusion. In human fetuses of 4-6 months old there is anatomical variability of the chest muscles, characterized by bilateral asymmetry, variability of shape, size and topography of both their individual parts and muscle as a whole. In early human fetuses, thoracic fascia is a rather thin structural plate, in the structure of which there is no layering. Intervertebral spaces at the level of rib cartilage are filled with internal intervertebral muscles, the fibers of which near the edges of the thorax have a vertical direction, and from the point of connection of the rib cartilage to the thorax – oblique. In the gap between the external and internal intervertebral muscles of fascia as such is not manifested, but only a small layer of loose fiber is determined, in which the vascular-nerve bundles pass. In the fetuses of 6 months, the endothorаcic fascia on the posterior wall of the chest is somewhat thickened, split into separate plates and forms fascial cases for vascular-nerve formations located near the spinal column

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Bioengineered Muscle Implants

10.1115/imece2000-2546 ◽

2000 ◽

Author(s):

G. L. Bowlin ◽

Barbara Wise ◽

L. Terracio ◽

D. G. Simpson

Keyword(s):

Injection Site ◽

Cardiac Tissue ◽

Treatment Options ◽

Three Dimensional ◽

Small Animal ◽

Scar Tissue ◽

Specific Domain ◽

Complete Replacement ◽

Cell Based Therapy ◽

And Function

Abstract Fundamental research has defined many of the mechanistic events that mediate congenital malformations and the pathological disease processes that alter cardiac structure and function. Despite these efforts, there are a limited number of clinical treatment options available for many of these conditions. In many cases, even for disease processes that cause focal defects in the ventricular wall, the only viable treatment is the complete replacement of the damaged organ by transplant. Unfortunately, the supply of cardiac tissue that is available for transplant therapy remains chronically, and critically, short of demand. The reconstruction of a specific domain of dysfunctional ventricular tissue with a cell-based therapy is a potential avenue of treatment. One of the most direct strategies in this type of treatment regime is the injection of a suspension of fetal or neonatal cardiac myocytes into the injured domain. In small animal models, two limitations have become apparent with this strategy. First, differentiated myocytes do not undergo migration when they are injected into scar tissue and as a result they tend to remain concentrated in the vicinity of the injection site. Second, the myocytes that survive in the injection site are not well integrated into the healthy tissue and contract at rates that are independent of the surrounding myocardium. The long-term objective of this project is to circumvent the limitations of injection therapy by fabricating a cardiac muscle prosthesis that mimics the three dimensional architecture of the intact heart.

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