Ex Vivo Electromechanical Reshaping of Costal Cartilage in the New Zealand White Rabbit Model

Badran, Karam W.; Manuel, Cyrus; Waki, Curtis; Protsenko, Dmitriy E.; Wong, Brian J. F.

doi:10.1002/lary.23730

Cited by 20 publications

(37 citation statements)

References 31 publications

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“…Similar to prior published results, 18,19 EMR causes a 1.5-mm to 2.5-mm region of cellular injury at the site of electrode insertion. As with thermal cartilage reshaping methods, laser-based 5-10 and radiofrequency-based 28,29 shape change is obtained at the expense of chondrocyte loss.…”

Section: Discussionsupporting

confidence: 90%

“…13-16,19 Af ter removal of the bolsters at 3 months, the control and EMR specimens manifested shape change. The control ears showed a mean of 55° in shape change compared with the EMR-treated ears, in which the bend angle varied from 60° to 125° depending on the dosimetry parameters.…”

Section: Discussionmentioning

confidence: 98%

“…18,19,21-23 To assess the viability of chon-drocytes, specimens were stained with the fluorophores calcein acetomethoxy and ethidium homodimer 1 and were imaged with a confocal microscope (Meta 510; Carl Zeiss LSM). Digital images were recorded and analyzed.…”

Section: Methodsmentioning

confidence: 99%

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In Vivo Needle-Based Electromechanical Reshaping of Pinnae

Yau

Manuel

Hussain

et al. 2014

JAMA Facial Plast Surg

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IMPORTANCE Electromechanical reshaping (EMR) is a low-cost, needle-based, and simple means to shape cartilage tissue without the use of scalpels, sutures, or heat that can potentially be used in an outpatient setting to perform otoplasty.OBJECTIVES To demonstrate that EMR can alter the shape of intact pinnae in an in vivo animal model and to show that the amount of shape change and the limited cell injury are proportional to the dosimetry. DESIGN, SETTING, AND SPECIMENSIn an academic research setting, intact ears of 18 New Zealand white rabbits underwent EMR using 6 different dosimetry parameters (4 V for 5 minutes, 4 V for 4 minutes, 5 V for 3 minutes, 5 V for 4 minutes, 6 V for 2 minutes, and 6 V for 3 minutes). A custom acrylic jig with 2 rows of platinum needle electrodes was used to bend ears at the middle of the pinna and to perform EMR. Treatment was repeated twice per pinna, in proximal and distal locations. Control pinnae were not subjected to current application when being bent and perforated within the jig. Pinnae were splinted for 3 months along the region of the bend using soft silicon sheeting and a cotton bolster. MAIN OUTCOMES AND MEASURESThe ears were harvested the day after splints were removed and before euthanasia. Photographs of ears were obtained, and bend angles were measured. Tissue was sectioned for histologic examination and confocal microscopy to assess changes to microscopic structure and cellular viability.RESULTS Treated pinnae were bent more and retained shape better than control pinnae. The mean (SD) bend angles in the 7 dosimetry groups were 55°(35°) for the control, 60°(15°) for 4 V for 4 minutes, 118°(15°) for 4 V for 5 minutes, 88°(26°) for 5 V for 3 minutes, 80°(17°) for 5 V for 4 minutes, 117°(21°) for 6 V for 2 minutes, and 125°(18°) for 6 V for 3 minutes. Shape change was proportional to electrical charge transfer, which increased with voltage and application time. Hematoxylin-eosin staining of the pinnae identified localized areas of cell injury and fibrosis in the cartilage and in the surrounding soft tissue where the needle electrodes were inserted. This circumferential zone of injury (range, 1.5-2.5 mm) corresponded to dead cells on cell viability assay, and the diameter of this region increased with total electrical charge transfer to a maximum of 2.5 mm at 6 V for 3 minutes.CONCLUSIONS AND RELEVANCE Electromechanical reshaping produced shape change in intact pinnae of rabbits in this expanded in vivo study. A short application of 4 to 6 V can achieve adequate reshaping of the pinnae. Tissue injury around the electrodes increases with the amount of total current transferred into the tissue and is modest in spatial distribution. This study is a critical step toward evaluation of EMR in clinical trials.LEVEL OF EVIDENCE NA.

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Section: Discussionsupporting

confidence: 90%

Section: Discussionmentioning

confidence: 98%

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In Vivo Needle-Based Electromechanical Reshaping of Pinnae

Yau

Manuel

Hussain

et al. 2014

JAMA Facial Plast Surg

Self Cite

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show abstract

“…For the limited data we have, the extent of tissue injury very clearly mirrors that observed in the previous in vivo studies in rabbits 23,27 and in numerous investigations performed on ex vivo cartilage tissues. 18,22,26,28 …”

Section: Discussionmentioning

confidence: 99%

“…18–27 Electromechanical reshaping is a non–thermal-based method that relies on chemical reduction-oxidation (redox) reaction to alter tissue matrix structure and thus change tissue stress-strain associations. To perform EMR, a mold or jig is first used to bend cartilage to a desired shape, and electrodes are inserted into regions of increased internal stress.…”

mentioning

confidence: 99%