Modular Component Assembly Approach to Microtia Reconstruction

Gandy, Jessica R.; Lemieux, Bryan; Foulad, Allen; Wong, Brian J. F.

doi:10.1001/jamafacial.2015.1838

Cited by 6 publications

(4 citation statements)

References 56 publications

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“…Hence, it is worthy of exploring the optimal structure of the costal cartilage ear framework to earn better stabilization with minimal stress/strain under continuous suction pressure. Based on the modified Nagata technique and the clinical experiences, the helix, antihelix, scapha, and fossa triangularis are essential to maintain the base frame of the auricular morphological features that their fabrication had generally reached a consensus among the global surgeons ( Gandy et al, 2016 ; Wang et al, 2016 ). All these structures typically were sculpted as the reference with the parental or contralateral healthy ears ( Li et al, 2018 ).…”

Section: Discussionmentioning

confidence: 99%

Shape Optimization of Costal Cartilage Framework Fabrication Based on Finite Element Analysis for Reducing Incidence of Auricular Reconstruction Complications

Zhong

Chen

Zhao

et al. 2021

Front. Bioeng. Biotechnol.

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Skin necrosis is the most common complication in total auricular reconstruction, which is mainly induced by vascular compromise and local stress concentration of the overlying skin. Previous studies generally emphasized the increase in the skin flap blood supply, while few reports considered the mechanical factors. However, skin injury is inevitable due to uneasily altered loads generated by the intraoperative continuous negative suction and uneven cartilage framework structure. Herein, this study aims to attain the stable design protocol of the ear cartilage framework to decrease mechanical damage and the incidence of skin necrosis. Finite element analysis was initially utilized to simulate the reconstructive process while the shape optimization technique was then adopted to optimize the three-pretested shape of the hollows inside the scapha and fossa triangularis under negative suction pressure. Finally, the optimal results would be output automatically to meet clinical requirement. Guided by the results of FE-based shape optimization, the optimum framework with the smallest holes inside the scapha and fossa triangularis was derived. Subsequent finite element analysis results also demonstrated the displacement and stress of the post-optimized model were declined 64.9 and 40.1%, respectively. The following clinical study was performed to reveal that this new design reported lower rates of skin necrosis decrease to 5.08%, as well as the cartilage disclosure decreased sharply from 14.2 to 3.39% compared to the conventional method. Both the biomechanical analysis and the clinical study confirmed that the novel design framework could effectively reduce the rates of skin necrosis, which shows important clinical significance for protecting against skin necrosis.

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Section: Discussionmentioning

confidence: 99%

Shape Optimization of Costal Cartilage Framework Fabrication Based on Finite Element Analysis for Reducing Incidence of Auricular Reconstruction Complications

Zhong

Chen

Zhao

et al. 2021

Front. Bioeng. Biotechnol.

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“…In our department, we use the full-sized cartilage models for resembling the most realistic framework in these patient-specific operations. This benefit may not be achieved through sculpturing various other materials 17–20 . Fabrication simulation using these cartilage models can assess the cartilages more intuitively and further determine an appropriate graft amount to be harvested, thus avoiding excessive logging.…”

Section: Discussionmentioning

confidence: 99%

“…This benefit may not be achieved through sculpturing various other materials. [17][18][19][20] Fabrication simulation using these cartilage models can assess the cartilages more intuitively and further determine an appropriate graft amount to be harvested, thus avoiding excessive logging. Decreased amount of harvested grafts will decrease the incidence of chest wall deformity which is 1 of the major complications for autogenous cartilage microtia reconstruction and may further cause secondary spinal deformity.…”

Section: Discussionmentioning

confidence: 99%

Three-Dimensional Auricular Subunit Models for Cartilage Framework Fabrication: Our Preliminary Experience

Wang

et al. 2021

Journal of Craniofacial Surgery

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Background: Three-dimensional (3D) digital imaging and printing techniques have been popularly applied in microtia reconstruction. However, there is a lack of clinical report of using them to create 3D printed ear subunit models for cartilage framework fabrication. Methods: A retrospective study of patients who underwent auricle reconstruction with 3D templates was performed. Patients' demography, surgical complications, framework accuracy, and aesthetic outcomes of the reconstructed auricles were analyzed. Results: Twenty cases included in this study. Complications were minor. The average (median) assessing scores for the framework quality and the reconstructed auricle aesthetics were 8.50 (8) and 8.30 (8), respectively. Conclusions: Our study found that the use of custom-printed tridimensional ear subunit models achieved a relatively high framework precision and gained good outcomes of the reconstructed ears.Level of Evidence: Level IV.

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“…17,18 Autologous costal cartilage is widely used in plastic surgery procedures (such as rhinoplasty, ear microtia reconstruction, and skull reconstruction) because it does not lead to complications. [19][20][21] Autogenous costal cartilage can be extracted in large quantities and poses few problems during healing. 22 The technology of the entire cartilaginous sheath is evolving, reflecting an improvement in shape, each time including new framework elements.…”

Section: ▪ Type Imentioning

confidence: 99%

Reconstruction of Post-Traumatic Defects of the External Ear and Nose With Autologous Costal Cartilage

Shahparonyan¹

2023

JBSMFS

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Traumatic ear amputation and post-traumatic nose defect are aesthetic deformities that can have negative consequences (lead to psychological trauma), leading to a change in the quality of life. The presented clinical case describes a protocol for the reconstruction of a partially amputated defect of the external ear and nose, which required various surgical steps; including the removal of cartilage from the ribs, followed by the creation of a cartilaginous model of the ear, the introduction of its subcutaneous region behind the ear, taking into account the anatomy of the outer ear as much as possible. The second stage after 1.5 months is the restoration of the amputated ear area with a combined superficial temporal fascial flap, costal cartilage with suturing to the amputated part of the ear and dorsal rhinoplasty using modeling costal autocartilaginous flap. The postoperative result is satisfactory with the restoration of a good aesthetic appearance of the ear and nose. Reconstruction of the external ear after partial traumatic amputation and post-traumatic nose defect with autocartilage from the ribs provides a stable aesthetic result and becomes the method of choice for such injuries.

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Modular Component Assembly Approach to Microtia Reconstruction

Cited by 6 publications

References 56 publications

Shape Optimization of Costal Cartilage Framework Fabrication Based on Finite Element Analysis for Reducing Incidence of Auricular Reconstruction Complications

Shape Optimization of Costal Cartilage Framework Fabrication Based on Finite Element Analysis for Reducing Incidence of Auricular Reconstruction Complications

Three-Dimensional Auricular Subunit Models for Cartilage Framework Fabrication: Our Preliminary Experience

Reconstruction of Post-Traumatic Defects of the External Ear and Nose With Autologous Costal Cartilage

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