Strategies for ear elevation and the treatment of relevant complications in autologous cartilage microtia reconstruction

Xu, Zhicheng; Li, Yiyuan; Li, Datao; Zhang, Ruhong; Zhang, Qun; Xu, Feng; Chen, Xia

doi:10.1038/s41598-022-17007-3

Sci Rep

2022

DOI: 10.1038/s41598-022-17007-3

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Strategies for ear elevation and the treatment of relevant complications in autologous cartilage microtia reconstruction

Zhicheng Xu

Yiyuan Li

Datao Li

et al.

Abstract: Despite various surgical techniques for ear elevation in autogenous cartilage microtia reconstruction, it is still challenging for plastic surgeons to obtain a satisfactory depth of the cephaloauricular sulcus and stable projection of the reconstructed ear. Here, the authors demonstrate individualized options for surgical approaches and relevant details for complication management. Between January 2014 and June 2020, a series of 895 patients who underwent the second stage of microtia reconstruction were review… Show more

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Cited by 3 publications

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“Mortise and Tenon Joint” Technique to Improve the Stability of Three-Dimensional Costal Cartilage Framework in Fully Expansion Ear Reconstruction

Yang,

Pan,

2024

Journal of Craniofacial Surgery

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Objective: For full expansion of ear reconstruction, the stability of a cartilage framework is very important. However, most techniques for framework fabrication focus on three-dimensional structure and adequate projection. Few studies are available on improving the stability of the reconstructed framework. This study introduces a new “mortise and tenon joint” technique to create a more stable framework in fully expansion ear reconstruction. Methods: A total of 137 patients with microtia underwent full expansion ear reconstruction with the “mortise and tenon joint” technique from January 2018 to July 2022. Results: Hematoma was found in 2 patients after the expander was implanted and evacuated timely to save the flap. Ear cartilage framework exposure occurred in 3 patients after the second stage of surgery. The wounds were debridement and covered by a retroauricular fascia flap with a skin graft. No other complications, such as infection, expander exposure, or rupture, were observed. All patients were followed up for 6 to 12 months after ear reconstruction and asked to fill in a form anonymously about their satisfaction with the reconstructed ear. One hundred thirty-four patients (97.8%) were satisfied with the results. Conclusions: In fully expansion ear reconstruction, the “mortise and tenon joint” technique improves not only the stability of the cartilage framework but also the stereoperception of the reconstructed ear. Most patients who underwent the new technique were satisfied with clear contour and delicate substructures of the reconstructed ear, matched skin color, and long-term dimensional stability.

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“Mortise and Tenon Joint” Technique to Improve the Stability of Three-Dimensional Costal Cartilage Framework in Fully Expansion Ear Reconstruction

Yang,

Pan,

2024

Journal of Craniofacial Surgery

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Strategies of Total Auricular Reconstruction for Patients With Poor Skin Coverage at the Mastoid Area

et al. 2023

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Objective Burns and injuries can lead to massive defects in the mastoid tissues, which increase the difficulty of ear reconstruction. It is crucial to choose an appropriate surgical method for these patients. Here, we introduce strategies for auricular reconstruction in patients without satisfactory mastoid tissues. Methods From April 2020 to July 2021, 12 men and 4 women were admitted to our institution. Twelve patients were severely burned, 3 patients experienced car accidents, and 1 patient had a tumor on his ear. The temporoparietal fascia was used for ear reconstruction in 10 cases, and the upper arm flap was used in 6 cases. All of the ear frameworks were made of costal cartilage. Results The location, size, and shape of both sides of the auricles were generally the same. Two patients needed further surgical repair because of cartilage exposure at the helix. All of the patients were satisfied with the outcome of the reconstructed ear. Conclusion For patients with ear deformity and poor skin coverage in the mastoid area, we can choose the temporoparietal fascia if the patient’s available superficial temporal artery is longer than 10 cm. If not, we can choose the upper arm flap. The latter needs a five-stage operation, which is more time consuming and difficult than the former. Moreover, the expanded upper arm flap is thinner and has better elasticity than the temporoparietal fascia, so the shape of the reconstructed ear is better. We need to evaluate the condition of the affected tissue and choose the appropriate surgical method to achieve a good result.

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Challenges in tendon–bone healing: emphasizing inflammatory modulation mechanisms and treatment

Jiang,

Zhao,

Zhang

et al. 2024

Front. Endocrinol.

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Tendons are fibrous connective tissues that transmit force from muscles to bones. Despite their ability to withstand various loads, tendons are susceptible to significant damage. The healing process of tendons and ligaments connected to bone surfaces after injury presents a clinical challenge due to the intricate structure, composition, cellular populations, and mechanics of the interface. Inflammation plays a pivotal role in tendon healing, creating an inflammatory microenvironment through cytokines and immune cells that aid in debris clearance, tendon cell proliferation, and collagen fiber formation. However, uncontrolled inflammation can lead to tissue damage, and adhesions, and impede proper tendon healing, culminating in scar tissue formation. Therefore, precise regulation of inflammation is crucial. This review offers insights into the impact of inflammation on tendon–bone healing and its underlying mechanisms. Understanding the inflammatory microenvironment, cellular interactions, and extracellular matrix dynamics is essential for promoting optimal healing of tendon–bone injuries. The roles of fibroblasts, inflammatory cytokines, chemokines, and growth factors in promoting healing, inhibiting scar formation, and facilitating tissue regeneration are discussed, highlighting the necessity of balancing the suppression of detrimental inflammatory responses with the promotion of beneficial aspects to enhance tendon healing outcomes. Additionally, the review explores the significant implications and translational potential of targeted inflammatory modulation therapies in refining strategies for tendon–bone healing treatments.

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Strategies for ear elevation and the treatment of relevant complications in autologous cartilage microtia reconstruction

Cited by 3 publications

References 37 publications

“Mortise and Tenon Joint” Technique to Improve the Stability of Three-Dimensional Costal Cartilage Framework in Fully Expansion Ear Reconstruction

“Mortise and Tenon Joint” Technique to Improve the Stability of Three-Dimensional Costal Cartilage Framework in Fully Expansion Ear Reconstruction

Strategies of Total Auricular Reconstruction for Patients With Poor Skin Coverage at the Mastoid Area

Challenges in tendon–bone healing: emphasizing inflammatory modulation mechanisms and treatment

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