Teaching Ear Reconstruction Using an Alloplastic Carving Model

Murabit, Amera; Anzarut, Alexander; Kasrai, Laila; Fisher, David M.; Wilkes, Gordon H.

doi:10.1097/scs.0b013e3181f3c755

Cited by 19 publications

(25 citation statements)

References 5 publications

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“…Non-absorbable frames, such as silastic or high-density polyethylene (Medpor®), generate an excellent ear shape without donor site morbidity, but they lack bioactivity and can lead to extrusion and infections. Autologous rib cartilage transplantation is the current gold-stand treatment for microtia, but harvesting rib cartilage inevitably leads to donor site injury, and replicating the complex 3D ear structure is hard to achieve using surgeons’ hand skill, which is highly depended on the training background and clinical experiences ( Breugem et al, 2011 , Han et al, 2015 , Magritz and Siegert, 2014 , Murabit et al, 2010 ).…”

Section: Introductionmentioning

confidence: 99%

In Vitro Regeneration of Patient-specific Ear-shaped Cartilage and Its First Clinical Application for Auricular Reconstruction

et al. 2018

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Microtia is a congenital external ear malformation that can seriously influence the psychological and physiological well-being of affected children. The successful regeneration of human ear-shaped cartilage using a tissue engineering approach in a nude mouse represents a promising approach for auricular reconstruction. However, owing to technical issues in cell source, shape control, mechanical strength, biosafety, and long-term stability of the regenerated cartilage, human tissue engineered ear-shaped cartilage is yet to be applied clinically. Using expanded microtia chondrocytes, compound biodegradable scaffold, and in vitro culture technique, we engineered patient-specific ear-shaped cartilage in vitro. Moreover, the cartilage was used for auricle reconstruction of five microtia patients and achieved satisfactory aesthetical outcome with mature cartilage formation during 2.5 years follow-up in the first conducted case. Different surgical procedures were also employed to find the optimal approach for handling tissue engineered grafts. In conclusion, the results represent a significant breakthrough in clinical translation of tissue engineered human ear-shaped cartilage given the established in vitro engineering technique and suitable surgical procedure.This study was registered in Chinese Clinical Trial Registry (ChiCTR-ICN-14005469).

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Section: Introductionmentioning

confidence: 99%

In Vitro Regeneration of Patient-specific Ear-shaped Cartilage and Its First Clinical Application for Auricular Reconstruction

et al. 2018

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“…In addition, they can be shaped to resemble costal cartilage, adding the realism of rib shape and handling characteristics to the carving model. 5,6 Yamada et al 7 found the model to be less stiff than real costal cartilage. Consequently, working with surgical instruments on a silicone model will not simulate real surgery.…”

Section: Discussionmentioning

confidence: 98%

“…These are freely available, but not analogous in any manner to TECHNICAL STRATEGY the clinical setting. 5,6 Cadaver cartilage may most closely reflect the anatomy of live patients but is less freely available and often calcified because of age of the deceased, difficulty to carve, and lack of flexibility. 6 Silicone models have been introduced.…”

Section: Discussionmentioning

confidence: 99%

A Porcine Rib Cartilage Model for Practicing Ear-Framework Fabrication

Shin

Hong

2013

Journal of Craniofacial Surgery

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Surgical training models should be readily available to enable practice in vitro until the trainee is comfortable with the procedure. It is also important that the anatomy of the training model sufficiently resembles that of humans. Here, we present our model for training surgeons to fabricate costal cartilage for total ear reconstruction, using porcine rib cartilage. Pig ribs are very familiar and available at grocery stores at a low cost. The greatest advantage of this training model is the realistic anatomy and tactile nature similar to that of human cartilage. Using this training model, trainees could learn how to fabricate an auricular framework that is stable and aesthetically pleasing.

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“…Although Brent [ 8 ] recommended the use of human cadaver rib cartilage for the framework training, the use of cadaver cartilage does not simulate live donor cartilage as it is stiff and brittle; moreover, it is not freely available. [ 6 9 ] Recently, the use of animal cartilages including bovine scapula and porcine rib has been proposed for framework training. [ 11 12 ] Those materials are very similar to human rib cartilage and are relatively available on the market, but they present the potential risk of disease transmission.…”

Section: Discussionmentioning

confidence: 99%

“…[ 5 ] As artistic sense, surgical aptitude and personal effort are all required for a successful outcome,[ 3 ] inexperienced surgeons need training to improve their surgical skills. To that end, a workshop-based instructional programme was successfully conducted in Canada,[ 6 ] where a silicone costal cartilage model was employed for the ear framework. Thus far, the use of many different materials for the framework training models has been described, but each has disadvantages including limited availability and/or lack of realism.…”

Section: Introductionmentioning

confidence: 99%

Use of a plastic eraser for ear reconstruction training

Erdogan

Morioka

Hamada

et al. 2018

Indian J Plast Surg

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Background:Microtia reconstruction is a challenging procedure, especially in developing nations. The most complex part is learning how to fabricate a framework from costal cartilage. We herein propose a training regimen for ear reconstruction with the use of a plastic eraser.Materials and Methods:The texture of a plastic eraser made from polyvinyl chloride is similar to that of human costal cartilage. The first step of the training is carving out the sixth through eighth rib cartilages from a block of plastic eraser. The second step is a fabrication of the framework from plastic rib cartilages, referring to a template from the intact auricle.Results:As plastic erasers are inexpensive and universally available, inexperienced surgeons can repeatedly perform this framework training. Following several of these training sessions in developing nations, the co-authors and local surgeons successfully performed their microtia reconstructions in a reasonable operative time.Conclusions:This realistic carving model allows surgeons to gain experience before performing an actual ear reconstruction, even in resource-constrained circumstances.

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Teaching Ear Reconstruction Using an Alloplastic Carving Model

Abstract: An appropriate and applicable surgical training model and training method can aid in attaining skills necessary for successful auricular reconstruction.

Cited by 19 publications

References 5 publications

In Vitro Regeneration of Patient-specific Ear-shaped Cartilage and Its First Clinical Application for Auricular Reconstruction

In Vitro Regeneration of Patient-specific Ear-shaped Cartilage and Its First Clinical Application for Auricular Reconstruction

A Porcine Rib Cartilage Model for Practicing Ear-Framework Fabrication

Use of a plastic eraser for ear reconstruction training

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