Ultrasonographische Haut- und Knorpeldickenmessungen an gesunden und rekonstruierten Ohren mit einem 20-MHz-Ultraschallgerät*

Danter, J.; Siegert, R.; Weerda, Hilko

doi:10.1055/s-2007-997542

Cited by 16 publications

(8 citation statements)

References 1 publication

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“…The cartilage thicknesses at the region of modification for the rabbit and pig ears were approximately 0.2 and 0.8 mm, respectively. This supports the use of needle-based EMR in the reshaping of human ear, because the thickness of human ear, approximately 0.6 mm, falls within the range of thicknesses investigated in our study 5. However, it is likely that in the clinical reshaping of human ears some degree of overcorrection will be needed, at least in areas of thicker tissue.…”

Section: Discussionsupporting

confidence: 85%

Needle Electrode-Based Electromechanical Reshaping of Cartilage

et al. 2010

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Electromechanical reshaping (EMR) of cartilage provides an alternative to the classic surgical techniques of modifying the shape of facial cartilages. The original embodiment of EMR required surface electrodes to be in direct contact with the entire cartilage region being reshaped. This study evaluates the feasibility of using needle electrode systems for EMR of facial cartilage and evaluates the relationships between electrode configuration, voltage, and application time in effecting shape change. Flat rabbit nasal septal cartilage specimens were deformed by a jig into a 90° bend, while a constant electric voltage was applied to needle electrodes that were inserted into the cartilage. The electrode configuration, voltage (0–7.5 V), and application time (1–9 min) were varied systematically to create the most effective shape change. Electric current and temperature were measured during voltage application, and the resulting specimen shape was assessed in terms of retained bend angle. In order to demonstrate the clinical feasibility of EMR, the most effective and practical settings from the septal cartilage experimentation were used to reshape intact rabbit and pig ears ex vivo. Cell viability of the cartilage after EMR was determined using confocal microscopy in conjunction with a live/dead assay. Overall, cartilage reshaping increased with increased voltage and increased application time. For all electrode configurations and application times tested, heat generation was negligible (<1 °C) up to 6 V. At 6 V, with the most effective electrode configuration, the bend angle began to significantly increase after 2 min of application time and began to plateau above 5 min. As a function of voltage at 2 min of application time, significant reshaping occurred at and above 5 V, with no significant increase in the bend angle between 6 and 7.5 V. In conclusion, electromechanical reshaping of cartilage grafts and intact ears can be effectively performed with negligible temperature elevation and spatially limited cell injury using needle electrodes.

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Section: Discussionsupporting

confidence: 85%

Needle Electrode-Based Electromechanical Reshaping of Cartilage

et al. 2010

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“…To advance toward clinical trials, the safety and efficacy of EMR on living tissue must be assessed. 14 This study demonstrated that EMR technology can be applied along the entire width of the auricle to create shape change, without complications of major skin injury, necrosis, or infection. Skin injury merits discussion because the electrodes were in contact with the skin and cartilage during the procedure.…”

Section: Commentmentioning

confidence: 78%

In Vivo Electromechanical Reshaping of Ear Cartilage in a Rabbit Model

Oliaei

Manuel²,

Karam³

et al. 2013

JAMA Facial Plast Surg

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“…The feasibility of this technology is further supported by findings from anatomical studies that show that the thickness of the skin, subcutaneous tissues, and auricular cartilage in the rabbit are similar to that of the human ear—especially in the pediatric population. 12 Cryogen spray cooling allows protection of the skin from severe thermal injury while facilitating substantial subsurface temperature elevations, at least above threshold values required for cartilage shape change. Heating cartilage results in a change in the material properties of this tissue that facilitates shape change and is manifested by accelerated stress relaxation.…”

Section: Commentmentioning

confidence: 99%

Minimally Invasive Ear Reshaping With a 1450-nm Diode Laser Using Cryogen Spray Cooling in New Zealand White Rabbits

Holden

Chlebicki

Wong

2009

Arch Facial Plast Surg

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Background Otoplasty is the current standard of care for treating prominent ears, a psychologically and sometimes functionally disabling disorder. The technically demanding procedure carries many risks such as poor aesthetic outcome, need for revision surgery, and need for general anesthesia. This study investigates the use of laser irradiation combined with cryogen skin cooling and stenting to reshape cartilage in the ears of New Zealand white rabbits. Methods In this prospective, randomized, internally controlled animal study, the right ears of 9 rabbits were mechanically deformed with a jig and then irradiated with a 1450-nm diode laser combined with cryogen skin cooling (14 J/pulse with cryogen spray for 33 milliseconds per cycle and a 6-mm spot size). The left ear served as the control. The ears were splinted for 1, 3, or 4 weeks. The rabbits were then given a lethal dose of intravenous pentobarbital, and the splints were removed and ears examined and photographed. Light and confocal microscopy were performed on the specimens. Results Shape change was observed in all 9 treated rabbit ears, while none of the control ears (stenting alone) showed significant change. Qualitatively, reshaped ears were stiffer after 4 weeks of splinting than after 1 or 3 weeks. None of the rabbits showed evidence of skin injury nor did they show signs of postprocedural pain. Findings from histologic analysis in the treated areas showed evidence of an expanded chondrocyte population in the region of laser irradiation, along with some perichondrial thickening and some fibrosis of the deep dermis. Confocal microscopy revealed minimal cellular death at 1 week and none thereafter. Conclusions Cartilage reshaping using laser energy can be performed safely transcutaneously using cryogen spray cooling in rabbits. This animal model has similarity to human ears with regard to skin and cartilage thickness and is a stepping stone toward developing minimally invasive laser auricle reshaping in humans.

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Ultrasonographische Haut- und Knorpeldickenmessungen an gesunden und rekonstruierten Ohren mit einem 20-MHz-Ultraschallgerät*

Abstract: The 20-MHz B-Mode ultrasound is suitable for examining the methods of plastic surgery in malformed auricles. Based on the demonstrated results, surgical modifications should be assessed in future.

Cited by 16 publications

References 1 publication

Needle Electrode-Based Electromechanical Reshaping of Cartilage

Needle Electrode-Based Electromechanical Reshaping of Cartilage

In Vivo Electromechanical Reshaping of Ear Cartilage in a Rabbit Model

Minimally Invasive Ear Reshaping With a 1450-nm Diode Laser Using Cryogen Spray Cooling in New Zealand White Rabbits

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