Objective To investigate the biochemical differences between the cartilage of the residual ear of microtia patient and normal person. Methods Seven cartilage specimens from 7 about 10-years-old microtia patient's residual ears and 7 normal ears from cadaver of the same age were measured by electrophoretic mobility shift assay and spectrophotometer for collagen glycoaminoglycan (GAG), chondroitin sulfate (Chs), hyaluronan (HA) and keratin sulfate (KS) .Results Biochemical analysis showed that no significant difference were found in the collagen contents of the two groups. The microtia cartilage had more GAG (49.00?25.60) ?g/mg than that of the normal (28.25?4.80) ?g/mg. The composition of GAG were different between two groups: microtia group (HA 38.96+4.97 %, Chs 29.02 %?4.12 %, KS 32.16 %?7.41) % and normal group (HA 32.94 %?3.24 %, Chs 33.10 %?2.61%, KS 33.96 %?1.66 %). There were differences in HA and Chs relative contents, but not in KS between the two groups. Conclusions There is no difference in the collagen content between normal and microtia ear cartilage. But the latter has more GAG than the former. As for the constitution of GAG, microtia cartilage has a higher percentage of HA, lower percentage of Chs, and no significant difference in KS.

Objective To investigate the possibility of using poly-hydroxybutyate-hydroxyhexate p(3HB-co-3HH)), a modified extracellular matrix, the third generation of PHA family, as a scaffold for seeding of chondrocytes from the residual ear of microtia patients to generate tissue engineered cartilage in athymus mice. Methods The residual ear cartilage from eight 7-years-old microtia patients was enzymatically dissolved by collagenase, and chondrocytes were harvested and seeded into foams of PHB-PHH. After incubation for 1 week in vitro, chondrocyte-polymer constructs were implanted subcutaneously into 8 athymus mice. A control groups was established by subcutaneous implantation of PHB-PHH foams alone. One athymus mice were killed at 4 weeks postoperatively, and 6 were sacrificed at 8 weeks. The specimens were dissected and examined macroscopically and histologically. Results Specimens harvested from chondrocyte-polymer constructs subjected to gross morphologic and histology analysis demonstrated new cartilage formation, and those from control groups showed no cartilage formation. The one of 4 weeks still had some remains of the scaffold with nodules of neocartilage. After 8 weeks, all the 6 mice had neocartilage formed almost the same as natural. The PHB-PHH scaffold were totally absorbed. Conclusion These findings demonstrate that the foam of PHB-PHH is not only a good "matrix" for cartilage tissue engineering, but also optimal scaffold for the seeding of chondrocytes from the residual ear to generate new cartilage that would be useful in plastic and reconstructive surgery. Chondrocytes from the residual ear of microtia patients are good candidates for generation of tissue engineered cartilage.

Objective To investigate the effect of treatment for la rg e-sized auricular nevus through split-thickness grafting over perichondrium. Methods In the six cases with large-sized and giant cong enital melanocytic nevi of the auricle, the auricular lesions were radically exc ised in stages, and each time followed by split-thickness skin grafting. The ou tcome was evaluated. Results The grafts completely surviv ed. During the time of follow-up ranging from one to two years, the grafts expe rienced no contraction, and auricular deformity did not occur. Conclu sion Treatment of large-sized auricular nevus through staged split -thickness skin grafting over perichondrium is simple and reliable.

Objective To investigate the effects of substance P (SP) on the expression of apoptosis-associated genes in fibroblasts derived from pathological scars. Methods Fibroblasts derived from keloid, hypertrophic scar and normal skin were cultured separately in media containing SP and SP receptor antagonist. PCNA, bcl-2 and bax protein in fibroblasts were assessed by means of immunohistochemistry. Results SP enhanced PCNA and bcl-2 expression in all three kinds of fibroblasts, whereas, bax expression was inhibited significantly. SP inhibited the expression of bax in keloid scar fibroblasts (KSFB) more remarkably than that in hypertrophic scar fibroblasts (HSFB) or normal fibroblasts (NFB), and the effect was stronger on HSFB than on NFB. SP receptor antagonist could inhibit those effects of SP totally or partially. Conclusion SP may play an important role in the formation of pathological scars by modulating the expression of apoptosis-associated genes, which is mediated by SP receptor.

Objective: To explore the psycho-social and behavioral outcomes of microtia children and psychological health of their parents after microtia reconstruction, and to observe the effects of microtia reconstruction on the psycho-social health of microtia children and their parents. Methods: 72 patients were recruited and investigated for their psycho-social behavioral problems with Achenbach′s Child Behavior Checklist (CBCL). Their parents were investigated for psychological health with symptom checklist 90 (SCL-90). The patients and their parents were both assessed with questionnaire before the after operation (6 to 12months post-operation). Results: After microtia reconstruction, the scores of CBCL and SCL-90 decreased significantly.①As determined from CBCL, after operation the scores of activity and sociality ability of the patients increased with significant difference in statistics (P<0. 01). The behavioral problems raw scores were lower than that of pre-operation. The percentage of behavioral problems of the microtia children decreased significantly compared with that before operation, it was significant in statistics (P<0. 01). ②As determined from SCL- 90, it is found out that the general scores and the number of positive items of the parents with microtia children decreased with significant difference in statistics (P<0.01). The scores of SCL-90 factors decreased with a significant difference in statistics (P<0.05). Conclusions There was significant improvement in the psycho-social behavioral outcomes of microtia children and their patients after microtia reconstruction. There is a positive effect of microtia reconstruction on microtia children and their parents.

Objective:To explore the technique of two-flap in ear reconstruction.Method:Quantitative tissue expansions were used in the mastoid area in the first stage.After the final injection,there was 1 month of sustaining time.Expanded skin flap and unexpanded fascia flap were designed in the second stage,so thetwo-flaptechnique was used in the ear reconstruction.From January 2004 to December 2008,1 427 patients of microtia were treated using two-flap technque.Result:The expanded skin flap could show the fine structures of the reconstructed ears.The reconstructed ears had vivid cranioauricular angle after using the unexpanded fascia flap.Conclusion: Two-flap method was easily manipulated and the complications were rare.The reconstructed ears had lucid and three-dimensional contour.

OBJECTIVETo investigate the feasibility of ear reconstruction using local expanded scarred skin flap.

METHODWe used local postauricular expanded scar skin flaps to reconstruct external ear in 24 patients.

RESULTSOf these cases, 22 flaps survived completely. In 2 patients, the cartilage framework exposed over the upper pole of helix region because of undue tension in suturing the tissue edges. One year's follow-up revealed satisfactory results.

CONCLUSIONUsing the expanded scarred skin flap for ear reconstruction is practical and effective, when there's no normal skin available in the local area.

Adolescent ; Adult ; Child ; Ear, External ; surgery ; Female ; Humans ; Male ; Rhinoplasty ; Surgical Flaps ; Tissue Expansion

Objective To explore the protective affect of individual earmuffs in microtia reconstruction using tissue expander.Methods 95 patients performed the implantation of tissue expander had been grouped into the experimental group(49 cases)and the control group(46 cases).Patients in the experimental group wore individual earmuffs,whereas patients in the control group wore traditional earmuffs.The survey including the information of patients' experience in wearing the earmuffs was carried out on the day when patients were given auricular reconstruction.Data collected from the two groups were analyzed to evaluate the aspects of permeability and safety.Results Patients in the experimental group complained less discomfort in sultry in permeability and tinnitus than patients in the control group.From the perspective of safety,there was no complaints of mosquitoes climbing into the earmuffs from the two groups.Because of the good adhesiveness of the individual earmuffs to the skin,the incidence of redness of skin in the experimen tal group was significantly lower than that in the control group.Conclusions Individual earmuff is a safe and comfortable nursing appliance which is practical for clinical application because of its good permeability,adhesiveness and less incidence of redness of skin.

OBJECTIVELow hairline is one of the most troublesome problem in auricle reconstruction. There was no satisfactory way to manage the problem. This article discuss surgical depilation to deal with this problem and reconstructed auricle.

METHODSAccording to the degree of the low hairline, Postaurical scalp was expanded and part of the lower follicles within the dermal were removed, or postaurical scalp that part of lower follicles and dermal had been removed was expanded and covered skeleton of ear with this expanded skin to reconstructed auricle.

RESULTSAuricles were reconstructed with this method in 152 lowhairline microtial cases, the result was very satisfactory.

CONCLUSIONThis procedure is an effective way to deal with low hairline in reconstructing auricle.

Adolescent ; Adult ; Child ; Ear, External ; abnormalities ; surgery ; Female ; Hair Removal ; methods ; Humans ; Male ; Reconstructive Surgical Procedures ; methods ; Scalp ; surgery ; Surgical Flaps ; Tissue Expansion

OBJECTIVE: To explore the role of vrk1 gene in two Chinese pedigrees of the first and second branchial arch syndrome. METHOD: Sixty members in 2 Chinese pedigrees were recruited. The exon 2 -13 were analyzed by polymerase chain reaction and direct sequencing. RESULT: We found a new SNP in proband of Shandong pedigree. CONCLUSION vrk1 gene mutation can be excluded in 2 Chinese pedigrees of the first and second branchial arch syndrome.
Asian Continental Ancestry Group ; genetics ; Branchial Region ; Exons ; Female ; Humans ; Intracellular Signaling Peptides and Proteins ; genetics ; Macrostomia ; genetics ; Male ; Mutation ; Pedigree ; Protein-Serine-Threonine Kinases ; genetics ; Syndrome