Objective:This study was aimed to evaluate the clinical effectiveness of tympanoplasty using auricular cartilage combined with balloon eustachian tuboplasty for the treatment of adhesive otitis media（adhesive otitis media, AdOM） under endoscopic. Methods:A retrospective analysis was conducted on 60 patients with unilateral adhesive otitis media who visited Department of Otolaryngology Head and Neck Surgery, the First Affiliated Hospital of Xiamen University between January 2017 and February 2022. All patients were divided into three groups: ①conservative treatment group;②simple tympanoplasty group; ③tympanoplasty combined with balloon dilation group（BET group）. All patients were regularly assessed for the improvement of tympanic membrane morphology, hearing, and Eustachian tube function, as well as complications, after treatment. Results:There was no significant improvement in eardrum morphology, hearing, or eustachian tube function in the conservative treatment group（P>0.05）; both the simple tympanoplasty group and the BET group showed significant improvements in eardrum morphology and hearing after surgery（P<0.01）; In terms of Eustachian tube function improvement, the BET group showed significantly greater improvements in Eustachian tube manometry（TMM） and Eustachian Tube Dysfunction Questionnaire（ETDQ-7） scores compared to the tympanoplasty alone group（P<0.01）. Conclusion:Tympanoplasty using auricular cartilage combined with balloon eustachian tuboplasty shows good clinical outcomes in the treatment of adhesive otitis media, significantly ameliorating patients' subjective symptoms such as tinnitus and ear congestion after surgery, thereby improving the patient's quality of life.
Humans ; Eustachian Tube/surgery* ; Retrospective Studies ; Tympanoplasty/methods* ; Otitis Media/surgery* ; Ear Cartilage/surgery* ; Endoscopy ; Dilatation ; Treatment Outcome ; Male ; Female ; Adult ; Middle Aged

OBJECTIVES: Rhinoplasty is one of the most common cosmetic surgeries in China. Septal extension grafts (SEG) have been widely used in rhinoplasty, but there are few reports on SEG derived from ear cartilage. This study aims to explore the effectiveness and stability of auricular cartilage nasal SEG transplantation in Chinese rhinoplasty. METHODS: A retrospective analysis of 35 rhinoplasty patients admitted from September 2019 to March 2022 has been conducted. Among them, 29 patients underwent rhinoplasty for the first time and 6 patients underwent rhinoplasty with the age of 18-32 (average 22.4) years old. The postoperative follow-up was 3-28 (average 18.5) months. The improvement of the nose shape was observed. The changes of the nose tip angle, nasolabial angle, and nasofrontal angle were compared between before and after the operation, and the complications were recorded. RESULTS: All patients who underwent rhinoplasty with a septal extension grafts constructed from the concha cavity and concha cartilage showed significant improvement in nasal contour. The preoperative nasal tip angle, nasolabial angle, and nasofrontal angle were significantly improved compared with 3 months after operation (all P<0.001), and there was no significant difference between 3 months and 14 months after operation (all P>0.05). The appearance of nasal cavity was satisfactory in 32 patients after operation. Columella deviation occurred in 2 patients and 1 patient complained of downward rotation of the nasal tip, which was satisfied after readjustment of the graft. CONCLUSIONS The simplified SEG derived from auricular cartilage can provide stable support for the nasal tip, the nasal shape is natural after operation, and minimal trauma of unilateral auricle cartilage transplantation remains.
Humans ; Young Adult ; Adult ; Rhinoplasty ; Ear Cartilage/transplantation* ; Retrospective Studies ; Nasal Septum/transplantation* ; Plastic Surgery Procedures

Objective: To explore the feasibility of reconstruction of nasal tip with septal cartilage and auricular cartilage. Methods: From September 2018 to October 2019, 17 patients (two males and fifteen females) with low noses underwent rhinoplasty under general anesthesia. The age of the patients ranged from 19 to 39, with an average of 27 years old. Among them, all the 17 cases were primary rhinoplasty. During the operation, autologous nasal septum cartilage was used as septal extension graft to extend the caudal septum, and the auricular cartilage was used to enhance the stability of the strut and to elevate the tip for adjusting the shape of nose by making into spreader graft, columellar strut graft, derotation graft and onlay graft. The nasal dorsum was filled with polytetrafluoroethylene. Digital scanning technology was used to evaluate the nasal structure before and after operation. SPSS 22 software was used to analyze the data with paired t-test. Results: The follow-up was from 6 to 12 months, with an avaerge of 7.6 months. Seventeen patients were satisfied with postoperative nasal morphology and height. There was no infection, prosthesis displacement, skin flap necrosis, no auricle deformation and other complications. Statistical software SPSS 22 performed paired t-test on the preoperative and postoperative data obtained by digital technology: postoperative nasal length and nasal tip protrusion increased compared with that before surgery, and it was statistically significant(length:(3.60±0.77)mm, tip protrusion:(3.61±0.64)mm, t value was -19.203 and -23.132 respectively, both P<0.001). The nasolabial Angle was smaller than that before surgery, and the data were statistically significant(3.40°±2.11°,t=6.635, P<0.001). Conclusion: The nasal tip and nasal septum extension complex constructed by autogenous nasal septal cartilage combined with auricular cartilage can increase the length of nasal tip, increase the height of nasal tip and reduce the angle of nasolabial angle.
Adult ; Ear Cartilage ; Female ; Humans ; Male ; Nasal Cartilages/surgery* ; Nasal Septum/surgery* ; Nose/surgery* ; Prostheses and Implants ; Rhinoplasty ; Young Adult

Objective: To investigate the curative effect of rib cartilage framework supporting combined with local flap grafting for correction of cryptotia. Methods: Fourteen cases (nineteen ears) were corrected by rib cartilage framework supporting combined with local flap grafting method from January 2017 to March 2019. Part of the 7th rib cartilage was carved into a scalloped cartilage piece, which was implanted on the retroauricular cartilage to release and expand the deformed cartilage. A "M" incision was designed on the retroauricular skin to make the local flap grafting. Results: All corrected auricles were followed up for four months to three year and abtained satisfactory and stable appearance. In one case, the edge of the helix was broken two weeks after the operation, and well healed after repairing. Conclusions: The rib cartilage framework supporting combined with local flap grafting method can fully correct the deformity of cryptotia, and the long-term effect is satisfied. It can be an important complement to the classic methods.
Cartilage ; Ear, External/surgery* ; Humans ; Reconstructive Surgical Procedures ; Ribs ; Surgical Flaps

BACKGROUND: Because of the relatively similar size of organs to human and the physiological and structural similarities, the use of porcine as xenograft donors is progressing very actively. In this study, we analyzed the characteristics of porcine ear cartilage and evaluated its suitability as graft material in reconstructive and cosmetic surgery. METHODS: The auricular cartilage was harvested from two pigs, and subjected to histological examination by immunohistochemical staining. To determine the collagen content, samples were treated with collagenase and weight changes were measured. After sterilization by irradiation, the samples were grafted into rats and stained with Hematoxylin and Eosin and Masson Trichrome to observe inflammation and xenograft rejection. RESULTS: In IHC staining, extracellular matrices were mainly stained with type II collagen (20.69%), keratin sulfate (10.20%), chondroitin sulfate (2.62%), and hyaluronic acid (0.84%). After collagenase treatment, the weight decreased by 68.3%, indicating that about 70% of the porcine ear cartilage was composed of collagen. Upon xenograft of the sterilized cartilages in rats, inflammatory cells were observed for up to 2 months. However, they gradually decreased, and inflammation and reject-response were rarely observed at 5 months. CONCLUSION: The porcine ear cartilage was covered with perichondrium and cellular constituents were found to be composed of chondrocytes and chondroblasts. In addition, the extracellular matrices were mainly composed of collagen. Upon xenograft of irradiated cartilage into rats, there was no specific inflammatory reaction around the transplanted cartilage. These findings suggest that porcine ear cartilage could be a useful alternative implant material for human cosmetic surgery.
Animals ; Cartilage ; Chondrocytes ; Chondroitin Sulfates ; Collagen ; Collagen Type II ; Collagenases ; Ear Cartilage* ; Ear* ; Eosine Yellowish-(YS) ; Extracellular Matrix ; Hematoxylin ; Heterografts* ; Humans ; Hyaluronic Acid ; Inflammation ; Rats ; Sterilization ; Surgery, Plastic ; Swine ; Tissue Donors ; Transplants

BACKGROUND: Plastic surgeons have constantly investigated methods of nasal tip plasty and nasal lengthening in rhinoplasty. The septal extension graft has been widely applied as a very useful method for East Asians who have different internal nasal structures and nasal skin from those of Caucasians. In this study, we performed nasal tip plasty with a batten-type septal extension graft using ear cartilage. METHODS: Nasal tip plasty was performed for 48 patients by batten graft with ear cartilages at the Cocoa Plastic Surgery Clinic and in the plastic surgery unit of Hanil General Hospital from January 2009 to January 2015. A batten-type septal extension graft was constructed with cymba of the concha cartilage. An average area of 2.0 cm × 1.4 cm of the cymba and 1.0 cm × 1.0 cm of the cavum from the concha cartilage was harvested. RESULTS: Of the 48 patients who underwent batten-type septal extension graft using ear cartilages, nasal tip plasty and columellar lengthening were successfully achieved in almost all of the patients. The nasal tip's height was well-maintained for the follow-up period ranging from 6 months to 5 years after surgery. CONCLUSIONS: Nasal tip plasty using a septal extension graft is a very useful method for East Asians with a low nasal tip. The septal extension graft with ear cartilage enables the creation of a desirable nasal shape because there is a sufficient amount of ear cartilage to stably support the nasal tip, thus creating a natural and smooth nose shape.
Asian Continental Ancestry Group* ; Cacao ; Cartilage ; Ear Cartilage* ; Ear* ; Follow-Up Studies ; Hospitals, General ; Humans ; Methods ; Nose ; Plastics ; Rhinoplasty ; Skin ; Surgeons ; Surgery, Plastic ; Transplants*

OBJECTIVETo explore the curative effect of Z-plasty without skin grafting for correction of cryptotia.

METHODSTwenty-five cases (29 ears) with cryototia were corrected by Z-plasty without skin grafting in our department from June 2009 to January 2014. A Z-shaped incision with one arm on the back of antihelix and the other arm on the edge of hair was made on the back of ear and scalp. The adhesion on the back of antihelix cartilage was dissected and the cartilage framework was lifted and re-positioned. The postauricular flap was transferred to cover the wound on the back of antihelix. The other flap was transferred to cover the remnant wound and correct the malformation of cryptotia.

RESULTSAll the patients were followed up from 6 months to 1 year with stable and symmetric appearance.

CONCLUSIONSThe shape of auricle is natural after operation without skin grafting. It is a simple and ideal method for the treatment of cryptotia.

Ear Cartilage ; abnormalities ; surgery ; Ear, External ; abnormalities ; surgery ; Humans ; Skin Transplantation

OBJECTIVETo explore the therapeutic efficacy of a modified method with splints in correction of cryptotia.

METHODSFrom Oct. 2012 to Jan. 2014, 3 cases with unilateral cryptotia were treated with the modified method with splints. The muscles attached to the periosteum of cartilage were dissected. The muscles between the ear and temper were cut off. Then one silicon tube was put around the ear through cranioauricular sulcus. The other tube was placed within the cavum conchae and fixed with the tube around the ear.

RESULTSNo flap necrosis happened. The patients were followed up for six months to one year with satisfied and stable results.

CONCLUSIONSThe modified method is easy to perform with less morbidity. It is one of the ideal correction for cryptotia.

Ear Auricle ; abnormalities ; surgery ; Ear Cartilage ; abnormalities ; surgery ; Humans ; Reconstructive Surgical Procedures ; instrumentation ; methods ; Splints

OBJECTIVETo explor the curative effect of double pedicle sliding skin flap for correction of cryptotia.

METHODSFrom January 2011 to October 2014, 7 cases with cryptotia (12 ears) were treated. We designed a double pedicle sliding skin flap above the helix. The flap was slided downward to form a new auriculocephalic sulcus. The other wound was covered by skin graft.

RESULTSAll wounds healed very well with no complication. The follow-up period ranged from 3 months to 1 year, with an average of (5.67 ± 3.38) months. The ear had stable appearance with no recurrence. The result was satisfactory.

CONCLUSIONSThe method is simple with reliable flap survival rates. The new auriculocephalic sulcus is stable and resistant. It's a good choice for correction of cryptotia.

Ear Auricle ; abnormalities ; surgery ; Ear Cartilage ; abnormalities ; surgery ; Follow-Up Studies ; Graft Survival ; Humans ; Reconstructive Surgical Procedures ; methods ; Surgical Flaps ; transplantation ; Time Factors ; Wound Healing

OBJECTIVETo investigate the application of intense pulsed light (IPL) depilation in the auricular reconstruction with totally expanded skin and its suitable parameter.

METHODSFrom February 2009 to September 2013, one tissue expander(100 or 150 milliliters) were implanted under the skin of mastoid in 126 patients who suffered from microtia. During the skin expanding, the hair on the expanded skin was depilated by JPL technique. The parameter, operation, interval, the depilation result and the complication were recorded. The autologous rib cartilage frameworks were implanted in the second phase of auricular reconstruction.

RESULTSThe energy of IPL was 20 - 35 J/cm2 (mean 25. 3 J/cm2), the width of pulse was 26 - 30 ms ( mean 27. 9 ms), the interval between two operations was 4 weeks. Ninety-six patients were cured(76. 2%, 96/126). The total depilation efficient is 96. 8% (122/126). A fine banding blisters was found in one patient whose depilation areas was marked by black pen. Skin erythema was found in five patients and skin pigmentation was found in 7 patients. There were no skin necrosis and expander exposure in all patients. During 6 - 12 months of follow-up period, ninety-two patients were cured (73.0%, 92/126) and the total depilation efficient is 92. 9% (117/126).

CONCLUSIONSIPL depilation during the skin expanding is feasible and safe with careful procedure. The hairless expanded skin is enough to cover the framework, as well as the post-auricular area. The appearance of reconstructed ear is better without hair.

Congenital Microtia ; surgery ; Costal Cartilage ; transplantation ; Ear, External ; Erythema ; etiology ; Hair Removal ; methods ; Humans ; Mastoid ; Phototherapy ; adverse effects ; methods ; Reconstructive Surgical Procedures ; Skin Pigmentation ; Surgical Flaps ; Tissue Expansion ; Tissue Expansion Devices