1.Summary and analysis of total auricle reconstruction in adult microtia patients.
Xiu WANG ; Zhen Po ZHANG ; Xu Lun GUO ; Zhuo Fan YANG ; Teng Xiao MA ; Zheng Wen ZHANG
Chinese Journal of Otorhinolaryngology Head and Neck Surgery 2023;58(5):476-480
Objective: To observe the clinical effect of auricle reconstruction in adult patients with microtia and summarize the experience. Methods: Clinical data of adult patients with microtia who underwent total auricle reconstruction using the modified Nagata's two stage for microtia reconstruction from June 2016 to June 2021 were analyzed. A total of 41 adult patients (42 ears) with microtia were enrolled, including 30 males and 11 females, with the median age at the time of surgery of 37 years. Autogenous costal cartilage was used as the auricular framework for all patients in this group. The first stage surgery was performed according to the modified Nagata's two stage for microtia reconstruction procedure,cartilage auricular framework carving was performed by different methods according to the ossification state of adult costal cartilage. Six months following the primary operation, ear elevation and cranioauricular angle formation, retroauricular facial flap transfer and medium-thick skin grafting were performed in the second stage. Results: All patients successfully completed two stage operation. During the follow-up of 3 months and 24 months, all the 41 patients were satisfied with the morphology of reconstructed auricle. Conclusion: According to the costal cartilage status of adult patients, different costal cartilage carving techniques can be used for total auricle reconstruction to obtain ideal surgical results.
Male
;
Female
;
Humans
;
Adult
;
Surgical Flaps
;
Congenital Microtia/surgery*
;
Plastic Surgery Procedures
;
Ear, External/surgery*
;
Ear Auricle/surgery*
4.Correction of severe cup ears using postauricular tongue-shaped flap combined with deep fascial suspension.
Ying GUO ; Chen Long LI ; Yao Yao FU ; Tian Yu ZHANG
Chinese Journal of Otorhinolaryngology Head and Neck Surgery 2021;56(4):323-328
Objective: To investigate the effect and satisfaction of using the postauricular tongue-shaped flap combined with deep fascia suspension in correcting severe cup ear malformation. Methods: Between August 2018 and November 2019, nine cases (10 ears) of Tanzer type Ⅲ severe cup ear malformation were treated with postauricular tongue-shaped flap combined with deep fascia suspension in this study. Results: Nine cases primary healed without hematoma, infection or skin necrosis, except one case with postoperative incision dehiscence. The cup ear deformity was significantly improved after the operation, the helix was intact, and the anti-helix was visible. The length, width, and circumference of the auricle were significantly enlarged three months following surgeries. There were no other complications except 1 patient recurrence 12 months after surgery. The patients were highly satisfied with the results of the surgery. Conclusions: Although the aesthctic of the reconstructed auricle is insufficient, this new technology makes full use of the autologous auricle tissue to correct severe cup ear malformation with good results.
Ear Auricle/surgery*
;
Ear, External/surgery*
;
Humans
;
Reconstructive Surgical Procedures
;
Surgical Flaps
;
Tongue
6.Treatment effect of hemifacial dysplasia by injecting transplantation of autologous tissue in the second stage surgery for total auricle reconstruction.
Dong Yi ZHANG ; Lu Lu ZHANG ; Zhi Peng WANG ; Ying Wei XU ; Qing Liang LIU ; Shang Hua ZHAO ; Shen Song KANG
Chinese Journal of Otorhinolaryngology Head and Neck Surgery 2021;56(6):643-647
Objective: To observe the treatment effect of hemifacial dysplasia by injecting transplantation of autologous dermis and fat granules in the second stage surgery for total auricle reconstruction. Methods: From March 2013 to March 2018, 57 patients with unilateral microtia and mild-to-moderate hemifacial dysplasia were divided into concurrent treatment group (32 cases, including 13 females and 19 males and aged 6-33 years old with an average age of 12.5 years) and traditional treatment group (25 cases, including 10 females and 15 males and aged 6-21 years old with an average age of 11.3 years) according to the different surgical methods. Modified Nagata method of auricular reconstruction was chosen, in the second stage surgery (cranial ear angle plasty), patients in concurrent treatment group received the treatment of hemifacial dysplasia with autologous dermal and fat injection transplantation at the same time; Patients in traditional treatment group only received cranial ear angle plasty. Statistical analysis of the two groups of patients was carried out for the average operation time, the average length of hospital stay, the incidence of common complications and postoperative satisfaction rate. SPSS 21.0 software was used for statistical analysis. Results: The mean operation time of the concurrent treatment group (282.0±3.4)min was longer than that of the traditional treatment group (243.0±3.1)min, and the difference was statistically significant (t=9.884, P<0.05). There were no statistically significant differences in the average length of stay between the the concurrent treatment group (9.4±0.3)d and the traditional treatment group(9.5±0.2)d, t=0.256, P>0.05. There were no statistically significant differences in the incidence of common surgical complications between the concurrent treatment group (12.5%, 4/32) and the traditional treatment group(12.0%, 3/25), χ2=0, P>0.05. Postoperative satisfaction rate of the concurrent treatment group(90.6%, 29/32) was significantly higher than that of the traditional treatment group(56.0%, 14/25), the difference was statistically significant (χ2=9.081, P<0.05). Conclusions: Auricular reconstruction with treatment of hemifacial dysplasia should not significantly increase the average length of stay and the incidence of common complications compared with auricular reconstruction alone. Although the operation time is slightly extended, the scheme of concurrent treatment can reduce the times of operations, save medical resources and increase the satisfaction rate of patients.
Adolescent
;
Adult
;
Child
;
Congenital Microtia/surgery*
;
Ear Auricle/surgery*
;
Ear, External/surgery*
;
Female
;
Humans
;
Male
;
Operative Time
;
Reconstructive Surgical Procedures
;
Treatment Outcome
;
Young Adult
7.Epithelial defect repair in the auricle and auditory meatus by grafting with cultured adipose-derived mesenchymal stem cell aggregate-extracellular matrix.
Wen-Jin ZHANG ; Lei-Guo MING ; Jian-Jun SUN
Chinese Medical Journal 2019;132(6):680-689
BACKGROUND:
Several patients experience persistent otorrhea after a flawless surgical procedure because of insufficient epithelial healing. Several efforts, such as autologous tissue allograft and xenograft, have been made to halt otorrhea. However, a stable technology to induce temporal epithelial repair is yet to be established. Therefore, this study aims to investigate whether implantation of seeding adipose-derived mesenchymal stem cell (ADMSC) aggregates on extracellular matrix (ECM; herein, ADMSC aggregate-ECM) into damaged skin wound promotes skin regeneration.
METHODS:
ADMSC aggregate-ECM was prepared using a previously described procedure that isolated ADMSCs from rabbits and applied to the auricle and auditory meatus wound beds of New Zealand white rabbits. Wound healing was assessed by general observation and hematoxylin and eosin (H&E) staining. Secretion of growth factor of the tissue was evaluated by western blotting. Two other groups, namely, ECM and control, were used. Comparisons of three groups were conducted by one-way analysis of variance analysis.
RESULTS:
ADMSCs adhered tightly to the ECM and quickly formed cell sheets. At 2 weeks, general observation and H&E staining indicated that the wound healing rates in the ADMSC aggregate-ECM (69.02 ± 6.36%) and ECM (59.32 ± 4.10%) groups were higher than that in the control group (43.74 ± 12.15%; P = 0.005, P < 0.001, respectively) in ear auricle excisional wounds. At 7 weeks, The scar elevation index was evidently reduced in the ADMSC aggregate-ECM (2.08 ± 0.87) and ECM (2.31 ± 0.33) groups compared with the control group (4.06 ± 0.45; P < 0.001, P < 0.001, respectively). In addition, the scar elevation index of the ADMSC aggregate-ECM group reached the lowest rate 4 weeks in advance. In auditory meatus excisional wounds, the ADMSC aggregate-ECM group had the largest range of normal skin-like structure at 4 weeks. The ADMSC aggregate-ECM and ECM groups secreted increased amounts of growth factors that contributed to skin regeneration at weeks 1 and 2, respectively.
CONCLUSIONS
ADMSC aggregate-ECM and ECM are effective repair materials for wound healing, especially ADMSC aggregate-ECM. This approach will provide a meaningful experimental basis for mastoid epithelium repair in subsequent clinical trials.
Adipose Tissue
;
cytology
;
Animals
;
Cell Differentiation
;
physiology
;
Cell Proliferation
;
physiology
;
Cells, Cultured
;
Ear Auricle
;
cytology
;
Extracellular Matrix
;
chemistry
;
Flow Cytometry
;
Mesenchymal Stem Cell Transplantation
;
methods
;
Mesenchymal Stem Cells
;
cytology
;
Microscopy, Electron, Scanning
;
Osteogenesis
;
physiology
;
Rabbits
;
Real-Time Polymerase Chain Reaction
8.Health Problems in Clinical Nurses as Identified by Auricular Acupuncture Points
Korean Journal of Occupational Health Nursing 2019;28(3):148-155
PURPOSE: The purpose of this study was to identify health problems in clinical nurses through an examination of their auricular acupuncture points. METHODS: Data were collected from 90 nurses working in D city. Participants' ears were photographed and their auricular points were analyzed. Data analysis was performed by descriptive statistics and the χ2 test. RESULTS: Musculoskeletal problems were the most severe, followed by problems of the digestive, nervous, and reproductive systems, in that order. Furthermore, the average number of health problems was 5.22, with a range of 4 to 6. Leg/foot pain was the highest reported musculoskeletal problem, followed by shoulder and lumbar/back pain. Gastric ptosis was the highest reported digestive problem, followed by indigestion and hypersensitive colitis. Additionally, among participants with gastric ptosis, lumbar pain was significantly high. CONCLUSION: The results suggest that further research using an auricular points as a diagnosis and treatment point is necessary to improve the health of nurses.
Acupuncture Points
;
Acupuncture, Ear
;
Colitis
;
Diagnosis
;
Dyspepsia
;
Ear
;
Ear Auricle
;
Shoulder
;
Statistics as Topic
9.Helical Rim Advancement Flap with an Additional Postauricular Skin Flap: A Case Report
Seung Ho KIM ; Jeong Hwan CHOI
Journal of Audiology & Otology 2019;23(4):210-213
The auricle is a three-dimensional cartilaginous frame covered with thin overlying skin. Due to its complex features, reconstructing helical rim defects after the excision of an auricular mass is challenging. Shortage of subcutaneous tissue and the presence of a tightly bound epithelium further hamper the primary closure of lateral (anterior) auricular skin defects. We present herein a case in which we used a helical rim advancement flap along with an additional postauricular skin flap. We achieved a satisfactory esthetic result with minimal loss of helical diameter and a low risk of flap necrosis by preserving the vascular network of the flap. This technique is less traumatic and will facilitate faster healing as well as improved patient recovery.
Carcinoma, Squamous Cell
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Ear Auricle
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Ear, External
;
Epithelium
;
Humans
;
Necrosis
;
Skin
;
Subcutaneous Tissue
10.Tragus formation during concha-type microtia repair using a chondrocutaneous island flap.
Jeong Hyun HA ; Euicheol JEONG ; Hudson LAZARO
Archives of Craniofacial Surgery 2018;19(1):79-82
Formation of an ideally-shaped tragus remains one of the most challenging issues during staged tragus reconstruction in microtia patients. The authors describe a new method used to treat a unique case of concha-type microtia in which the 10-year-old male patient had only a portion of pre-existing cartilage at the tragus site. An anomalous skin lump was also present. During the initial stages of the reconstruction, the two-stage Nagata method was used for surgical correction of the microtia. An autologous rib cartilage graft was used to form the ear framework. A temporoparietal fascia flap was also constructed. Remnant skin tags and anomalous cartilage that accompany microtia are usually removed during microtia repair. However, the cartilage and skin lump were preserved during the reconstruction. The skin lump was later used to form a vascularized chondrocutaneous island flap that supplemented the portion of cartilage during tragus formation. The result was a new tragus that was satisfactorily improved in both size and shape. Patients with concha-type microtia may benefit from the use of this new method for tragus formation.
Cartilage
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Child
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Congenital Microtia*
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Ear
;
Ear Auricle
;
Fascia
;
Humans
;
Male
;
Methods
;
Ribs
;
Skin
;
Surgical Flaps
;
Transplants

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