• Archives of Craniofacial Surgery
• /
• v.22 no.6
• /
• pp.337-340
• /
• 2021

Full-thickness nasal tip reconstruction is a challenging process that requires provision of ample skin and soft tissue, and intricate cartilage structure that maintains its architecture in the long term. In this report, we describe reconstruction of a full-thickness nasal tip and ala defect using a posterior auricular artery perforator based chondrocutaneous free flap. The flap consisted of two lay ers of skin covering conchal cartilage, and was based on a perforating branch of the posterior auricular artery. A superficial vein was secured at the posterior margin. The donor perforator was anastomosed to a perforating branch of the lateral nasal artery. The superficial vein was connected to a superficial vein of the surrounding soft tissue. The donor healed well after primary closure. The flap survived without complications, and the contour of the nasal rim was sustained at follow-up 6 months later. As opposed to combined composite reconstructions using a free cartilage graft together with a small free flap or pedicled nasolabial flap, the posterior auricular artery perforator free flap encompasses all required tissue types, and is similar in contour to the alar area. This flap is a useful option in single-stage reconstruction of nasal composite defects.

• Proceedings of the KOR-BRONCHOESO Conference
• /
• 1983.05a
• /
• pp.14.3-14
• /
• 1983

In recent years there has been considerable interest in reconstructive surgery of the trachea for cervical tracheal stenosis developed by complication of endotracheal intubation or tracheotomy, or trauma of the neck. The methods used to reconstruct the tracheal defects can be repaired with end-to - end anastomosis, cervical flaps, and autogenous graft materials. Since Grillo had undertaken tracheal reconstruction after circumferential resection in dogs, resection and end - to - end anastomosis was used in cases of circumferential stenosis. And, costal, nasal septal and auricular cartilage have been used for the autogenous graft materials. Since Caputo and Consiglio had undergone tracheoplasty with auricular cartilage, Morgenstein reported successful repair of a tracheal defect with a composite postauricular cartilage graft. The advantages of the auricular cartilage graft are its easy accessibility, availability and familiarity to the otolaryngologist. In past 2 years, We performed the tracheoplasty with auricular cartilage graft and end- to end an astomosis after segmental resection in 5 patients who had suffered from tracheal stenosis. And we obtained good results. So, we reported the cases with review of the literatures.

• Archives of Plastic Surgery
• /
• v.34 no.1
• /
• pp.81-87
• /
• 2007

Purpose: Correction of saddle nose remains problematic both in the technique of reconstruction and in the choice of implant material for nasal augmentation. A large variety of graft materials have been used for the reconstruction of the saddle nose deformity. The purpose of this study is to determinate an algorithm for deciding alternative graft materials used in correction of saddle nose deformity. Methods: Six patients with saddle nose who were corrected using by auricular cartilage and costal cartilage at Chosun university hospital were analyzed. Results: After a mean interval of 12 months, all patients were satisfied with the esthetic and functional result. Conclusion: Auricular cartilage is an excellent graft material for esthetic and functional reconstruction of mild to moderate saddle nose deformity.

• Archives of Plastic Surgery
• /
• v.33 no.3
• /
• pp.313-318
• /
• 2006

The preauricular fistula is a congenital malformation of the ear with a small opening in the preauricular area. In general, this malformation should be treated by excision after its infection is brought under control with antibiotics. For cosmetic consideration, we performed a elliptic incision around opening, and then we dissected along the fistula tract to the cyst without sacrificing too much soft tissues. From March 2001 to March 2005, 90 patients with 102 cases of fistulas were excised including a small portion of auricular perichondrium and cartilage, where they adhered closely. Then, histologic findings of preauricular fistula were studied. The histologic findings reveal that the fistular tract is very close to auricular cartilage, and the thickness of fistular epithelium and perichondrium are about the same. There was no specific complications related to this procedure. The recurrence rate for the excision with cartilage was 2 out of 102(2%). Results of surgery in all cases were satisfactory. It is important, in preauricular fistular excision, perichondrium and auricular cartilage should be excised to prevent recurrence.

• Journal of Medicine and Life Science
• /
• v.20 no.4
• /
• pp.183-187
• /
• 2023

Empty nose syndrome is an uncommon complication of turbinoplasty and other nasal operations. It presents with various manifestations, with the most common symptom being paradoxical nasal obstruction. Here, we report the case of a 67-year-old male patient diagnosed with empty nose syndrome 20 years after turbinoplasty. Autologous auricular conchal cartilage was harvested and implanted into the lateral wall of the inferior turbinate to reduce nasal volume. The patient experienced significant relief from subjective nasal obstruction symptoms immediately after surgery. Over a 23-month follow-up period, no side effects or symptom recurrence was reported.

• Maxillofacial Plastic and Reconstructive Surgery
• /
• v.15 no.1
• /
• pp.49-61
• /
• 1993

The transplantation of cartilage, especially auricular cartilage, has assumed a role of importance in the field of plastic and reconstructive surgery. From long years ago, many reports have appeared in the literature describing the experimental and clinical results of the use of cartilage. At present, the evidence for survival of autograft of cartilage is admitted, But, the results for interrelationship between the bone and cartilage grafts with or without perichondrium is not so conclusive. The purpose of this study were observed as to whether autogenous cartilage grafts were fixed by means of tie with 4-0 vicryl and fibrin adhesive on the femur or microscopic findings of union state in 16 rabbits. We sacrified the experimental animals after 1, 2, 4, 6 weeks postoperatively and made the specimens as a routine laboratory procedures and stained with Hematoxylin-Eosin stain, Verhoeff-van Gieson elastic fiber stain, and alcian blue periodic acid-Schiff(AB-PAS) for mucopolysaccharide. Histologic evaluation was performed under microscope. The obtaind results were as follows : 1. Fibrous union was formed between the grafting cartilage and the femur, nor any findings of calcification and formation of new bone. 2. Partial fibrous adhesion was observed in fibrin adhesive groups on 6 weeks postoperatively. 3. Appositional growth has performed more in fibrin adhesive groups than tie groups. 4. There are little difference in both for new copillary proliferation and fibroblast activations. 5. Degenerative changes have apperared more in tie groups than adhesive groups, but not related to the healing periods.

• Journal of International Society for Simulation Surgery
• /
• v.1 no.2
• /
• pp.80-82
• /
• 2014

Purpose Microtia is congenital anomaly of external ear and the reconstruction method for the external ear of microtia patient was based on autogenous costal cartilage framework. The application of 3D printing technique in medical science has made more possibility of human tissue restoration, and we tried to apply this technique in auricular reconstruction field. Materials and Methods As for unilateral microtia patient, the contralateral side ear is normal and reconstructive surgeon tried to mimic it for reconstruction of affected ear. So, we obtained facial CT scan of microtia patient and made mirror image of normal side ear. Moreover, to make the 3D scaffold based on the mirror image of normal ear and to apply this scaffold for the auricular reconstruction surgery, we included auriculocephalic sulcus and anterior fixation part. Results We could successfully obtain mirror image of normal ear, auriculocephalic sulcus and anterior fixation part for 3D scaffold printing. Conclusions Using this CT image processing and 3D printing technique, we will be able to make the scaffold for auricular reconstruction of unilateral microtia patient, and perform auricular reconstruction in near future.

• Archives of Plastic Surgery
• /
• v.37 no.4
• /
• pp.421-426
• /
• 2010

Purpose: Patients with serious burns are prone to chondritis due to lack of soft tissue in the auricle, which can cause severe defects in the auricular morphology. In addition, skin damage occurs frequently in the vicinity of post-burn wounds, presenting difficulties in reconstruction surgery. An auricular reconstruction has functional and cosmetic significance. The aim of this study is to develop appropriate reconstruction methods for auricular defects. Methods: Thirty seven patients, who were treated for auricular defects from 2005 to 2009, were enrolled in this study. A local flap, multiple regional flaps and cartilage framework with or without a temporal fascial flap were applied in reconstruction surgery according to the location of the auricular defect. Results: The age of the subjects ranged from 11 to 56. Some subjects had defects that cover more than half of the helical rim with most exhibiting post-burn scars in the vicinity, for whom a multiple regional flap was used. A single use of a tubed flap was sufficient for subjects with defects that covered less than half of the helical rim. A regional flap was also used for reconstruction in subjects with defects covering both the helical rim and antehelix. Conclusion: Achieving satisfactory results from the skin flaps and skin grafts for post-burn auricular defects in both functional and cosmetic aspects is a difficult task. Therefore, selecting an appropriate surgical method through proper diagnosis of the auricular defect and the state of the available skin in the vicinity is essential.

• Archives of Plastic Surgery
• /
• v.32 no.4
• /
• pp.511-515
• /
• 2005

Autologous cartilage grafts have become an integral part of aesthetic and reconstructive plastic surgery. However, little objective information is available about the actual quantitative resorption of cartilage in human. This study sought to objectively quantify and compare the resorption of costal cartilage in human. To compare the resorption characteristics of rib cartilage autografts, we harvested rib cartilage grafts from 37 microtia patients. All autografts were implanted subcutaneously on chest and then removed after 6 to 17 months. Graft mass and volume were compared before and after implantion. Rib cartilage grafts with perichondrium averaged $10.8{\pm}7.4%$ resorption by volume, On the other hand rib cartilage grafts without perichondrium $25.5{\pm}6.8%$. There was no evidence of necrosis or inflammatory changes. The rib cartilage is the preferred source of autogenous cartilage for auricular reconstruction. Short-term resorption of rib cartilage without perichondrium appears to be higher than with perichondrium. The low resorption of cartilage with perichondrium may be due to in part to cartilage forming capacity of the perichondrium. It remains to be seen whether these differences in resorption persist in the long term.

• International Journal of Stem Cells
• /
• v.16 no.3
• /
• pp.304-314
• /
• 2023

Background and Objectives: Ear cartilage malformations are commonly encountered problems in reconstructive surgery, since cartilage has low self-regenerating capacity. Malformations that impose psychological and social burden on one's life are currently treated using ear prosthesis, synthetic implants or autologous flaps from rib cartilage. These approaches are challenging because not only they request high surgical expertise, but also they lack flexibility and induce severe donor-site morbidity. Through the last decade, tissue engineering gained attention where it aims at regenerating human tissues or organs in order to restore normal functions. This technique consists of three main elements, cells, growth factors, and above all, a scaffold that supports cells and guides their behavior. Several studies have investigated different scaffolds prepared from both synthetic or natural materials and their effects on cellular differentiation and behavior. Methods and Results: In this study, we investigated a natural scaffold (alginate) as tridimensional hydrogel seeded with progenitors from different origins such as bone marrow, perichondrium and dental pulp. In contact with the scaffold, these cells remained viable and were able to differentiate into chondrocytes when cultured in vitro. Quantitative and qualitative results show the presence of different chondrogenic markers as well as elastic ones for the purpose of ear cartilage, upon different culture conditions. Conclusions: We confirmed that auricular perichondrial cells outperform other cells to produce chondrogenic tissue in normal oxygen levels and we report for the first time the effect of hypoxia on these cells. Our results provide updates for cartilage engineering for future clinical applications.