Comparison of Microtia Reconstruction Outcomes Using Rib Cartilage vs Porous Polyethylene Implant

Constantine, Kristin K.; Gilmore, James; Lee, Kenneth H.; Leach, Joseph L.

doi:10.1001/jamafacial.2014.30

Cited by 74 publications

(79 citation statements)

References 14 publications

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“…However, they may lead to complications such as infection and extrusion of the implant (Hwan Wang et al, ; Sevin et al, ). A study using polyethylene implants showed better cosmetic appearance of ear but possess a higher risk for infection and extrusion (Constantine, Gilmore, Lee, & Leach, ). As a consequence, there continues to search for alternative materials (Mandl et al, ; Rotter et al, ).…”

Section: Introductionmentioning

confidence: 99%

Novel decellularized animal conchal cartilage graft for application in human patient

Bhattacharya

Das

Joardar

et al. 2018

J Tissue Eng Regen Med

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Restoration of the external ear and nose in human patients, in either congenital deformity or acquired defects, is a challenge in reconstructive surgery. Optimization of the currently available materials is necessary for rhinoplasty and microtia correction to avoid intraoperative manoeuvring and early rejection. The aim of this study was to develop cross-linked decellularized caprine conchal cartilages as biocompatible, robust, and non-toxic matrix template. The characterization of the decellularized tissue encompasses in vitro lymphoproliferation assay, cytotoxicity test, agar gel precipitation test, in vivo immunocompatibility study, histology, and determination of pro-inflammatory cytokines in animal model. Decellularized cartilage was implanted in human volunteer at R. G. Kar Medical College and Hospital, Kolkata, India, and samples were assessed histologically by retrieving those after 4 months. The processed cartilages were implanted in rhinoplasty (nine) and microtia patients (six) keeping autogenous cartilage graft as control up to 18 months after surgery. Primary outcomes were viability and safety of the material, both in animal model and human pre-application in actual site. Secondary outcomes included self-assessed clinical findings on gross examination. This study is under the ethical approval no. RKC/14 dated January 27, 2012. The in vitro cellular reactivity was less in processed cartilage protein than control. Histology of retrieved tissues in animal model and human volunteer showed no adverse reactions. Production of IL-2, IL-6, and TNF-α cytokines was lower at 4 weeks. The rhinoplasty and microtia operation in clinical patients utilizing the processed cartilage showed satisfactory recovery with improved facial look. These low cost, easily available, biocompatible, safe xenocartilage biomatrices of caprine conchal cartilage origin are very flexible in shape and size, enabling them as potential bioimplant for repair of nasal and auricular structure without any rejection or diverse biomedical applications.

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Section: Introductionmentioning

confidence: 99%

Novel decellularized animal conchal cartilage graft for application in human patient

Bhattacharya

Das

Joardar

et al. 2018

J Tissue Eng Regen Med

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“…11e13 Due to this, artificial implants or prosthetics are considered an option in adult patients; however, these methods are limited by complications such as extrusion and infection and the absence of long-term follow-up results. 14,15 To the best of our knowledge, there are few large published series on the use of autologous rib cartilage grafts in patients >20 years for auricular reconstruction, including objective evaluation and patient satisfaction with surgical results. In this article, we retrospectively reviewed a series of 84 adult patients (!20 years) who had favorable outcomes using autologous rib cartilage grafts.…”

Section: Introductionmentioning

confidence: 99%

Aesthetic auricular reconstruction with autologous rib cartilage grafts in adult microtia patients

Han

Lim

Pyon

et al. 2015

Journal of Plastic, Reconstructive & Aesthetic Surgery

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“…Although extrusion rates of MEDPOR frameworks operated by experienced surgeons might be small, follow-up studies show higher rates than in autogenous reconstruction. 32 Good coverage of MEDPOR with superficial temporal fascia is important for healing and resistance to microtrauma. However, if the implant is exposed due to injury or local infection, the risk of persistent infection and ultimately extrusion of the implant, in contrast to autogenous cartilage, is high.…”

Section: The Future and Alternatives To Autogenous Ear Reconstructionmentioning

confidence: 99%

67 Congenital Auricular Deformities

Papel¹,

Frodel²,

Holt³

et al. 2016

Facial Plastic and Reconstructive Surgery

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a less distinguished posterior relief. With the exception of the cartilage-free lobule, the static basis of the auricle is formed by an elastic cartilage, which has a thickness of 1 to 3 mm. 1,2,3 The anterior skin is fixed to the perichondrium without subcutaneous tissue in between, being almost immobile. It is 0.8 to 1.2 mm thick. In contrast, the posterior side has a subcutaneous layer of 1.2 to 3 mm, which leads to a certain mobility. 3 The blood supply of the auricle is variable and dominated by branches of the superficial temporal and posterior auricular vessels. Innervation of the auricle is due to branches of N. auricularis magnus, N. auriculotemporalis, and N. occipitalis minor. The auricular muscles are relatively unimportant and small. Two muscles might be detected intraoperatively: M. auricularis posterior and M. auricularis superior. In addition, the auricle is stabilized by one posterior and two anterior ligaments. 1 The lymphatic fluid of the auricle is drained into the superficial and deep neck nodes, into the parotid gland, and toward the submandibular nodes and, in addition, the postauricular and mastoid lymph nodes.

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Comparison of Microtia Reconstruction Outcomes Using Rib Cartilage vs Porous Polyethylene Implant

Cited by 74 publications

References 14 publications

Novel decellularized animal conchal cartilage graft for application in human patient

Novel decellularized animal conchal cartilage graft for application in human patient

Aesthetic auricular reconstruction with autologous rib cartilage grafts in adult microtia patients

67 Congenital Auricular Deformities

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