Die Verwendung von autologem Ohrknorpel in der Lidchirurgie

Abstract

Autologous ear cartilage is relatively easy to procure in suitable form and sufficient quantity. At the donor site, there are, as a rule, no complications to be expected. Autologous ear cartilage without conjunctival coverage is of good use for replacing and lengthening the inner layer of an eyelid, not only to reconstruct large eyelid-defects, but also to give additional support and length. The cartilage graft will grow on well, provided the wound is well vascularized. This must not be expected with scarring or poor blood perfusion. The brittleness of the cartilage demands an adapted technique. Precautions to protect the cornea and to prevent adhesions in the fornix are to be taken.

Eyelid reconstruction using cartilage grafts from auricular scapha

“…All eyelid layers must be repaired, guaranteeing stability as well as mobility in order to maintain the corneal lubrication and cleansing, in addition to providing blinking, especially with regard to the upper eyelid [22,29]. Cartilage grafts have usually been used in segmental or total loss to achieve such goals [12,21,24,25,27].…”

“…The surgical access to the concha is simple and morbidity is low, unfortunately the concha is relatively thick. In the 90's, Heinz used a silastic lamina to separate the conchal cartilage graft from the bulbar conjunctiva, and reported good results [12,18]. However, Matsuo in 1987 [20,21], reported the possibility of using the conchal cartilage graft with the perichondrium placed directly in contact with the bulbar conjunctiva and showed that cover with conjunctiva from the edges of the defect occurred in 3 to 4 weeks.…”

“…The classical procedure of Hughes [13] and Cutler-Beard [25,31] are also often used. In cases of full thickness eyelid reconstruction, skin grafts, local cutaneous flaps or eyelid myocutaneous flaps have been given good results for external lamella repair [11,12,22,26,32]. Uni-or bipedicle eyelid flaps of full thickness have been described more recently [2,3].…”