Titanium Mesh Strut: A Novel Instrument for Firm Elevation of the Reconstructed Auricle

Li, Datao; Zhang, Ruhong; Zhang, Qun; Xu, Feng; Xu, Zhicheng; Tang, Xinjie

doi:10.1007/s00266-012-9868-3

Cited by 13 publications

(4 citation statements)

References 18 publications

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“…Specifically, dimensions of 12–15 mm in height, 20 mm or more in length and no less than 4–5 mm in thickness are fundamental to attain a symmetric projection. If the residual cartilage from the first stage could not match the minimum requirements, particularly in some children, artificial materials such as porous polyethylene 14 , MEDPOR 15 , EH 16 and titanium mesh strut 17 could be an alternative option.…”

Section: Discussionmentioning

confidence: 99%

Strategies for ear elevation and the treatment of relevant complications in autologous cartilage microtia reconstruction

et al. 2022

Sci Rep

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Despite various surgical techniques for ear elevation in autogenous cartilage microtia reconstruction, it is still challenging for plastic surgeons to obtain a satisfactory depth of the cephaloauricular sulcus and stable projection of the reconstructed ear. Here, the authors demonstrate individualized options for surgical approaches and relevant details for complication management. Between January 2014 and June 2020, a series of 895 patients who underwent the second stage of microtia reconstruction were reviewed. Complications occurred in 103 patients aged between 8 and 34 years. Recommended surgical selections, as well as appropriate strategies for complication prophylaxis and treatment, were shown to minimize the negative influence on the contour of the cephaloauricular sulcus according to individual conditions. We found that 78% of the patients were satisfied with the auricle contour with harmonious integrity. Individualized strategies for ear elevation and complication treatment contribute to symmetry and satisfactory projection of the reconstructed auricle.

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Section: Discussionmentioning

confidence: 99%

Strategies for ear elevation and the treatment of relevant complications in autologous cartilage microtia reconstruction

et al. 2022

Sci Rep

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“…If the rib cartilage is insufficient for the second-stage surgery, a biological material can be used as a replacement. [ 8 9 10 11 12 13 ] Thus, the harvesting of sufficient rib cartilage is beneficial for cartilage framework carving and shaping in the first-stage; late trimming to make up the deformity is difficult.…”

Section: Discussionmentioning

confidence: 99%

Rib Cartilage Assessment Relative to the Healthy Ear in Young Children with Microtia Guiding Operative Timing

Kang

Guo

Zhang

et al. 2015

Chinese Medical Journal

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Background:The optimal age at which to initiate for auricular reconstruction is controversial. Rib cartilage growth is closely related to age and determines the feasibility and outcomes of auricular reconstruction. We developed a method to guide the timing of auricular reconstruction in children with microtia ranging in age from 5 to 10 years.Methods:Rib cartilage and the healthy ear were assessed using low-dose multi-slice computed tomography. The lengths of the eighth rib cartilage and the helix of the healthy ear (from the helical crus to the joint of the helix and the earlobe) were measured. Surgery was performed when the two lengths were approximately equal.Results:The preoperative eighth rib measurements significantly correlated with the intraoperative measurements (P < 0.05). From 5 to 10 years of age, eighth rib growth was not linear. In 76 (62.8%) of 121 patients, the eighth rib length was approximately equal to the helix length in the healthy ear; satisfactory outcomes were achieved in these patients. In 18 (14.9%) patients, the eighth rib was slightly shorter than the helix, helix fabrication was accomplished by adjusting the length of the helical crus of stent, and satisfactory outcomes were also achieved. Acceptable outcomes were achieved in 17 (14.0%) patients in whom helix fabrication was accomplished by cartilage splicing. In 9 (7.4%) patients with insufficient rib cartilage length, the operation was delayed. In one (0.8%) patient with insufficient rib cartilage length, which left no cartilage for helix splicing, the result was unsatisfactory.Conclusions:Eighth rib cartilage growth is variable. Rib cartilage assessment relative to the healthy ear can guide auricular reconstruction and personalize treatment in young patients with microtia.

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“…Moreover, the remaining costal cartilage block might be insufficient and the fixed cartilage wedge block may be absorbed or slip out, resulting in unsatisfactory ear projection [15,16]. Some authors have recently reported that not only the costal cartilage but also artificial materials such as hydroxyapatite or porous polyethylene or titanium mesh strut could be used for elevation [20][21][22]. However, artificial materials lack safety and reliability, as well as published results of research on long-term outcomes.…”

Section: Discussionmentioning

confidence: 99%

“…Some authors have recently reported that not only the costal cartilage but also artificial materials such as hydroxyapatite or porous polyethylene or titanium mesh strut could be used for elevation [ 20 21 22 ]. However, artificial materials lack safety and reliability, as well as published results of research on long-term outcomes.…”

Section: Discussionmentioning

confidence: 99%

Onlay Rib Bone Graft in Elevation of Reconstructed Auricle: 17 Years of Experience

2013

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BackgroundA cartilage wedge block and covering flap are standard procedures for firm elevation of the ear in microtia correction. However, using costal cartilage for elevation of the reconstructed auricle can be insufficient, and the fixed cartilage wedge block may be absorbed or may slip out. Furthermore, elevating covering flaps is time-consuming and uses up fascia, a potential source of reconstruction material. Therefore, we propose an innovative method using autologous onlay rib bone graft for auricular elevation of microtia.MethodsFrom February 1995 to August 2012, 77 patients received a first stage operation with a rib cartilage framework graft. In the second stage operation, a small full thickness of rib bone was harvested through the previous donor scar. The bihalved rib bone was inserted into the subperiosteal pocket beneath the cartilage framework.ResultsThe follow-up time ranged from 1 month to 17 years, with a mean of 3 years. All of the patients sustained the elevation of their ears very well during the follow-up period. Donor site problems, except for hypertrophic scars, were not observed. Surgery-related complications, specifically skin necrosis, infection, or hematoma, occurred in 4 cases.ConclusionsOnlay rib bone graft used to elevate the reconstructed auricle is a more anatomically appropriate material than cartilage, due to the bone-to-bone contact between the bone graft and the temporal bone. Postoperative minor correction of the elevation degree is straightforward and the skin graft survives better. Therefore, reconstructed auricle elevation using onlay rib bone graft is a useful and valuable method.

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Titanium Mesh Strut: A Novel Instrument for Firm Elevation of the Reconstructed Auricle

Abstract: This journal requires that authors assign a level of evidence to each article. For a full description of these evidence-based medicine ratings, please refer to the Table of contents or the online instructions to authors at www.springer.com/00266.

Cited by 13 publications

References 18 publications

Strategies for ear elevation and the treatment of relevant complications in autologous cartilage microtia reconstruction

Strategies for ear elevation and the treatment of relevant complications in autologous cartilage microtia reconstruction

Rib Cartilage Assessment Relative to the Healthy Ear in Young Children with Microtia Guiding Operative Timing

Onlay Rib Bone Graft in Elevation of Reconstructed Auricle: 17 Years of Experience

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