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Ku PK, Vlantis AC, Tong MC, Chan TT, Yeung ZW, Cho RH, Hui TS, Ho OY, Leung IO, Tsang WS, Lai NK, Chang WT, Abdullah V, van Hasselt A, Tong MC. A Hybrid Auricular Framework of Autologous Rib Cartilage and a Porous Polyethylene Implant for Reconstruction of Congenital Microtia: A Modification of Nagata's Technique. Facial Plast Surg Aesthet Med 2024; 26:15-22. [PMID: 37256708 PMCID: PMC10794839 DOI: 10.1089/fpsam.2022.0152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/02/2023] Open
Abstract
Background: An implant (porous polyethylene) is an alternative to rib cartilage for microtia reconstruction but carries a risk of extrusion. Objective: To evaluate the outcome of a hybrid framework of implant with rib cartilage for microtia reconstruction. Methods: Patients who underwent Nagata's technique for microtia reconstruction were reviewed for complications and aesthetic score. In stage 1, a rib cartilage framework or a hybrid framework of implant with rib cartilage was used. In stage 2, the framework was elevated and supported by an implant for projection. Postoperative outcomes were reported for both groups. Results: Forty-four ears of 40 patients underwent surgery. Eleven ears received a rib auricular framework and 33 ears a hybrid auricular framework. The mean postoperative follow-up for the rib and hybrid groups was 76.3 and 43.1 months, respectively. No supporting postauricular implant extruded, whereas stainless-steel wires extruded in seven ears (15.9%). Five (15.2%) hybrid frameworks were removed due to infection or extrusion. Mean operating time was 2 h shorter in the hybrid group. Aesthetic outcomes were similar for both groups. Conclusion: A hybrid framework of rib and implant that requires less harvested cartilage is feasible for microtia reconstruction, but caution should be used due to its higher explantation rate.
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Affiliation(s)
- Peter K.M. Ku
- Department of Otorhinolaryngology—Head and Neck Surgery, Division of Facial Plastic Surgery, United Christian Hospital and Tseung Kwan O Hospital, Hong Kong SAR, China
- Department of Otorhinolaryngology, Head and Neck Surgery, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Alexander C. Vlantis
- Department of Otorhinolaryngology, Head and Neck Surgery, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Marcus C. Tong
- Department of Otorhinolaryngology—Head and Neck Surgery, United Christian Hospital and Tseung Kwan O Hospital, Hong Kong SAR, China
| | - Trevor T.T. Chan
- Department of Otorhinolaryngology—Head and Neck Surgery, United Christian Hospital and Tseung Kwan O Hospital, Hong Kong SAR, China
| | - Zenon W.C. Yeung
- Department of Otorhinolaryngology—Head and Neck Surgery, United Christian Hospital and Tseung Kwan O Hospital, Hong Kong SAR, China
| | - Ryan H.W. Cho
- Department of Otorhinolaryngology—Head and Neck Surgery, United Christian Hospital and Tseung Kwan O Hospital, Hong Kong SAR, China
| | - Thomas S.C. Hui
- Department of Otorhinolaryngology—Head and Neck Surgery, United Christian Hospital and Tseung Kwan O Hospital, Hong Kong SAR, China
| | - Osan Y.M. Ho
- Department of Otorhinolaryngology—Head and Neck Surgery, Division of Facial Plastic Surgery, United Christian Hospital and Tseung Kwan O Hospital, Hong Kong SAR, China
| | - Iris O.S. Leung
- Department of Otorhinolaryngology—Head and Neck Surgery, Division of Facial Plastic Surgery, United Christian Hospital and Tseung Kwan O Hospital, Hong Kong SAR, China
| | - Willis S.S. Tsang
- Department of Otorhinolaryngology, Head and Neck Surgery, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Nelson K.L. Lai
- Department of Otorhinolaryngology—Head and Neck Surgery, Division of Facial Plastic Surgery, United Christian Hospital and Tseung Kwan O Hospital, Hong Kong SAR, China
| | - Wai-tsz Chang
- Department of Otorhinolaryngology, Head and Neck Surgery, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Victor Abdullah
- Department of Otorhinolaryngology—Head and Neck Surgery, United Christian Hospital and Tseung Kwan O Hospital, Hong Kong SAR, China
| | - Andrew van Hasselt
- Department of Otorhinolaryngology, Head and Neck Surgery, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Michael C.F. Tong
- Department of Otorhinolaryngology, Head and Neck Surgery, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong SAR, China
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Fan Y, Wei H, Zhao R, Lin X, Bai S. Accuracy of implant placement using CAD-CAM tooth-supported surgical guides for an auricular prosthesis in vitro. J Prosthodont 2024; 33:70-76. [PMID: 36710294 DOI: 10.1111/jopr.13651] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Revised: 01/11/2023] [Accepted: 01/11/2023] [Indexed: 01/31/2023] Open
Abstract
PURPOSE To evaluate the accuracy of tooth-supported surgical guides used to place implants in auricular prostheses. The accuracy (trueness and precision) of the implant positions was evaluated, and the difference between the surgical guide with and without retention of the external auditory canal (EAC) was compared. MATERIALS AND METHODS This study simulated implant placement in vitro for the treatment of right auricle malformation. Surgical guides and other casts were fabricated using additive manufacturing technology. The casts were divided into 2 groups according to the surgical guide, with 10 bone blocks in each group (with or without the EAC plug (Guides 1 and 2)). Three implant positions (Implants 1-3) were prepared for each bone block using surgical guides. Implant positions were registered using light-body silicone impressions combined with optical surface scans to measure the coronal, apical, depth, and angular deviations. Four deviations of trueness and precision were reported as the mean ± standard deviation, which was analyzed by Student's t-test. RESULTS Each group of 10 bone blocks with 30 implant positions was successfully prepared and digitally reproduced as implants. The accuracies of implant position with surgical guides were acceptable when compared with the preoperatively planned implant positions. Compared with the Guide 2 group, there was a significant difference in the apical, depth, and angular deviations of Guide 1 group in terms of precision (p = 0.001). There was a significant difference in the depth deviation of Implant 1 (p = 0.028) and apical deviation of Implant 2 (p < 0.001) compared two groups in terms of trueness. In terms of precision, there was a significant difference in the coronal (p = 0.002), apical (p = 0.001), and depth (p < 0.001) deviation of Implant 1; apical (p = 0.036) and angular (p < 0.001) deviation of Implant 2 also existed significant difference; the coronal deviation of Implant 3 (p = 0.018) also existed significant difference. Moreover, the group with the EAC plug showed lower deviation in precision and a smaller volume in the 95% confidence ellipsoid. CONCLUSION Both types of tooth-supported surgical guides can provide acceptable accuracy. A surgical guide with an EAC plug was considered to be more precise.
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Affiliation(s)
- Yiping Fan
- State Key Laboratory of Military Stomatology & National Clinical Research Center for Oral Diseases & Shaanxi Key Laboratory of Stomatology, Digital Center, School of Stomatology, The Fourth Military Medical University, Xi'an, Shaanxi, P. R. China
- Department of Stomatology, The First Medical Centre, Chinese PLA General Hospital, Beijing, P. R. China
| | - Hongbo Wei
- State Key Laboratory of Military Stomatology & National Clinical Research Center for Oral Diseases & Shaanxi Engineering Research Center for Dental Materials and Advanced Manufacture, Department of Oral Implants, School of Stomatology, The Fourth Military Medical University, Xi'an, Shaanxi, P. R. China
| | - Ruifeng Zhao
- State Key Laboratory of Military Stomatology & National Clinical Research Center for Oral Diseases & Shaanxi Key Laboratory of Stomatology, Digital Center, School of Stomatology, The Fourth Military Medical University, Xi'an, Shaanxi, P. R. China
| | - Xiuwen Lin
- State Key Laboratory of Military Stomatology & National Clinical Research Center for Oral Diseases & Shaanxi Key Laboratory of Stomatology, Digital Center, School of Stomatology, The Fourth Military Medical University, Xi'an, Shaanxi, P. R. China
| | - Shizhu Bai
- State Key Laboratory of Military Stomatology & National Clinical Research Center for Oral Diseases & Shaanxi Key Laboratory of Stomatology, Digital Center, School of Stomatology, The Fourth Military Medical University, Xi'an, Shaanxi, P. R. China
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Burns HR, Dinis J, Ding Y, Buchanan EP. Seminars in Plastic Surgery: Pediatric Ear Anomalies and Reconstruction. Semin Plast Surg 2023; 37:287-298. [PMID: 38098685 PMCID: PMC10718655 DOI: 10.1055/s-0043-1775888] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2023]
Abstract
Congenital ear anomalies affect 15 to 20% of neonates and can be categorized as either auricular deformations or malformations. Deformations involve a fully developed, albeit abnormally shaped, chondrocutaneous framework, which makes them amenable to correction with ear molding within the first few months of life. Malformations involve hypoplastic or fully absent auricular structures that require augmentation with alloplastic and/or autogenous reconstruction. The goal of this article is to outline the various auricular deformities and malformations, followed by a description of the latest clinical management options, both nonsurgical and surgical, by auricular anomaly.
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Affiliation(s)
- Heather R. Burns
- Michael E. DeBakey Department of Surgery, Division of Plastic Surgery, Baylor College of Medicine, Houston, Texas
- Division of Plastic Surgery, Texas Children's Hospital, Houston, Texas
| | - Jacob Dinis
- Michael E. DeBakey Department of Surgery, Division of Plastic Surgery, Baylor College of Medicine, Houston, Texas
- Division of Plastic Surgery, Texas Children's Hospital, Houston, Texas
| | - Yang Ding
- Michael E. DeBakey Department of Surgery, Division of Plastic Surgery, Baylor College of Medicine, Houston, Texas
- Division of Plastic Surgery, Texas Children's Hospital, Houston, Texas
| | - Edward P. Buchanan
- Michael E. DeBakey Department of Surgery, Division of Plastic Surgery, Baylor College of Medicine, Houston, Texas
- Division of Plastic Surgery, Texas Children's Hospital, Houston, Texas
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Liang J, Cao T, Wang Y, Wang B, Qian J, Chen Q, Zhang Q. A modified tissue expander method for ear reconstruction in patients with excessively insufficient postauricular skin. EAR, NOSE & THROAT JOURNAL 2023; 102:NP449-NP456. [PMID: 37139961 DOI: 10.1177/01455613231172332] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/05/2023] Open
Abstract
OBJECTIVE For microtia patients with excessively insufficient postauricular skin, it is difficult to obtain a satisfied outcome with existing strategies. In this study, we developed a modified tissue expander method for auricular reconstruction. METHODS The modified tissue expander method divided into 4 stages. In the first stage, a 30 ml or 50 ml kidney-shaped tissue expander was implanted in the mastoid region. A short time expansion (average 33.5 days) was conducted subsequently. In the second stage, the expander was removed and a modified cartilage framework without tragus was inserted through the same incision. A crescent-shaped cartilage pad was inserted into the incision of cartilage-harvest site at the same time. In the third stage, the reconstructed ear was elevated. Lobule rotation and remanent modification were performed in the fourth stage. The patients were followed up between half a year and 10 years. The outcomes of the reconstructed ears were scored with evaluation criteria. RESULTS From January 2010 to December 2019, a total of 45 microtia patients with excessively insufficient postauricular skin were performed the modified tissue expander method. Fourty-two patients showed satisfied outcomes. Complications such as hyperpigmentation in the skin graft area (3, 6.7%), scar hyperplasia (3, 6.7%) and folliculitis (1, 2.2%) were found. There were no complications related to the tissue expander. CONCLUSION The modified tissue expander method is an effective and safe technique for auricular reconstruction in patients having excessively insufficient postauricular skin, with satisfying medium-term results.
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Affiliation(s)
- Jiaxin Liang
- Department of Ear Reconstruction, Plastic Surgery Hospital, Chinese Academy of Medical Sciences, Beijing, China
| | - Tongyu Cao
- Department of Burns and Plastic Surgery, Beijing Jishuitan Hospital, Beijing, China
| | - Yue Wang
- Department of Ear Reconstruction, Plastic Surgery Hospital, Chinese Academy of Medical Sciences, Beijing, China
| | - Bingqing Wang
- Department of Ear Reconstruction, Plastic Surgery Hospital, Chinese Academy of Medical Sciences, Beijing, China
| | - Jin Qian
- Department of Ear Reconstruction, Plastic Surgery Hospital, Chinese Academy of Medical Sciences, Beijing, China
| | - Qi Chen
- Department of Ear Reconstruction, Plastic Surgery Hospital, Chinese Academy of Medical Sciences, Beijing, China
| | - Qingguo Zhang
- Department of Ear Reconstruction, Plastic Surgery Hospital, Chinese Academy of Medical Sciences, Beijing, China
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Allen RS, Biswas SK, Seifert AW. Neural crest cells give rise to non-myogenic mesenchymal tissue in the adult murid ear pinna. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2023:2023.08.06.552195. [PMID: 37609220 PMCID: PMC10441307 DOI: 10.1101/2023.08.06.552195] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/24/2023]
Abstract
Despite being a major target of reconstructive surgery, development of the external ear pinna remains poorly studied. As a craniofacial organ highly accessible to manipulation and highly conserved among mammals, the ear pinna represents a valuable model for the study of appendage development and wound healing in the craniofacial complex. Here we provide a cellular characterization of late gestational and postnatal ear pinna development in Mus musculus and Acomys cahirinus and demonstrate that ear pinna development is largely conserved between these species. Using Wnt1-cre;ROSAmT/mG mice we find that connective tissue fibroblasts, elastic cartilage, dermal papilla cells, dermal sheath cells, vasculature, and adipocytes in the adult pinna are derived from cranial crest. In contrast, we find that skeletal muscle and hair follicles are not derived from neural crest cells. Cellular analysis using the naturally occurring short ear mouse mutant shows that elastic cartilage does not develop properly in distal pinna due to impaired chondroprogenitor proliferation. Interestingly, while chondroprogenitors develop in a mostly continuous sheet, the boundaries of cartilage loss in the short ear mutant strongly correlate with locations of vasculature-conveying foramen. Concomitant with loss of elastic cartilage we report increased numbers of adipocytes, but this seems to be a state acquired in adulthood rather than a developmental abnormality. In addition, chondrogenesis remains impaired in the adult mid-distal ear pinna of these mutants. Together these data establish a developmental basis for the study of the ear pinna with intriguing insights into the development of elastic cartilage.
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Affiliation(s)
- Robyn S. Allen
- Department of Biology, University of Kentucky, Lexington, KY 40506, USA
| | - Shishir K. Biswas
- Department of Biology, University of Kentucky, Lexington, KY 40506, USA
| | - Ashley W. Seifert
- Department of Biology, University of Kentucky, Lexington, KY 40506, USA
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Liu D, Su X, Hu J. Auricular Protection after Ear Reconstruction Using an Antipressure Alarm. PLASTIC AND RECONSTRUCTIVE SURGERY-GLOBAL OPEN 2023; 11:e5169. [PMID: 37547343 PMCID: PMC10402954 DOI: 10.1097/gox.0000000000005169] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Accepted: 06/20/2023] [Indexed: 08/08/2023]
Abstract
Auricular protection is an important part of postoperative care for ear reconstruction and has an important impact on the expected outcome of the surgery. Therefore, we developed an antipressure alarm to protect the reconstructed ear in the supine position. The device consists of three components: an alarm, a pressure detector, and an adjustable elastic band. When the patient is in a supine position, the pressure sensor is located above the back of the reconstructed ear. When the head is rotated to the affected side, the pressure detector senses the pressure signal in advance compared with the reconstructed ear, and then triggers an alarm to remind the patient to adjust his position in time to avoid pressing the reconstructed ear. The device has been applied to more than 100 patients and has achieved satisfactory clinical results.
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Affiliation(s)
- Di Liu
- From the Outpatient Operation Room, Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People’s Republic of China
| | - Xueshang Su
- Department of Cicatrix Minimally Invasive Treatment Center, Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College. Beijing, People’s Republic of China
| | - Jintian Hu
- Department of Cosmetic Injection Center, Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People’s Republic of China
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Rani D, Chitara N, Kanchan T, Krishan K. 3D printed bionic ear and microtia-anotia: Medical and forensic implications. Congenit Anom (Kyoto) 2023; 63:60-65. [PMID: 36680564 DOI: 10.1111/cga.12507] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Revised: 12/26/2022] [Accepted: 01/15/2023] [Indexed: 01/22/2023]
Abstract
Advances in science and technology result in continuous upgrading of the medical and clinical fields. These upgrades have been beneficial to many patients suffering from congenital and developmental diseases causing compromised functionality as well as the structural integrity of the affected organs. One such congenital anomaly is the microtia-anotia spectrum, which results in deformities of the external ear, affecting the hearing capability of an individual. The collaboration and integration of electronics in human biology are exemplified by the development of a 3D printed cyborg bionic ear from the patient's own cells, which is implanted to ameliorate microtia and improve the patient's hearing capacity. Since the late nineteenth century, forensic scientists have explored the external ear, establishing the significance of ear biometrics in the identification process. Similarly, ear prints can also play an important role in identifying the felon of a crime. In this regard, we examine the structure and functionality of implanted ears. This communication is an attempt to enlighten investigators on the forensic importance and limitations of the use of bionic ears for identification.
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Affiliation(s)
- Deepika Rani
- Department of Anthropology, Panjab University, Chandigarh, India
| | - Nandini Chitara
- Department of Anthropology, Panjab University, Chandigarh, India
| | - Tanuj Kanchan
- Department of Forensic Medicine, All India Institute of Medical Sciences, Jodhpur, India
| | - Kewal Krishan
- Department of Anthropology, Panjab University, Chandigarh, India
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Yao X, Yang Y, Zhou Z. Non-Mulberry Silk Fiber-Based Composite Scaffolds Containing Millichannels for Auricular Cartilage Regeneration. ACS OMEGA 2022; 7:15064-15073. [PMID: 35557673 PMCID: PMC9089373 DOI: 10.1021/acsomega.2c00846] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/10/2022] [Accepted: 04/07/2022] [Indexed: 06/07/2023]
Abstract
Tissue engineering has made significant progress as a cartilage repair alternative. It is crucial to promote cell proliferation and migration within three-dimensional (3D) bulk scaffolds for tissue regeneration through either chemical gradients or physical channels. In this study, by developing optimized silk fiber-based composite scaffolds, millimeter-scaled channels were created in the corresponding scaffolds via facile physical percussive drilling and subsequently utilized for auricular cartilage regeneration. We found that by the introduction of poly-l-lactic acid porous microspheres (PLLA PMs), the channels incorporated into the Antheraea pernyi (Ap) silk fiber-based scaffolds were reinforced, and the mechanical features were well maintained. Moreover, Ap silk fiber-based scaffolds reinforced by PLLA PMs containing channels (CMAF) exhibited excellent chondrocyte proliferation, migration, and synthesis of cartilage-specific extracellular matrix (ECM) in vitro. The biological evaluation in vivo revealed that CMAF had a higher chondrogenic capability for an even deposition of the specific ECM component. This study suggested that multihierarchical CMAF may have potential application for auricular cartilage regeneration.
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Dong X, Premaratne ID, Bernstein JL, Samadi A, Lin AJ, Toyoda Y, Kim J, Bonassar LJ, Spector JA. Three-Dimensional-Printed External Scaffolds Mitigate Loss of Volume and Topography in Engineered Elastic Cartilage Constructs. Cartilage 2021; 13:1780S-1789S. [PMID: 34636646 PMCID: PMC8804786 DOI: 10.1177/19476035211049556] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
OBJECTIVE A major obstacle in the clinical translation of engineered auricular scaffolds is the significant contraction and loss of topography that occur during maturation of the soft collagen-chondrocyte matrix into elastic cartilage. We hypothesized that 3-dimensional-printed, biocompatible scaffolds would "protect" maturing hydrogel constructs from contraction and loss of topography. DESIGN External disc-shaped and "ridged" scaffolds were designed and 3D-printed using polylactic acid (PLA). Acellular type I collagen constructs were cultured in vitro for up to 3 months. Collagen constructs seeded with bovine auricular chondrocytes (BAuCs) were prepared in 3 groups and implanted subcutaneously in vivo for 3 months: preformed discs with ("Scaffolded/S") or without ("Naked/N") an external scaffold and discs that were formed within an external scaffold via injection molding ("Injection Molded/SInj"). RESULTS The presence of an external scaffold or use of injection molding methodology did not affect the acellular construct volume or base area loss. In vivo, the presence of an external scaffold significantly improved preservation of volume and base area at 3 months compared to the naked group (P < 0.05). Construct contraction was mitigated even further in the injection molded group, and topography of the ridged constructs was maintained with greater fidelity (P < 0.05). Histology verified the development of mature auricular cartilage in the constructs within external scaffolds after 3 months. CONCLUSION Custom-designed, 3D-printed, biocompatible external scaffolds significantly mitigate BAuC-seeded construct contraction and maintain complex topography. Further refinement and scaling of this approach in conjunction with construct fabrication utilizing injection molding may aid in the development of full-scale auricular scaffolds.
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Affiliation(s)
- Xue Dong
- Laboratory of Bioregenerative Medicine
& Surgery, Department of Surgery, Division of Plastic Surgery, Weill Cornell
Medical College, New York, NY, USA
- Department of Breast Surgery, Xiangya
Hospital, Central South University, Changsha, Hunan, China
| | - Ishani D. Premaratne
- Laboratory of Bioregenerative Medicine
& Surgery, Department of Surgery, Division of Plastic Surgery, Weill Cornell
Medical College, New York, NY, USA
| | - Jaime L. Bernstein
- Laboratory of Bioregenerative Medicine
& Surgery, Department of Surgery, Division of Plastic Surgery, Weill Cornell
Medical College, New York, NY, USA
| | - Arash Samadi
- Laboratory of Bioregenerative Medicine
& Surgery, Department of Surgery, Division of Plastic Surgery, Weill Cornell
Medical College, New York, NY, USA
| | - Alexandra J. Lin
- Laboratory of Bioregenerative Medicine
& Surgery, Department of Surgery, Division of Plastic Surgery, Weill Cornell
Medical College, New York, NY, USA
| | - Yoshiko Toyoda
- Laboratory of Bioregenerative Medicine
& Surgery, Department of Surgery, Division of Plastic Surgery, Weill Cornell
Medical College, New York, NY, USA
| | - Jongkil Kim
- Nancy E. and Peter C. Meinig School of
Biomedical Engineering, Cornell University, Ithaca, NY, USA
| | - Lawrence J. Bonassar
- Nancy E. and Peter C. Meinig School of
Biomedical Engineering, Cornell University, Ithaca, NY, USA
- Sibley School of Mechanical and
Aerospace Engineering, Cornell University, Ithaca, NY, USA
| | - Jason A. Spector
- Laboratory of Bioregenerative Medicine
& Surgery, Department of Surgery, Division of Plastic Surgery, Weill Cornell
Medical College, New York, NY, USA
- Nancy E. and Peter C. Meinig School of
Biomedical Engineering, Cornell University, Ithaca, NY, USA
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10
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Reply: "Nonsurgical Correction of Congenital Ear Anomalies: A Review of the Literature". PLASTIC AND RECONSTRUCTIVE SURGERY-GLOBAL OPEN 2021; 9:e3562. [PMID: 34150418 PMCID: PMC8205219 DOI: 10.1097/gox.0000000000003562] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022]
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11
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Chang B, Cornett A, Nourmohammadi Z, Law J, Weld B, Crotts SJ, Hollister SJ, Lombaert IMA, Zopf DA. Hybrid Three-Dimensional-Printed Ear Tissue Scaffold With Autologous Cartilage Mitigates Soft Tissue Complications. Laryngoscope 2021; 131:1008-1015. [PMID: 33022112 PMCID: PMC8021596 DOI: 10.1002/lary.29114] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2020] [Revised: 07/24/2020] [Accepted: 08/25/2020] [Indexed: 02/02/2023]
Abstract
OBJECTIVES/HYPOTHESIS To analyze the use of highly translatable three-dimensional (3D)-printed auricular scaffolds with and without novel cartilage tissue inserts in a rodent model. STUDY DESIGN Preclinical rodent animal model. METHODS This prospective study assessed a single-stage 3D-printed auricular bioscaffold with or without porcine cartilage tissue inserts in an athymic rodent model. Digital Imaging and Communications in Medicine computed tomography images of a human auricle were segmented to create an external anatomic envelope filled with orthogonally interconnected spherical pores. Scaffolds with and without tissue inset sites were 3D printed by laser sintering bioresorbable polycaprolactone, then implanted subcutaneously in five rats for each group. RESULTS Ten athymic rats were studied to a goal of 24 weeks postoperatively. Precise anatomic similarity and scaffold integrity were maintained in both scaffold conditions throughout experimentation with grossly visible tissue ingrowth and angiogenesis upon explantation. Cartilage-seeded scaffolds had relatively lower rates of nonsurgical site complications compared to unseeded scaffolds with relatively increased surgical site ulceration, though neither met statistical significance. Histology revealed robust soft tissue infiltration and vascularization in both seeded and unseeded scaffolds, and demonstrated impressive maintenance of viable cartilage in cartilage-seeded scaffolds. Radiology confirmed soft tissue infiltration in all scaffolds, and biomechanical modeling suggested amelioration of stress in scaffolds implanted with cartilage. CONCLUSIONS A hybrid approach incorporating cartilage insets into 3D-printed bioscaffolds suggests enhanced clinical and histological outcomes. These data demonstrate the potential to integrate point-of-care tissue engineering techniques into 3D printing to generate alternatives to current reconstructive surgery techniques and avoid the demands of traditional tissue engineering. LEVEL OF EVIDENCE NA Laryngoscope, 131:1008-1015, 2021.
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Affiliation(s)
- Brian Chang
- Department of Pediatrics, University of California Los Angeles Mattel Children's Hospital, Los Angeles, California, U.S.A
| | - Ashley Cornett
- Department of Biologic and Materials Sciences, School of Dentistry, University of Michigan, Ann Arbor, Michigan, U.S.A
- Biointerfaces Institute, University of Michigan, Ann Arbor, Michigan, U.S.A
| | - Zahra Nourmohammadi
- Department of Otolaryngology-Head and Neck Surgery, University of Michigan, Ann Arbor, Michigan, U.S.A
| | - Jadan Law
- Department of Biomedical Engineering, Michigan Engineering, Ann and Robert H. Lurie Biomedical Engineering Building, Ann Arbor, Michigan, U.S.A
| | - Blaine Weld
- Department of Biomedical Engineering, Michigan Engineering, Ann and Robert H. Lurie Biomedical Engineering Building, Ann Arbor, Michigan, U.S.A
| | - Sarah J Crotts
- Center for 3D Medical Fabrication, Coulter Department of Biomedical Engineering, Georgia Institute of Technology, Atlanta, Georgia, U.S.A
| | - Scott J Hollister
- Center for 3D Medical Fabrication, Coulter Department of Biomedical Engineering, Georgia Institute of Technology, Atlanta, Georgia, U.S.A
| | - Isabelle M A Lombaert
- Department of Biologic and Materials Sciences, School of Dentistry, University of Michigan, Ann Arbor, Michigan, U.S.A
- Biointerfaces Institute, University of Michigan, Ann Arbor, Michigan, U.S.A
| | - David A Zopf
- Department of Biomedical Engineering, Michigan Engineering, Ann and Robert H. Lurie Biomedical Engineering Building, Ann Arbor, Michigan, U.S.A
- Department of Otolaryngology-Head and Neck Surgery, Michigan Medicine, C.S. Mott Children's Hospital, Ann Arbor, Michigan, U.S.A
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Zeng Y, Li X, Liu X, Yang Y, Zhou Z, Fan J, Jiang H. PLLA Porous Microsphere-Reinforced Silk-Based Scaffolds for Auricular Cartilage Regeneration. ACS OMEGA 2021; 6:3372-3383. [PMID: 33553955 PMCID: PMC7860514 DOI: 10.1021/acsomega.0c05890] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/03/2020] [Accepted: 01/13/2021] [Indexed: 05/17/2023]
Abstract
Microtia, frequently encountered in plastic surgery practice, is usually corrected by auricular reconstruction with prostheses or autologous cartilages. In recent decades, however, cartilage tissue engineering has been emerging as a promising alternative for its minimal invasion and low immunogenicity. As a critical factor for tissue engineering, scaffolds are expected to be sufficiently porous and stiff to facilitate chondrogenesis. In this work, we introduce novel poly-l-lactic acid (PLLA) porous microsphere-reinforced silk-based hybrid (SBH) scaffolds with a multihierarchical porous structure. The scaffolds are fabricated by embedding PLLA porous microspheres (PMs) into a blending matrix of silk fibroin (SF) and gelatin solution, followed by mixing with a degummed silk fiber mesh and freeze-drying process. Through adjusting the amount of PLLA PMs, the mechanical strength approximates to natural cartilage and also balanced physical properties were realized. Biological evaluations of SBH scaffolds, both in vitro and in vivo, were conducted and PM-free plain silk-based (PSB) scaffolds were applied as control. Overall, it suggests that the incorporation of PLLA PMs remarkably improves mechanical properties and the capability to promote chondrogenesis of SBH scaffolds, and that SBH scaffolds appear to be a promising construct for potential applications in auricular cartilage tissue engineering and relevant fields.
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Affiliation(s)
- Yan Zeng
- Plastic
Surgery Hospital and Institute, Chinese
Academy of Medical Sciences & Peking Union Medical College, Beijing 100144, China
| | - Xiaokai Li
- Biomedical
Barriers Research Center, Institute of Biomedical Engineering, Chinese Academy of Medical Sciences & Peking Union
Medical College, Tianjin 300192, China
- Tianjin
Key Laboratory of Biomedical Materials, Tianjin 300192, China
| | - Xia Liu
- Plastic
Surgery Hospital and Institute, Chinese
Academy of Medical Sciences & Peking Union Medical College, Beijing 100144, China
| | - Yuzhou Yang
- Biomedical
Barriers Research Center, Institute of Biomedical Engineering, Chinese Academy of Medical Sciences & Peking Union
Medical College, Tianjin 300192, China
- Tianjin
Key Laboratory of Biomedical Materials, Tianjin 300192, China
| | - Zhimin Zhou
- Biomedical
Barriers Research Center, Institute of Biomedical Engineering, Chinese Academy of Medical Sciences & Peking Union
Medical College, Tianjin 300192, China
- Tianjin
Key Laboratory of Biomedical Materials, Tianjin 300192, China
| | - Jincai Fan
- Plastic
Surgery Hospital and Institute, Chinese
Academy of Medical Sciences & Peking Union Medical College, Beijing 100144, China
| | - Haiyue Jiang
- Plastic
Surgery Hospital and Institute, Chinese
Academy of Medical Sciences & Peking Union Medical College, Beijing 100144, China
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Assessment of ear metric properties in young Turkish adults. JOURNAL OF SURGERY AND MEDICINE 2020. [DOI: 10.28982/josam.774357] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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