Статті в журналах: "Autologous ear reconstruction"

1

Chen, Kevin, and James P. Bradley. "Autologous Ear Reconstruction." Plastic and Reconstructive Surgery 144, no. 6 (December 2019): 1121e. http://dx.doi.org/10.1097/prs.0000000000006233.

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Olshinka, Asaf, Matthew Louis, and Tuan Truong. "Autologous Ear Reconstruction." Seminars in Plastic Surgery 31, no. 03 (August 2017): 146–51. http://dx.doi.org/10.1055/s-0037-1603959.

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Since the pioneering use of autologous rib cartilage for the reconstruction of microtia, there have been significant advances in surgical technique that have helped to ameliorate the psychological burden of microtia. To date, the use of rib cartilage for auricular reconstruction is one of the most enduring and ubiquitous techniques for microtia reconstruction as it provides excellent aesthetic results with lasting durability. In this review, the authors outline the most common methods of microtia reconstruction with a comparison of each technique and illustrative case examples.

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Ito, Ken, Makiko Toma-Hirano, and Takuya Yasui. "Successful Posterior Canal Wall Reconstruction with Tissue-Engineered Cartilage." OTO Open 3, no. 1 (January 2019): 2473974X1982562. http://dx.doi.org/10.1177/2473974x19825628.

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Difficulties are associated with reconstruction of middle ear bony structures in surgery for destructive lesions, including cholesteatoma. Although autologous cartilage appears to be the optimal choice because of its resistance to infection, the harvesting of sufficient volumes may be challenging. Therefore, regenerative medicine techniques to obtain sufficient material for reconstruction are awaited. We herein present a case of middle ear surgery for cholesteatoma with a sufficient volume of stick-shaped tissue-engineered cartilage produced from a piece of autologous auricular cartilage and autologous serum, with sufficient firmness to reconstruct bony structures. During surgery, sections of tissue-engineered cartilage were placed side by side to reconstruct the posterior canal wall. The postoperative course was uneventful. This is the first-in-human report of reconstructing middle ear bony structures with tissue-engineered cartilage. The results suggest a promising future for the satisfactory reconstruction of middle ear structures with minimal morbidity at the donor site.

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Stewart, Ken, and Sven-Olof Wikström. "Autologous Ear Reconstruction – Celebrating 50 Years." Journal of Plastic, Reconstructive & Aesthetic Surgery 61 (January 2008): S2—S4. http://dx.doi.org/10.1016/j.bjps.2008.09.014.

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Ali, Kausar, Jeffrey Trost, Tuan Truong, and Raymond Harshbarger. "Total Ear Reconstruction Using Porous Polyethylene." Seminars in Plastic Surgery 31, no. 03 (August 2017): 161–72. http://dx.doi.org/10.1055/s-0037-1604261.

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AbstractTotal ear reconstruction has been approached by several techniques involving autologous graft, prosthetic implant, and alloplastic implant options. Recent studies have shown the superiority of porous polyethylene (Medpor, Porex Surgical) reconstruction over autologous reconstruction based on improved aesthetic results, earlier age of intervention, shorter surgery times, fewer number of required procedures, and a simpler postoperative recovery process. A durable and permanent option for total ear reconstruction, like Medpor, can help alleviate the cosmetic concerns that patients with auricular deformities may be burdened with on a daily basis. In this article, the authors discuss the advantages of Medpor-based ear reconstruction and discuss recent advances in the surgical techniques involved, such as harvesting a temporoparietal fascia flap and full-thickness skin graft to adequately cover the Medpor framework and decrease extrusion rates.

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Firmin, Françoise, and Alexandre Marchac. "A Novel Algorithm for Autologous Ear Reconstruction." Seminars in Plastic Surgery 25, no. 04 (October 20, 2011): 257–64. http://dx.doi.org/10.1055/s-0031-1288917.

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Kasrai, Leila, Alison K. Snyder-Warwick, and David M. Fisher. "Single-Stage Autologous Ear Reconstruction for Microtia." Plastic and Reconstructive Surgery 133, no. 3 (March 2014): 652–62. http://dx.doi.org/10.1097/prs.0000000000000063.

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Katwala, Priyank K., Vishal A. Pawar, Palak P. Katwala, and Ketan H. Parmar. "A clinical study of external ear reconstruction: a study of 20 cases." International Surgery Journal 6, no. 11 (October 24, 2019): 4072. http://dx.doi.org/10.18203/2349-2902.isj20195125.

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Background: Auricular defects pose one of the most difficult challenges in reconstructive surgery of the head and neck. The reason is the unique three-dimensional anatomical architecture of the auricle, with its multiple concavities and convolutions of the cartilage and the thin, delicate skin cover. Acquired auricular deformities commonly result from traumatic injuries, burn trauma or tumour extirpation. These vary in severity from simple lacerations to complete auricular avulsions. Congenital ear deformity (microtia) occurs in every 1 out of 6000 live births. The goal of reconstruction is the precise duplication of the missing anatomical part with regard to size, orientation and anatomical landmarks.Methods: Range from healing by secondary intention to complete replacement with autologous rib cartilage and/or auricular prosthesis. Total auricular reconstruction was done by two methods: (1) Nagata and (2) Brent’s method. Nagata’s technique is commonly performed in this study. The present study aimed to evaluate the reconstruction of auricular defects using autologous rib cartilage graft with or without temperoparietal fascia flap covered by split-thickness skin graft.Results: Excellent cosmetic result can be obtained with adequate skills and training in carving the cartilage for auricular framework. This improves confidence and gives psychological support to microtia patients.Conclusions: With training and method, results in ear reconstruction using autologous rib cartilage are excellent and reproducible.

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Mussi, Elisa, Michaela Servi, Flavio Facchini, Yary Volpe, and Rocco Furferi. "A rapid prototyping approach for custom training of autologous ear reconstruction." International Journal on Interactive Design and Manufacturing (IJIDeM) 15, no. 4 (October 8, 2021): 577–85. http://dx.doi.org/10.1007/s12008-021-00782-0.

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AbstractAutologous ear reconstruction is the preferred treatment in case of partial or total absence of the patient external ear. This kind of surgery can be really challenging since precise replication of complex three-dimensional structure of the ear is crucial to provide the patients with aesthetically consistent reconstructed anatomy. Therefore, the results strongly depends on the “artistic skills” of the surgeon who is in charge to carry out a three-dimensional sculpture, which resembles the shape of a normal ear. In this context, the definition of a preoperative planning and simulation process based on the patient's specific anatomy may help the surgeon in speeding up the ear reconstruction process and, at the same time, to obtain better results, thus allowing a superior surgical outcome. In the present work the main required features for performing an effective simulation of the ear reconstruction are identified and a strategy for their interactive design and customization is devised with the perspective of a semi-automatization of the procedure. In detail, the paper provides a framework which start from the acquisition of 3D data from both a healthy ear of the patient (or, if not available e.g. due to bilateral microtia of the ear of one of his parents or from a template) and of costal cartilage. Acquired 3D data are properly processed to define the anatomical elements of the ear and to find, using nesting-based algorithms, the costal cartilage portions to be used for carving the ear itself. Finally, 3D printing is used to create a mockup of the ear elements and a prototype of the ear to be reconstructed is created. Validated on a test case, the devised procedure demonstrate its effectiveness.

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Ma, Yangmyung, and Mark Sheldon Lloyd. "Systematic Review of Medpor Versus Autologous Ear Reconstruction." Journal of Craniofacial Surgery 33, no. 2 (October 13, 2021): 602–6. http://dx.doi.org/10.1097/scs.0000000000008130.

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Yen, Paul, and Cynthia Verchere. "Donor Site Calcification and Deformation Following Microtia Repair in a Pediatric Patient With Mosaic Trisomy 22." Plastic Surgery Case Studies 5 (January 1, 2019): 2513826X1983172. http://dx.doi.org/10.1177/2513826x19831721.

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A microtia, or small or abnormally formed pinna, is an uncommon congenital abnormality of the external ear which can present as an isolated defect or as part of an underlying clinical syndrome. External ear reconstruction is a possibility, with either an autologous or non-autologous framework. The Nagata type of autologous reconstruction is a multistage process whereby costal cartilage, temporoparietal fascia, and a full thickness skin graft are used to form a new pinna. Here, we present the unique case of a young female born with mosaic trisomy 22, an extremely rare genetic condition, and a right-sided microtia. Between the first and second stages of her reconstruction, an anterior chest wall deformation was observed, coupled with unusual dystrophic calcifications over the cartilage near the ribs and sternum.

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Bedri, Es-Hak, and Miriam Redleaf. "Ossicular Chain Reconstruction in a Developing Country." Annals of Otology, Rhinology & Laryngology 127, no. 5 (March 5, 2018): 306–11. http://dx.doi.org/10.1177/0003489418760054.

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Objectives: In Ethiopia, 2-stage operations with middle ear prostheses are economically unfavorable. We hypothesized that single-stage autologous ossiculoplasty results in acceptable tympanic membrane (TM) and hearing improvements in a setting of limited resources. Methods: One hundred eighty-eight patients (197 ears) who underwent 1-stage autologous ossiculoplasty for ossicular dysfunction are presented. All but 14 of these ears also had perforations of the TM. Conditions of the middle ear were granulation tissue, ossicular disruption only, tympanosclerosis, and cholesteatoma. Reconstructions of the ossicular chain were performed with autologous ossicles only. Results: The closure rate of TM perforations was 95%. Preoperative air bone gaps were 27 to 60 dB (mean [SD] = 44 [7] dB); postoperative air bone gaps were 0 to 50 dB (average [SD] = 23 [10] dB), for an average improvement of 21 dB across all reconstruction types ( P < .001). The largest favorable changes in air bone gaps were with incus and malleus columellas from the footplate to the TM (33 and 23 dB, respectively) ( P < .001). No patient had worsening of sensorineural hearing levels or extrusion of the reconstructed ossicles. Conclusion: Autologous ossiculoplasty performed well in this setting. Acceptable TM closure rates and improvement of air bone gaps were seen in 1-stage operations without the use of prostheses.

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13

Kristiansen, Martina, Martin Öberg, and Sven Olof Wikström. "Patients' satisfaction after ear reconstruction with autologous rib cartilage." Journal of Plastic Surgery and Hand Surgery 47, no. 2 (February 15, 2013): 113–17. http://dx.doi.org/10.3109/2000656x.2012.751027.

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14

Mussi, Elisa, Rocco Furferi, Yary Volpe, Flavio Facchini, Kathleen S. McGreevy, and Francesca Uccheddu. "Ear Reconstruction Simulation: From Handcrafting to 3D Printing." Bioengineering 6, no. 1 (February 5, 2019): 14. http://dx.doi.org/10.3390/bioengineering6010014.

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Microtia is a congenital malformation affecting one in 5000 individuals and is characterized by physical deformity or absence of the outer ear. Nowadays, surgical reconstruction with autologous tissue is the most common clinical practice. The procedure requires a high level of manual and artistic techniques of a surgeon in carving and sculpting of harvested costal cartilage of the patient to recreate an auricular framework to insert within a skin pocket obtained at the malformed ear region. The aesthetic outcomes of the surgery are highly dependent on the experience of the surgeon performing the surgery. For this reason, surgeons need simulators to acquire adequate technical skills out of the surgery room without compromising the aesthetic appearance of the patient. The current paper aims to describe and analyze the different materials and methods adopted during the history of autologous ear reconstruction (AER) simulation to train surgeons by practice on geometrically and mechanically accurate physical replicas. Recent advances in 3D modelling software and manufacturing technologies to increase the effectiveness of AER simulators are particularly described to provide more recent outcomes.

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Tiwari, Vinay Kumar, Deepak Nanda, Raman Tandon, and Rohit Babu Mula. "Salvaging collateral damage by COVID-19 pandemic in form of exposed silicone ear framework in 33-year post reconstructed ear." International Journal of Research in Medical Sciences 9, no. 8 (July 28, 2021): 2468. http://dx.doi.org/10.18203/2320-6012.ijrms20213100.

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Total ear reconstruction is being practiced by different techniques. Ready to use Silicone ear framework (Silastic ear framework by Dow corning) was being used frequently by Plastic surgeons in the eighties and nineties of the twentieth century. Framework exposure, either due to skin necrosis or due to infection used to be the commonest complication in the early postoperative period. A follow-up case of a 50 year old male patient, our 33 years follow up case of Total ear reconstruction by silicone ear framework implantation presented to us with exposed silicone framework and infection. Due to constant use of facemask with elastic ear loop for support during COVID-19 pandemic. The exposed infected implant successfully salvaged using negative pressure wound therapy. In all cases of autologous or alloplastic ear reconstruction, we strictly recommend not to use facemasks with elastic ear loops. If a facemask has to be used it should have a head loop or to be used with an ear protector.

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Martins, Deborah B., Gina Farias-Eisner, Rachel S. Mandelbaum, Han Hoang, James P. Bradley, and Justine C. Lee. "Intraoperative Indocyanine Green Laser Angiography in Pediatric Autologous Ear Reconstruction." Plastic and Reconstructive Surgery - Global Open 4, no. 5 (May 2016): e709. http://dx.doi.org/10.1097/gox.0000000000000696.

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Tulong, Marcella Tirza, Mendy Hatibie Oley, Maximillian Christian Oley, Ali Sundoro, and Muhammad Faruk. "The Use of Hyperbaric Oxygen Therapy for Ear Reconstruction: A Case Series." Jurnal Plastik Rekonstruksi 8, no. 2 (November 6, 2021): 93–98. http://dx.doi.org/10.14228/jprjournal.v8i2.325.

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Introduction: The unique anatomy of the ear makes the reconstruction more challenging. Microtia and auricula hematomas are deformities or defects that can occur in the ear. Treating traumatic injury and congenital malformations of the ears needs some technique and expertise. Hyperbaric Oxygen Therapy is an additional therapy that makes a significant contribution and is effective in wound healing. Case Series: In our first case, a 52-year-old man presented with a traumatic right cauliflower ear due to a traffic accident two weeks before hospital admission. The second case involves a boy 14-year-old who has a Microtia in the right ear with total ear construction performed using autologous costochondral cartilage techniques in a two-stage. Results: Both cases following hyperbaric oxygen therapy, yield good results with good scars, no sign of infection nor tissue necrosis Summary: The combination therapy of reconstructive surgery and administration of oxygen therapy gave satisfactory results in both cases. Five sessions of hyperbaric treatment showed promising results. There is no infection, rapid wound healing, and cessation of flap compromise.

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Solanki, Karnadev, Navdeep Chavda, and Hiren Doshi. "OSSICULOPLASTY: AUTOGRAFT VS ALLOGRAFT." International Journal of Advanced Research 10, no. 12 (December 31, 2022): 800–805. http://dx.doi.org/10.21474/ijar01/15906.

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Background: Chronic otitis media (COM) is defined as a perforation of the tympanic membrane with persistent drainage of pus from the middle ear lasting at least two weeks. Tympanoplasty is a surgical procedure in ENT practice which aims at removal of diseased pathology from middle ear along with reconstruction of sound conducting mechanism by reconstructing the ossicular chain with various materials. Methods:All the cases of CSOM with ossicular chain deformity were included. Ear examination was done in detail, Preoperative hearing assessment was done and Hearing loss was calculated by average air bone gap on PTA.For Auto graftstragal cartilage or incus was used andfor allograft Teflon TORP/PORP with cartilage cap was used. Results: Comparison forossiculoplasty was done by comparing its advantages and disadvantages in the terms of extrusion rate and hearing restoration in postoperative period. Overall failure rate for autologous material was 8% and for alloplastic material was 12%. Conclusion: the use of autologous graft is more advantageous in terms of surgical outcome, extrusion rate, and postoperative hearing gain.

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Harris, P. A., K. Ladhani, R. Das-Gupta, and D. T. Gault. "Reconstruction of acquired sub-total ear defects with autologous costal cartilage." British Journal of Plastic Surgery 52, no. 4 (June 1999): 268–75. http://dx.doi.org/10.1054/bjps.1998.3053.

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Eley, Karen A., and David T. Gault. "The bacteriology of children prior to 1st stage autologous ear reconstruction." Journal of Plastic, Reconstructive & Aesthetic Surgery 63, no. 12 (December 2010): 2001–3. http://dx.doi.org/10.1016/j.bjps.2010.01.009.

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Gopalan, G., M. K. Rajendran, and R. Shankar. "Study on esthetic appearance of reconstructed pinna in microtia." International Surgery Journal 5, no. 12 (November 28, 2018): 3940. http://dx.doi.org/10.18203/2349-2902.isj20185023.

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Background: The normal external ear is a complex three-dimensional structure and, as such, reconstruction of the ear is a demanding undertaking. A new era in ear reconstruction began in 1959 when Tanzer introduced his multistage autologous rib cartilage technique and it gained wide acceptance from the surgeons. The aim of the present study was reconstruction of pinna in microtia cases using esthetic component and to study its surgical outcome.Methods: A prospective longitudinal study was conducted in the department of plastic, reconstructive and facio-maxillary surgery, Government Mohan Kumaramangalam Medical College, Salem, for a period of 2 years. A total of 26 patients with microtia were included in our study. The reconstruction of microtia was done by the following steps; a. first stage – removal of the rib cartilage and framework implantation; b. second stage - rotation of the ear lobule by Z plasty incision; c. third stage– creation of cephaloauricular sulcus; d. fourth stage - tragus construction and concha excavation. All the socio-demographic details and the clinical parameters related to the reconstructed ear were measured and tabulated.Results: The mean age of the study subjects was 14.3 years with a male: female ratio of 2:1. Based on the Tanzer classification all the patients were either in grade IIA or grade III of microtia with 35% of the patients had the hearing loss exceeding 40db. The mean length, breadth, degree of protrusion and degree of inclination of the reconstructed ear were 58.5mm, 34.6mm, 25o and 13o respectively. The most common complication reported in present study subjects was malposition of the reconstructed pinna (21.7%) followed by hematoma infection (8.6%) and hidden helix. Post-operatively the mean hearing loss was only 25db.Conclusions: The esthetic results of each of these techniques can be excellent when performed by an experienced surgeon in appropriately selected patients.

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Al Mamun, Md Abdullah, Md Zahedul Alam, Md Rozibul Haque, Mani Lal Aich, Mohammad Hanif, Mohammad Amzad Hossain, and Md Mizanur Rahman. "Autologous cartilagenous graft in ossiculoplasty." Bangladesh Journal of Otorhinolaryngology 19, no. 1 (May 3, 2013): 24–28. http://dx.doi.org/10.3329/bjo.v19i1.14860.

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CSOM is a most common ENT disease in our country, among them the atticoantral variety is life threatening if not treated earlier. So treatment plan is still radical surgery to eradicate the disease to save life ignoring the hearing conservation. Henceforth post operative hearing loss remains a problem for the patient. Ensuring total clearance of the disease depending on the ossicular status, tragal cartilage graft was used as easily available material for ossiculoplasty to improve the post operative hearing .The study presents 35 ear operation of varied middle ear pathology using tragal cartilage & perichodrium as a choice graft. We have recorded our observation & result & concluded that tragal cartilage & perichondrium is an ideal graft for ossiculoplaty. The objective of study was to asses the efficacy of tragal cartilage, the functional capacity in restoring hearing acuity, its mechanical survival, its extrusion rate & its functional integrity in ossicular reconstruction. The patients those underwent surgery in Sir Salimullah Medical College Mitford Hospital had significant improvement of hearing with no recurrence of disease. DOI: http://dx.doi.org/10.3329/bjo.v19i1.14860 Bangladesh J Otorhinolaryngol 2013; 19(1): 24-28

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Parri, Francisco, Veronica Alonso, Asteria Albert, Miguel Bejarano, Francisco Vicario, and Josep Rubio-Palau. "Auricular Reconstructive Surgery Improvement to the Firmin Technique for Placing an Earring." Cleft Palate-Craniofacial Journal 56, no. 9 (April 11, 2019): 1260–62. http://dx.doi.org/10.1177/1055665619842727.

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Microtia has an incidence of 1 in 7000 to 8000 births. Ear reconstruction has 2 main aims: reconstructive and aesthetic, and a considerable number of patients ask for an earring at the end of their treatment. Herein, we explain our team’s modification to the Firmin technique, perforating the lowest part of the autologous cartilage framework (Parri’s modification). The orifice is cartilaginous and the skin covering both sides is easily perforable without contacting the rest of the framework. In conclusion, our modification for placing an earring is simple; it does not increase the surgical time and contributes to approach the perfection of auricular reconstructive surgery.

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Yong, Li Yenn, Luca Lancerotto, Scott Inglis, Kerr Clapperton, Jonathan J. Cubitt, and Ken J. Stewart. "Three-dimensional video scanning, planning and printing to optimise autologous ear reconstruction." Journal of Plastic, Reconstructive & Aesthetic Surgery 74, no. 9 (September 2021): 2392–442. http://dx.doi.org/10.1016/j.bjps.2021.03.087.

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Hur, Young Kyun, Yeonsu Jeong, and Sung Huhn Kim. "Auricular Reconstruction in Microtia Patients: A Single Institution Experience." Korean Journal of Otorhinolaryngology-Head and Neck Surgery 65, no. 6 (June 21, 2022): 319–27. http://dx.doi.org/10.3342/kjorl-hns.2020.00647.

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Background and Objectives Microtia is a congenital deformity where the pinna and middle ear structures are underdeveloped. Auricular reconstruction in microtia is one of the most difficult surgeries in otolaryngology due to the complex three-dimensional structure of the auricle. This study investigated the post-operative results in total auricular reconstruction performed by otologic surgeons in a single institution.Subjects and Method We analyzed data from 27 microtia patients who underwent auricular reconstruction in our institution from 2011 to 2019. The post-operative results were evaluated in terms of the shape of the auricle, the symmetry of the ear, and the degree of auriculocephalic sulcus stricture. The type and frequency of post-operative complications associated with the reconstruction were also evaluated.Results Of the 24 patients, the shape of the auricle was good in 11 (40.7%), moderate in 11 (40.7%), and poor in 5 (18.6%) patients. The symmetry of the ear size was symmetric in 24 (88.9%) and asymmetric in 3 (11.1%) patients. The degree of auriculocephalic sulcus stricture was good in 11 (40.7%), partial stricture in 12 (44.4%), and severe stricture in 4 (14.8%) patients. Postoperative complications included skin necrosis, suture material exposure, and wound infection with cartilage deformation.Conclusion Total auricular reconstruction is a complex and sophisticated operation utilizing either autologous rib cartilage or artificial implant material. Considering that microtia is often accompanied by ear canal stenosis and hearing impairment, otolaryngologists should be more interested in the field of auricular reconstruction.

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Delaere, Pierre R., Robert Hermans, Jose Hardillo, and Bert Van Den Hof. "Prefabrication of Composite Tissue for Improved Tracheal Reconstruction." Annals of Otology, Rhinology & Laryngology 110, no. 9 (September 2001): 849–60. http://dx.doi.org/10.1177/000348940111000909.

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Tracheal repair tissues were evaluated experimentally to provide an evidence-based choice for decision-making in clinical tracheal reconstruction. Tracheal reconstructive tissue was characterized as providing for vascularization, support, and/or lining. A tissue equivalent was developed in the rabbit for each of the individual tissues. The individual tissues consisted of nonepithelialized soft tissue (vascularized fascia), epithelialized tissue (vascularized fascia grafted with buccal mucosa), and supportive tissue (ear cartilage). The 3 reconstructive tissues were evaluated in 30 rabbits after repair of an anterior laryngotracheal defect. Morphometric and histologic analysis was applied to the reconstructions. After a 1-month follow-up period, defects repaired with nonepithelialized soft tissue showed healing by secondary intention and a wound that was contracted to 44% of the initial surface area of the defect. Mucosa-lined soft tissue flaps and cartilage grafts showed a less than 10% wound contraction. Compared to cartilage grafts, mucosa-lined soft tissue (vascularized fascia grafted with buccal mucosa) seemed preferable for clinical use, because it showed healing by primary intention. A mucosa-lined radial forearm fascia flap was used successfully in cases of restenosis after tracheal resection. One deficiency of the mucosa-lined soft tissue was the absence of supportive tissue. In cases of extensive stenosis, it might be useful to obtain additional expansion of the airway lumen by creating a convexity at the site of reconstruction. In a second set of experiments, we attempted to improve the mucosa-lined soft tissue concept by adding elastic cartilage. A composite tissue consisting of vascularized fascia, buccal mucosa, and auricular cartilage was developed. Heterotopic prefabrication of the composite tissue was essential for survival of the cartilaginous component. Additional airway lumen expansion could be obtained after heterotopic flap prefabrication. After experimental evaluation, the concept of the prefabricated composite tissue was successfully applied in a clinical case of long-segment stenosis. Experimental and clinical evidence suggests that the combination of buccal mucosa and fascia form an optimized tissue combination for tracheal reconstruction. This combination can be improved by adding strips of autologous ear cartilage.

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Khan, Ikramullah, Amir M. Jan, and Farrukh Shahzad. "Middle-ear reconstruction: a review of 150 cases." Journal of Laryngology & Otology 116, no. 6 (June 2002): 435–39. http://dx.doi.org/10.1258/0022215021911220.

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This study is based on a retrospective analysis of 150 cases of tympanoplasty and ossicular chain reconstruction as a one-stage procedure. It was conducted at the Federal Government Services Hospital, Islamabad from 1983 to 1999. Temporalis fascia was used for myringoplasty and a sculptured autologous incus to bridge the malleus to stapes head and malleus to footplate gap. These interpositions have produced stable ossicular assemblies and provided satisfactory post-operative hearing gains. One hundred and twenty-six (84 per cent) patients achieved a healed tympanic membrane three months post-operatively. One year post-operatively, 121 (81 per cent) patients had an intact tympanic membrane and at five years 119 (79 per cent) had an intact tympanic membrane. The success rate was based on an intact tympanic membrane and an air-bone gapof less than 30 dB one-year post-operation. Accordingly, the overall success rate was 80 per cent (120 cases). Hearing gains in cases with an absent stapes arch were poorer than in cases with an intact arch. Early (one to three months) post-operative complications included tympanic membrane perforation, lateralization of the graft and persistence of infection. Late (one to five years) complications included the appearance of an anterior perforation and retraction and thinning of the tympanic membrane.

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Lan, Wei-Che, Ching-Yuan Wang, Ming-Hsui Tsai, and Chia-Der Lin. "Long-term follow-up of applying autologous bone grafts for reconstructing tympanomastoid defects in functional cholesteatoma surgery." PeerJ 9 (November 23, 2021): e12522. http://dx.doi.org/10.7717/peerj.12522.

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Objectives This study investigated the long-term surgical outcomes of functional cholesteatoma surgery with canal wall reconstruction using autologous bone grafts as the primary material in patients with acquired cholesteatoma. Subjects and Methods Medical charts were retrospectively reviewed for all patients admitted to one institution for surgical intervention between 2010 and 2018. We analyzed 66 patients (66 ears) who underwent functional tympanomastoidectomy involving the use of autologous bone grafts for canal wall defect reconstruction. Surgical outcomes were evaluated by comparing preoperative audiometric results with follow-up data (at least 36 months after surgery). Logistic regression analyses were performed to determine prognostic factors related to long-term hearing success. These factors included classification and stage of cholesteatoma, stapes condition, ossicular chain damage, active infection of the middle ear, state of the contralateral ear, preoperative hearing thresholds, gender, and age. Results The mean follow-up period was 49.2 months. The recidivism rate was 6% (four of 66 ears). The pure-tone average significantly improved from 50.78 ± 19.98 to 40.81 ± 21.22 dB hearing level (HL; p < 0.001). Air–bone gaps significantly improved from 26.26 ± 10.53 to 17.58 ± 8.21 dB HL (p < 0.001). In multivariate logistic regression analysis, early-stage disease (p = 0.021) and pars flaccida cholesteatoma (p = 0.036) exhibited statistically significant correlations with successful hearing preservation. Conclusion Functional cholesteatoma surgery with autologous bone grafts reconstruction is an effective approach to significantly improve hearing with low recidivism rates. Localized disease and pars flaccida cholesteatoma were two independent predictors of successful hearing preservation.

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Denadai, Rafael, Cassio Eduardo Raposo-Amaral, Guilherme Luis Zanco, and Cesar Augusto Raposo- Amaral. "Autologous Ear Reconstruction for Microtia Does Not Result in Loss of Cutaneous Sensitivity." Plastic and Reconstructive Surgery 143, no. 4 (April 2019): 808e—819e. http://dx.doi.org/10.1097/prs.0000000000005485.

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Zanje, Sneha S., Nikhil V. Kamat, Kunal K. Taware, M. L. Rokade, and Ashesh C. Bhumkar. "Utility of 3D CT Rib Study in Presurgical Planning of Autologous Ear Graft for Pinna Reconstruction in Microtia." Indian Journal of Radiology and Imaging 31, no. 03 (July 2021): 586–95. http://dx.doi.org/10.1055/s-0041-1735866.

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Abstract Purpose The aim of this study was to demonstrate the utility of three-dimensional computed tomography (3D) CT rib study in presurgical planning to select the autologous rib cartilage graft for pinna reconstruction. Materials and Methods Total of 35 patients of microtia for autologous rib graft from April 2017 to February 2020 were evaluated in this study. All patients had a plain low-dose multislice CT chest. The length of costal cartilages of sixth to ninth ribs bilaterally and width and height of sixth and seventh rib costal cartilage synchondrosis were measured in 3D reconstructed true size coronal images with best possible length displayed. All patients had high-resolution computed tomography (HRCT) temporal studies done to evaluate for associated anomalies in external canal, middle ear cavities, and inner ear structures. Eleven patients had simultaneous HRCT temporal bone done after plain CT chest and rest who had done recent prior study were reviewed without repetition of study. Results There were 19 males and 16 females for 3D CT rib study. Average age of the participants was 16.5 years. The average width of synchondrosis of sixth and seventh rib was 15.4 mm on right side and 14.7 mm on left side, average height of synchondrosis was 28.5 mm on right side and 30.7 mm on left side. Average length of the eighth rib costal cartilage was 88.6 mm on the right side and 90.5 mm on the left side. Average length of the ninth rib was 63.2 mm on the right side and 58.2 mm on the left side. Costal cartilage calcifications were present in 9 patients. Conclusion Preoperative 3D CT rib study provides accurate measurements of rib stock for sculpting autologous ear graft.

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Lee, Shu Jin, Heow Pueh Lee, Kwong Ming Tse, Ee Cherk Cheong, and Siak Piang Lim. "Computer-Aided Design and Rapid Prototyping–Assisted Contouring of Costal Cartilage Graft for Facial Reconstructive Surgery." Craniomaxillofacial Trauma & Reconstruction 5, no. 2 (June 2012): 75–81. http://dx.doi.org/10.1055/s-0031-1300964.

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Complex 3-D defects of the facial skeleton are difficult to reconstruct with freehand carving of autogenous bone grafts. Onlay bone grafts are hard to carve and are associated with imprecise graft-bone interface contact and bony resorption. Autologous cartilage is well established in ear reconstruction as it is easy to carve and is associated with minimal resorption. In the present study, we aimed to reconstruct the hypoplastic orbitozygomatic region in a patient with left hemifacial microsomia using computer-aided design and rapid prototyping to facilitate costal cartilage carving and grafting. A three-step process of (1) 3-D reconstruction of the computed tomographic image, (2) mirroring the facial skeleton, and (3) modeling and rapid prototyping of the left orbitozygomaticomalar region and reconstruction template was performed. The template aided in donor site selection and extracorporeal contouring of the rib cartilage graft to allow for an accurate fit of the graft to the bony model prior to final fixation in the patient. We are able to refine the existing computer-aided design and rapid prototyping methods to allow for extracorporeal contouring of grafts and present rib cartilage as a good alternative to bone for autologous reconstruction.

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Facchini, Flavio, Antonio Morabito, Francesco Buonamici, Elisa Mussi, Michaela Servi, and Yary Volpe. "Autologous Ear Reconstruction: Towards a Semiautomatic CAD-based Procedure for 3D Printable Surgical Guides." Computer-Aided Design and Applications 18, no. 2 (July 21, 2020): 357–67. http://dx.doi.org/10.14733/cadaps.2021.357-367.

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Faiz, Syed M., Anuja Bhargava, Saurabh Srivastava, Rajeev K. Gupta, Mariyam Parveen, Kriti Bhatt, and Abhijeet Singh. "Analysis of hearing improvement by various ossiculoplasty materials (autologous versus prostheses) in chronic otitis media patients." International Journal of Otorhinolaryngology and Head and Neck Surgery 9, no. 1 (December 27, 2022): 54. http://dx.doi.org/10.18203/issn.2454-5929.ijohns20223379.

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Background: The main purpose of surgery in cases of chronic otitis media is to eradicate the infection and restore the middle ear hearing function. Both intact tympanic membrane and ossicular chain are essential for the restoration of hearing in these cases. The world of material science has provided otologists with array of biomaterials for middle ear reconstruction. The use of ossicular graft material in ossicular chain reconstruction has significantly improved hearing results after surgeries for chronic otitis media.Methods: The study involved a total of 50 patients presenting with dry tympanic membrane perforation with ossicular disruption and air-bone gap (ABG) of >25 from July 2014 to December 2019. The patients were randomly allotted into two groups and they underwent tympanomastoidectomy with ossiculoplasty, in one group homologous incus was used as ossiculoplasty material and in the second group Teflon TORP/PORP was used as ossiculoplasty material.Results: The present study concluded that there was no inter-group difference in post-operative hearing outcome however the two groups individually noted significant post-operative improvement in hearing.Conclusions: In present study postoperative hearing improvement was similar in both groups. Although numerous approaches to ossicular reconstruction have been proven to be successful, no single technique has received universal acceptance.

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Mehta, Saahil, and Walid Sabbagh. "V-Y Flap in Second Stage Release for the Lower Pole Following Autologous Ear Reconstruction." Aesthetic Surgery Journal 38, no. 9 (June 28, 2018): NP138—NP140. http://dx.doi.org/10.1093/asj/sjy139.

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Mendis, KC, G. Pafitanis, and N. Bulstrode. "A technique to aid minimal access harvesting in the second stage of autologous ear reconstruction." Annals of The Royal College of Surgeons of England 101, no. 4 (April 2019): 304. http://dx.doi.org/10.1308/rcsann.2019.0005.

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Deng, Chen-Liang, Song-Lin Yang, Jiang-Hong Zheng, Guang-Yu Mao, and Wei-Dong Wan. "Reconstruction of the partial pinna using autologous ear cartilage combined with a local sliding skin flap." Journal of Plastic, Reconstructive & Aesthetic Surgery 67, no. 6 (June 2014): 869–71. http://dx.doi.org/10.1016/j.bjps.2014.01.007.

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Mizuno, Mitsuru, Shinji Kobayashi, Takanori Takebe, Hiroomi Kan, Yuichiro Yabuki, Takahisa Matsuzaki, Hiroshi Y. Yoshikawa, et al. "Brief Report: Reconstruction of Joint Hyaline Cartilage by Autologous Progenitor Cells Derived from Ear Elastic Cartilage." STEM CELLS 32, no. 3 (February 19, 2014): 816–21. http://dx.doi.org/10.1002/stem.1529.

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Landau, Shira, Ariel A. Szklanny, Majd Machour, Ben Kaplan, Yulia Shandalov, Idan Redenski, Margarita Beckerman, et al. "Human-engineered auricular reconstruction (hEAR) by 3D-printed molding with human-derived auricular and costal chondrocytes and adipose-derived mesenchymal stem cells." Biofabrication 14, no. 1 (December 3, 2021): 015010. http://dx.doi.org/10.1088/1758-5090/ac3b91.

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Abstract Microtia is a small, malformed external ear, which occurs at an incidence of 1–10 per 10 000 births. Autologous reconstruction using costal cartilage is the most widely accepted surgical microtia repair technique. Yet, the method involves donor-site pain and discomfort and relies on the artistic skill of the surgeon to create an aesthetic ear. This study employed novel tissue engineering techniques to overcome these limitations by developing a clinical-grade, 3D-printed biodegradable auricle scaffold that formed stable, custom-made neocartilage implants. The unique scaffold design combined strategically reinforced areas to maintain the complex topography of the outer ear and micropores to allow cell adhesion for the effective production of stable cartilage. The auricle construct was computed tomography (CT) scan-based composed of a 3D-printed clinical-grade polycaprolactone scaffold loaded with patient‐derived chondrocytes produced from either auricular cartilage or costal cartilage biopsies combined with adipose-derived mesenchymal stem cells. Cartilage formation was measured within the construct in vitro, and cartilage maturation and stabilization were observed 12 weeks after its subcutaneous implantation into a murine model. The proposed technology is simple and effective and is expected to improve aesthetic outcomes and reduce patient discomfort.

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Zhou, Jiayu, Bo Pan, Qinghua Yang, Yanyong Zhao, Leren He, Lin Lin, Hengyun Sun, et al. "Three-dimensional autologous cartilage framework fabrication assisted by new additive manufactured ear-shaped templates for microtia reconstruction." Journal of Plastic, Reconstructive & Aesthetic Surgery 69, no. 10 (October 2016): 1436–44. http://dx.doi.org/10.1016/j.bjps.2016.06.011.

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Sakahara, Daisuke, Hiroko Yanaga, Mariko Noto, Takuya Fujimoto, and Keisuke Imai. "Long-Term Clinical Results of Two-Stage Total Ear Reconstruction of Microtia Using Autologous Cell-Engineered Chondrocytes." Plastic & Reconstructive Surgery 151, no. 2 (November 10, 2022): 282e—287e. http://dx.doi.org/10.1097/prs.0000000000009854.

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Wong, Manzhi, Bien-Keem Tan, and Chong-Hee Lim. "Trachea Reconstruction with Single-Stage Composite Flaps in a Rabbit Model." Journal of Reconstructive Microsurgery 36, no. 01 (July 28, 2019): 001–8. http://dx.doi.org/10.1055/s-0039-1693452.

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Background Trachea reconstruction requires creation of a functional lining, semirigid support, and vascularity. We aimed to design composite flaps with these three components in a rabbit model. Methods Circumferential (n = 9) and partial anterior (n = 8) tracheal defects were created in rabbits. A circumferential defect was reconstructed with a tubed ear flap incorporating cartilage for support and skin for lining. This was pedicled on the posterior auricular vessels and tunneled into the neck to bridge the defect. In the second experiment, a longitudinal anterior trachea defect was patched with a pedicled rib cartilage and intercostal muscle flap based on the internal mammary vessels. The vascularized fascia over the intercostal muscles replaced the lining while the cartilage provided support. Postoperatively, the rabbits were monitored clinically and endoscopically. The tracheal constructs were examined histologically after the animals were sacrificed. Results Rabbits with circumferential defects reconstructed with the ear flap survived up to 6 months. Histology demonstrated vascularized cartilage with good integration of the flap with native trachea. However, hair growth and skin desquamation resulted in airway obstruction in the long term. In the second experiment, all the rabbits survived without respiratory distress, and the intercostal muscle fascia was completely covered by native respiratory epithelium. Conclusion We described two experimental techniques using autologous composite flaps for single-stage trachea reconstruction in a rabbit model. Skin was a poor lining replacement, whereas vascularized muscle fascia became covered with respiratory epithelium. A rib cartilage and muscle flap could potentially be used for reconstruction of partial defects in humans.

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Smith, M. C. F., C. Huins, and M. Bhutta. "Surgical treatment of chronic ear disease in remote or resource-constrained environments." Journal of Laryngology & Otology 133, no. 1 (December 19, 2018): 49–58. http://dx.doi.org/10.1017/s0022215118002165.

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AbstractBackgroundSurgery for chronic suppurative otitis media performed in low- and middle-income countries creates specific challenges. This paper describes the equipment and a variety of techniques that we find best suited to these conditions. These have been used over many years in remote areas of Nepal.Results and conclusionExtensive chronic suppurative otitis media is frequently encountered, with limited pre-operative investigation or treatment possible. Techniques learnt in better-resourced settings with good follow up need to be modified. The paper describes surgical methods suitable for resource-poor conditions, with rationales. These include methods of tympanoplasty for subtotal wet perforations, hearing reconstruction in wet ears and open cavities, large aural polyps, and canal wall down mastoidectomy with cavity obliteration. Various types of autologous ossiculoplasty are described in detail for use in the absence of prostheses. The following topics are discussed: decision-making for surgery on wet or best hearing ears, children, bilateral surgery, working with local anaesthesia, and obtaining adequate consent in this environment.

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Vranckx, Jan Jeroen, and Margot Den Hondt. "Tissue engineering and surgery: from translational studies to human trials." Innovative Surgical Sciences 2, no. 4 (June 24, 2017): 189–202. http://dx.doi.org/10.1515/iss-2017-0011.

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AbstractTissue engineering was introduced as an innovative and promising field in the mid-1980s. The capacity of cells to migrate and proliferate in growth-inducing medium induced great expectancies on generating custom-shaped bioconstructs for tissue regeneration. Tissue engineering represents a unique multidisciplinary translational forum where the principles of biomaterial engineering, the molecular biology of cells and genes, and the clinical sciences of reconstruction would interact intensively through the combined efforts of scientists, engineers, and clinicians. The anticipated possibilities of cell engineering, matrix development, and growth factor therapies are extensive and would largely expand our clinical reconstructive armamentarium. Application of proangiogenic proteins may stimulate wound repair, restore avascular wound beds, or reverse hypoxia in flaps. Autologous cells procured from biopsies may generate an ‘autologous’ dermal and epidermal laminated cover on extensive burn wounds. Three-dimensional printing may generate ‘custom-made’ preshaped scaffolds – shaped as a nose, an ear, or a mandible – in which these cells can be seeded. The paucity of optimal donor tissues may be solved with off-the-shelf tissues using tissue engineering strategies. However, despite the expectations, the speed of translation of in vitro tissue engineering sciences into clinical reality is very slow due to the intrinsic complexity of human tissues. This review focuses on the transition from translational protocols towards current clinical applications of tissue engineering strategies in surgery.

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Kuhlmann, Constanze, Jana C. Blum, Thilo L. Schenck, Riccardo E. Giunta, and Paul Severin Wiggenhauser. "Evaluation of the Usability of a Low-Cost 3D Printer in a Tissue Engineering Approach for External Ear Reconstruction." International Journal of Molecular Sciences 22, no. 21 (October 28, 2021): 11667. http://dx.doi.org/10.3390/ijms222111667.

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The use of alloplastic materials instead of autologous cartilage grafts offers a new perspective in craniofacial reconstructive surgery. Particularly for regenerative approaches, customized implants enable the surgeon to restore the cartilaginous framework of the ear without donor site morbidity. However, high development and production costs of commercially available implants impede clinical translation. For this reason, the usability of a low-cost 3D printer (Ultimaker 2+) as an inhouse-production tool for cheap surgical implants was investigated. The open software architecture of the 3D printer was modified in order to enable printing of biocompatible and biologically degradable polycaprolactone (PCL). Firstly, the printing accuracy and limitations of a PCL implant were compared to reference materials acrylonitrile butadiene styrene (ABS) and polylactic acid (PLA). Then the self-made PCL-scaffold was seeded with adipose-tissue derived stem cells (ASCs), and biocompatibility was compared to a commercially available PCL-scaffold using a cell viability staining (FDA/PI) and a dsDNA quantification assay (PicoGreen). Secondly, porous and solid patient-customized ear constructs were manufactured from mirrored CT-imagining data using a computer-assisted design (CAD) and computer-assisted manufacturing (CAM) approach to evaluate printing accuracy and reproducibility. The results show that printing of a porous PCL scaffolds was possible, with an accuracy equivalent to the reference materials at an edge length of 10 mm and a pore size of 0.67 mm. Cell viability, adhesion, and proliferation of the ASCs were equivalent on self-made and the commercially available PCL-scaffolds. Patient-customized ear constructs could be produced well in solid form and with limited accuracy in porous form from all three thermoplastic materials. Printing dimensions and quality of the modified low-cost 3D printer are sufficient for selected tissue engineering applications, and the manufacturing of personalized ear models for surgical simulation at manufacturing costs of EUR 0.04 per cell culture scaffold and EUR 0.90 (0.56) per solid (porous) ear construct made from PCL. Therefore, in-house production of PCL-based tissue engineering scaffolds and surgical implants should be further investigated to facilitate the use of new materials and 3D printing in daily clinical routine.

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Boumediene, Karim, Mira Hammad, Justin Dugué, Alexis Veyssière, and Catherine Baugé. "Tissue engineering of different cartilage types: a review of different approaches and recent advances." International Journal of Advances in Medical Biotechnology - IJAMB 2, no. 1 (March 1, 2019): 14. http://dx.doi.org/10.25061/2595-3931/ijamb/2019.v2i1.33.

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Cartilage is a connective tissue that serves as a structural support for maintaining the shape for specific appendices (nose, ear) and also helps for shock absorption when present in joints. Different types of cartilage coexist in the body: hyaline, elastic and fibrocartilage. Due to their different embryologic origin, they produce distinct extracellular matrix and therefore have specific functions according to their location. Cartilage is frequently subjected to many different lesions. Those include traumatic, metabolic and congenital forms, concerning all regions where this tissue is present: joints, head and neck area, intervertebral disks, etc. Increasing number of cancers also affects cartilage; especially in ear, nose and trachea. Unfortunately, this tissue has a poor regeneration ability. Few therapeutic options exist for cartilaginous lesions and most of them concern articular cartilage. They include micro fracture, autologous chondrocytes implantation, mosaicplasty, allograft and prosthesis. Ear and trachea are also targeted for reconstruction with lesser extent. Therefore, cartilage engineering highly addresses increasing number of pathologies associated to this tissue. In the last two decades, several trials were investigated using both progenitor cells and scaffolds. Even bone marrow derived stem cells were widely used and served as gold standard. Many progenitors from different areas are investigated for their capacity of chondrogenesis. On the other hand, biomaterials, natural and synthetic, are used to induce a 3D environment that allows proper growth and differentiation toward cartilage formation. Their characteristics depend on the location of the expected graft where porosity, biodegradability, ability to support strength and large scale use are the key points. Favorable environments are also needed to achieve appropriate chondrogenesis, including biochemical or mechanical stimuli and low oxygen tension. Bioprinting showed also encouraging outcomes in cartilage reconstruction with the investigation of several scaffolds.

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Uppal, Rajan S., Walid Sabbagh, Jagdip Chana, and David T. Gault. "Donor-Site Morbidity after Autologous Costal Cartilage Harvest in Ear Reconstruction and Approaches to Reducing Donor-Site Contour Deformity." Plastic and Reconstructive Surgery 121, no. 6 (June 2008): 1949–55. http://dx.doi.org/10.1097/prs.0b013e318170709e.

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Deshmukh, Bharat G., Deepak Bhisegaonkar, and Akanksha Bakre. "A comparative study of tragal cartilage and autologous incus for ossicular chain reconstruction in type IIB tympanoplasty at Dr. Hedgewar Hospital, Aurangabad." International Journal of Otorhinolaryngology and Head and Neck Surgery 6, no. 1 (December 23, 2019): 78. http://dx.doi.org/10.18203/issn.2454-5929.ijohns20195693.

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Background: Tympanoplasty is the surgical operation performed for the reconstruction of the eardrum (tympanic membrane) and/or the small bones of the middle ear. Chronic otitis media is a very common condition of middle ear which not only has a high incidence in the world but also in our set up. So, in view of this, we decided to conduct a study on the surgical management of CSOM-tubotympanic type.Methods: We conducted this study at ENT department of Dr. Hedgewar Rugnalaya, Aurangabad to compare air bone gap closure by using tragal cartilage and autologous incus in type IIB tympanoplasty in patients with chronic suppurative otitis media, (tubotympanic). 66 patients with central perforation of tympanic membrane, necrosed incus and mobile stapes requiring type IIB tympanoplasty, were included as a part of the study.Results: We performed type IIB tympanoplasty with a routine post-aural incision in 66 patients. According to our observation, both incus and cartilage are good materials for ossiculoplasty, tragal cartilage being better.Conclusions: After conducting this study we concluded that incus and tragal cartilage both are excellent materials for ossiculoplasty.

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Gupta, Sneha, Praveen Kumar Singh, Divya Mehrotra, Shadab Mohammad, Vibha Singh, Apjit Kaur, and Bal Krishna Ojha. "Patterns of Orbital Fractures Needing Surgical Reconstruction in a Large Tertiary Hospital in Northern India." Craniomaxillofacial Trauma & Reconstruction Open 6 (January 1, 2021): 247275122199916. http://dx.doi.org/10.1177/2472751221999163.

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Study Design: This is a prospective study for 3 year duration. Objective: The aim of this study was to observe the incidence and patterns of orbital fractures and discuss their treatment options. Methods: A total 29604 trauma patients visited our emergency department within May 2017 to Oct 2019, where 1230 (4.15%) patients presented with orbital fractures, of which only 44 (3.6% of orbital fracture) patients required surgical reconstruction, and were enrolled in our study and evaluated for their fracture patterns, size of bone defect, clinical presentation, timing of surgery, reconstruction, and complications. Results: The incidence of orbital fracture was 4.15%, of which only 20.5% were pure blow out. Associated fractures included 72.7% zygomatic complex, 50% LeFort, 31.8% mandible and 20.5% pan facial fractures. The most common pattern was the 1 wall orbital defect in 38.6%, 2 wall in 27.3%, 3 wall in 29.5% and 4 wall in 4.5%. The orbital floor fracture was seen in 100%, medial wall in 27.3%, lateral wall in 61.4%, roof in 15.9%. Different reconstruction options used included calvarial bone (2.3%), ear cartilage (2.3%), medpore (36.4%), polycaprolactone sheet (6.8%), titanium mesh (52.3%), patient specific implant (6.8%) and navigation (4.5%). Conclusion: Orbital fractures are mostly impure fractures, associated with zygomatic complex fractures, hence lateral wall fractures are seen more commonly. Patient specific implants, navigation guided reconstruction, autologous calvarial bone graft and preformed titanium mesh show better results, and fulfill the objectives of orbital reconstruction by restoring the normal anatomy and volume of the orbit.

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Verwoerd-Verhoef, Henriette L., Jim K. Bean, Gerjo J. V. M. Van Osch, Paul G. J. Ten Koppel, Jaap A. Meeuwis, and Caret D. A. Verwoerd. "Induction in Vivo of Cartilage Grafts for Craniofacial Reconstruction." American Journal of Rhinology 12, no. 1 (January 1998): 27–32. http://dx.doi.org/10.2500/105065898782103061.

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In the craniofacial region, defects of cartilage structures are preferably reconstructed with autologous cartilage. Donor-site morbidity related to the creation of a new defect elsewhere, and a lack of growth potential of the graft—mandatory in children—have stimulated investigators to find other ways to generate new “extra” cartilage. Several biomaterials have been tested as a matrix for the ingrowth of (peri)chondroblasts in experimental animals. In young (growing) rabbits we have developed a process of heterotopic cartilage induction with the use of a demineralized (bovine) bone matrix which is enfolded in a pedicled flap of ear perichondrium for at least three weeks. During this period the demineralized matrix is colonized by macrophages and polymorphonuclear cells which start a process of complete biodegradation of the material. Simultaneously, the collagen matrix is invaded by mesenchymal cells, originating from the perichondrium and differentiating into chondroblasts and later, into chondrocytes forming the intercellular substance. The developing, very young cartilage could be demonstrated as collagen type II, thus, hyaline cartilage. When applied with its adherent perichondrium as a graft, it merges easily with the more matured host cartilage and even appears to be capable of further growth. Therefore, it seems suitable for the reconstruction of a cartilaginous defect in growing cartilaginous structures like the nasal septum or the larynx.

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Siedentop, Karl H., Kevin O’Grady, Tapan K. Bhattacharyya, and Ami Shah. "Fibrin Tissue Adhesive and Autologous Concha Cartilage for Reconstruction of the Posterior–Superior Canal Wall of the Chinchilla Middle Ear." Otology & Neurotology 25, no. 3 (May 2004): 220–22. http://dx.doi.org/10.1097/00129492-200405000-00003.

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