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Li G, Lei C, Shan X, Ni X, Chen G, Wang M, Ke R, Wang B. Construction of a vascularized fascia-prosthesis compound model with axial pedicle for ear reconstruction surgery. Front Bioeng Biotechnol 2023; 11:1126269. [PMID: 37292096 PMCID: PMC10244754 DOI: 10.3389/fbioe.2023.1126269] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2022] [Accepted: 05/10/2023] [Indexed: 06/10/2023] Open
Abstract
Background: To design a vascular pedicled fascia-prosthesis compound model that can be used for ear reconstruction surgery. Methods: A vascularized tissue engineering chamber model was constructed in New Zealand rabbits, and fresh tissues were obtained after 4 weeks. The histomorphology and vascularization of the newly born tissue compound were analyzed and evaluated by tissue staining and Micro-CT scanning. Results: The neoplastic fibrous tissue formed in the vascularized tissue engineering chamber with the introduction of abdominal superficial vessels, similar to normal fascia, was superior to the control group in terms of vascularization, vascular density, total vascular volume, and total vascular volume/total tissue volume. Conclusion: In vivo, introducing abdominal superficial vessels in the tissue engineering chamber prepped for ear prosthesis may form a well-vascularized pedicled fascia-prosthesis compound that can be used for ear reconstruction.
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Affiliation(s)
- Guanmin Li
- Department of Plastic Surgery, The First Affiliated Hospital, Fujian Medical University, Fuzhou, China
- Department of Plastic and Wound Repair Surgery, National Regional Medical Center, Binhai Campus of the First Affiliated Hospital, Fujian Medical University, Fuzhou, China
| | - Chen Lei
- Department of Plastic Surgery, The First Affiliated Hospital, Fujian Medical University, Fuzhou, China
- Department of Plastic and Wound Repair Surgery, National Regional Medical Center, Binhai Campus of the First Affiliated Hospital, Fujian Medical University, Fuzhou, China
| | - Xiuying Shan
- Department of Plastic Surgery, The First Affiliated Hospital, Fujian Medical University, Fuzhou, China
- Department of Plastic and Wound Repair Surgery, National Regional Medical Center, Binhai Campus of the First Affiliated Hospital, Fujian Medical University, Fuzhou, China
| | - Xuejun Ni
- Department of Plastic Surgery, The First Affiliated Hospital, Fujian Medical University, Fuzhou, China
- Department of Plastic and Wound Repair Surgery, National Regional Medical Center, Binhai Campus of the First Affiliated Hospital, Fujian Medical University, Fuzhou, China
| | - Guojie Chen
- Senior Department of Burns and Plastic Surgery, The Fourth Medical Center of Chinese PLA General Hospital, Beijing, China
| | - Meishui Wang
- Department of Plastic Surgery, The First Affiliated Hospital, Fujian Medical University, Fuzhou, China
- Department of Plastic and Wound Repair Surgery, National Regional Medical Center, Binhai Campus of the First Affiliated Hospital, Fujian Medical University, Fuzhou, China
| | - Ruonan Ke
- Department of Plastic Surgery, The First Affiliated Hospital, Fujian Medical University, Fuzhou, China
- Department of Plastic and Wound Repair Surgery, National Regional Medical Center, Binhai Campus of the First Affiliated Hospital, Fujian Medical University, Fuzhou, China
| | - Biao Wang
- Department of Plastic Surgery, The First Affiliated Hospital, Fujian Medical University, Fuzhou, China
- Department of Plastic and Wound Repair Surgery, National Regional Medical Center, Binhai Campus of the First Affiliated Hospital, Fujian Medical University, Fuzhou, China
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Gao D, Chen X, Sun Q, Huang Y, Li H, Zhang M, Li J, Liu T, Wang B. Strategies of Total Auricular Reconstruction for Patients With Poor Skin Coverage at the Mastoid Area. Ear Nose Throat J 2023:1455613231158905. [PMID: 36803207 DOI: 10.1177/01455613231158905] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/22/2023] Open
Abstract
OBJECTIVE Burns and injuries can lead to massive defects in the mastoid tissues, which increase the difficulty of ear reconstruction. It is crucial to choose an appropriate surgical method for these patients. Here, we introduce strategies for auricular reconstruction in patients without satisfactory mastoid tissues. METHODS From April 2020 to July 2021, 12 men and 4 women were admitted to our institution. Twelve patients were severely burned, 3 patients experienced car accidents, and 1 patient had a tumor on his ear. The temporoparietal fascia was used for ear reconstruction in 10 cases, and the upper arm flap was used in 6 cases. All of the ear frameworks were made of costal cartilage. RESULTS The location, size, and shape of both sides of the auricles were generally the same. Two patients needed further surgical repair because of cartilage exposure at the helix. All of the patients were satisfied with the outcome of the reconstructed ear. CONCLUSION For patients with ear deformity and poor skin coverage in the mastoid area, we can choose the temporoparietal fascia if the patient's available superficial temporal artery is longer than 10 cm. If not, we can choose the upper arm flap. The latter needs a five-stage operation, which is more time consuming and difficult than the former. Moreover, the expanded upper arm flap is thinner and has better elasticity than the temporoparietal fascia, so the shape of the reconstructed ear is better. We need to evaluate the condition of the affected tissue and choose the appropriate surgical method to achieve a good result.
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Affiliation(s)
- Dejin Gao
- Department of Ear Reconstruction, Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Xueying Chen
- Department of Ear Reconstruction, Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Qing Sun
- Department of Ear Reconstruction, Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Yue Huang
- Department of Orthopaedic Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - He Li
- Department of Ear Reconstruction, Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Mingyu Zhang
- Department of Ear Reconstruction, Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Jingjing Li
- Department of Ear Reconstruction, Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Tun Liu
- Department of Ear Reconstruction, Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Bingqing Wang
- Department of Ear Reconstruction, Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
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Affiliation(s)
- Cong Vo
- OHSU Oral & Maxillofacial Surgery Clinic, Mark O. Hatfield Research Center, 3250 SW Sam Jackson Park Road, Portland, OR 97239, USA
| | | | | | - Daniel Petrisor
- OHSU Oral & Maxillofacial Surgery Clinic, Mark O. Hatfield Research Center, 3250 SW Sam Jackson Park Road, Portland, OR 97239, USA.
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Zuo KJ, Wilkes GH. Clinical Outcomes of Osseointegrated Prosthetic Auricular Reconstruction in Patients With a Compromised Ipsilateral Temporoparietal Fascial Flap. J Craniofac Surg 2016; 27:44-50. [PMID: 26703031 DOI: 10.1097/scs.0000000000002181] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Patients with major ear deformities and associated compromise of the superficial temporal artery are poor candidates for autogenous ear reconstruction because of a tenuous ipsilateral temporoparietal fascial flap (TPFF). Osseointegrated prosthetic auricular reconstruction (OPAR) is an alternative to contralateral free TPFF microsurgical and autogenous reconstruction, but data on clinical outcomes are limited. The records of patients with ear loss or major deformity and a compromised ipsilateral TPFF who underwent OPAR from 1989 to 2013 were reviewed. Satisfaction was assessed using a questionnaire based on a 5 point Likert scale. Thirty-two patients (8 women, 24 men) with mean age 43.0 years (range, 10-70 years) underwent OPAR. The ipsilateral TPFF was compromised due to major trauma (13 patients), cancer extirpation (9), burn injury (4), previous harvest (4), arteriovenous malformation (1), or infection (1). All but 2 patients had an associated craniofacial defect, such as soft tissue deformity (87.5%), hearing loss (46.9%), or bony deformity (31.3%). The overall implant success rate was 88.6% at mean follow-up time of 7.6 years post-OPAR. Prosthesis wear averaged 12.2 hours/day and 6.6 days/week (80.5 hours/week). All 5 patients who experienced implant failures had received prior head and neck irradiation. With their prosthesis, 76.2% (16 patients) stated that their self-consciousness and self-esteem were "better" or "much better," whereas 85.7% (18 patients) stated that their self-image was "better" or "much better." All patients declared that they would undergo the treatment again. Osseointegrated prosthetic auricular reconstruction is a reliable option in this challenging population with high patient satisfaction. Patients with prior radiotherapy may have a higher chance of implant failure and would benefit from extended annual follow-up.
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Affiliation(s)
- Kevin J Zuo
- *Faculty of Medicine and Dentistry, University of Alberta †Institute for Reconstructive Sciences in Medicine, Misericordia Hospital, Covenant Health Group ‡Division of Plastic and Reconstructive Surgery, University of Alberta, Edmonton, Canada
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