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[PMID]:28844147
[Au] Autor:Ho TT; Cochran T; Sykes KJ; Humphrey CD; Kriet JD
[Ad] Endereço:1 Department of Otolaryngology, University of Kansas Health System, Kansas City, Kansas, USA.
[Ti] Título:Costal and Auricular Cartilage Grafts for Nasal Reconstruction: An Anatomic Analysis.
[So] Source:Ann Otol Rhinol Laryngol;126(10):706-711, 2017 Oct.
[Is] ISSN:1943-572X
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:OBJECTIVES: The aim of this study was to measure the length, width, and surface area of costal and auricular cartilage harvested for grafting in rhinoplasty and nasal reconstruction. We also compared the sizes of ear cartilage grafts harvested from the anterior and posterior approaches. METHODS: Fifty-eight nasal reconstructive surgeries requiring rib or ear cartilage were performed by 2 facial plastic surgeons from February 2015 through January 2016. Among the 57 cases that met inclusion criteria, they comprised of 33 costal cartilage grafts and 24 auricular cartilage grafts (17 via anterior approach and 7 via posterior approach). RESULTS: The mean length, width, and surface area for the auricular cartilage grafts were 3.39 cm, 1.22 cm, and 4.38 cm , respectively. The mean length, width, and surface area of the costal cartilage grafts were 4.21 cm, 1.46 cm, and 17.87 cm , respectively. The differences in length, width, and surface area between the anterior versus posterior approach groups were all statistically significant. CONCLUSIONS: In our study, ear cartilage grafts harvested from the posterior approach had significantly greater length, width, and surface area. While this analysis has several limitations, it sets quantitative norms for costal and auricular cartilage harvest that can aid in surgical planning.
[Mh] Termos MeSH primário: Cartilagem Costal/anatomia & histologia
Cartilagem Costal/transplante
Cartilagem da Orelha/anatomia & histologia
Cartilagem da Orelha/transplante
Rinoplastia
[Mh] Termos MeSH secundário: Seres Humanos
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170925
[Lr] Data última revisão:
170925
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170829
[St] Status:MEDLINE
[do] DOI:10.1177/0003489417727549


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[PMID]:28734754
[Au] Autor:Kolodzynski MN; van Hövell Tot Westerflier CVA; Kon M; Breugem CC
[Ad] Endereço:Dutch Center for Ear Reconstruction, University Medical Center Utrecht, Heidelberglaan 100, PO Box 85500, 3508 GA Utrecht, The Netherlands. Electronic address: M.N.Kolodzynski-3@umcutrecht.nl.
[Ti] Título:Cost analysis of microtia treatment in the Netherlands.
[So] Source:J Plast Reconstr Aesthet Surg;70(9):1280-1284, 2017 Sep.
[Is] ISSN:1878-0539
[Cp] País de publicação:Netherlands
[La] Idioma:eng
[Ab] Resumo:INTRODUCTION: Ear reconstruction for microtia is a challenging procedure. Although analyzing esthetic outcome is crucial, there is a paucity of information with regard to financial aspects of microtia reconstruction. This study was conducted to analyze the costs associated with ear reconstruction with costal cartilage in patients with microtia. METHODS: Ten consecutive children with autologous ear reconstruction of a unilateral microtia were included in this analysis. All patients had completed their treatment protocol for ear reconstruction. Direct costs (admission to hospital, diagnostics, and surgery) and indirect cost (travel expenses and absence from work) were obtained retrospectively. RESULTS: The overall mean cumulative cost per patient was €14,753. Direct and indirect costs were €13,907 and €846, respectively. Hospital admission and surgery cover 55% and 32% of all the costs, respectively. DISCUSSION: This study analyzes the costs for autologous ear reconstruction. Hospital admission and surgery are the most important factors of the total costs. Total costs could be decreased by possibly decreasing admission days and surgical time. These data can be used for choosing and developing future treatment strategies.
[Mh] Termos MeSH primário: Microtia Congênita/economia
Microtia Congênita/cirurgia
Cartilagem Costal/transplante
Custos e Análise de Custo
Procedimentos Cirúrgicos Reconstrutivos/economia
Procedimentos Cirúrgicos Reconstrutivos/métodos
[Mh] Termos MeSH secundário: Adolescente
Criança
Efeitos Psicossociais da Doença
Feminino
Custos de Cuidados de Saúde
Seres Humanos
Masculino
Países Baixos
Estudos Retrospectivos
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170914
[Lr] Data última revisão:
170914
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170724
[St] Status:MEDLINE


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[PMID]:28421969
[Au] Autor:Schauer AM; Schucker A; Carlson CS
[Ad] Endereço:1 College of Veterinary Medicine, University of Minnesota, Saint Paul, Minnesota, USA.
[Ti] Título:Dystrophic Mineralization of Costal Cartilage in Hartley Guinea Pigs.
[So] Source:Toxicol Pathol;45(3):435-439, 2017 04.
[Is] ISSN:1533-1601
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Hartley guinea pigs are widely used animal models of disease, particularly in studies of osteoarthritis. The purpose of this study was to investigate lesions in the costal cartilage from 16 male, 5- to 6-month-old Hartley guinea pigs. Routine histological sections from the costal cartilage and costochondral junction (longitudinal and cross sections) and sternum (for evaluation of bone marrow) were examined. All 16 (100%) animals had histological lesions involving the costal cartilage that included matrix degeneration and mineralization, reduced cellularity, and evidence of chondrocyte necrosis. Of the 16, 4 (25%) of the lesions contained blood vessels and 3 (19%) contained central osseous metaplasia. The cartilage lesions were accompanied by degeneration (sometimes with regeneration and/or fibrosis) in adjacent skeletal muscle in 15 of the 16 (94%) animals. The lesions in the costal cartilage were interpreted as dystrophic mineralization of unknown cause and appear to be incidental findings, although they bear some resemblance to lesions occurring in Tietze's disease in humans. The significance of the lesions in skeletal muscle is unclear. Histological lesions of cartilage matrix degeneration and mineralization in these sites have not, to our knowledge, been reported previously.
[Mh] Termos MeSH primário: Calcinose
Cartilagem Costal/patologia
Modelos Animais de Doenças
Osteoartrite/patologia
[Mh] Termos MeSH secundário: Animais
Cobaias
Metaplasia
Músculo Esquelético/patologia
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1708
[Cu] Atualização por classe:171120
[Lr] Data última revisão:
171120
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170420
[St] Status:MEDLINE
[do] DOI:10.1177/0192623316683281


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[PMID]:28397538
[Au] Autor:Ha JF; Morrison RJ; Green GE; Zopf DA
[Ad] Endereço:1 Division of Pediatric Otolaryngology, Department of Otolaryngology-Head & Neck Surgery, University of Michigan, Ann Arbor, Michigan, USA.
[Ti] Título:Computer-Aided Design and 3-Dimensional Printing for Costal Cartilage Simulation of Airway Graft Carving.
[So] Source:Otolaryngol Head Neck Surg;156(6):1044-1047, 2017 Jun.
[Is] ISSN:1097-6817
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:Autologous cartilage grafting during open airway reconstruction is a complex skill instrumental to the success of the operation. Most trainees lack adequate opportunities to develop proficiency in this skill. We hypothesized that 3-dimensional (3D) printing and computer-aided design can be used to create a high-fidelity simulator for developing skills carving costal cartilage grafts for airway reconstruction. The rapid manufacturing and low cost of the simulator allow deployment in locations lacking expert instructors or cadaveric dissection, such as medical missions and Third World countries. In this blinded, prospective observational study, resident trainees completed a physical simulator exercise using a 3D-printed costal cartilage grafting tool. Participant assessment was performed using a Likert scale questionnaire, and airway grafts were assessed by a blinded expert surgeon. Most participants found this to be a very relevant training tool and highly rated the level of realism of the simulation tool.
[Mh] Termos MeSH primário: Projeto Auxiliado por Computador
Cartilagem Costal/transplante
Laringe/cirurgia
Otolaringologia/educação
Impressão Tridimensional
Procedimentos Cirúrgicos Reconstrutivos/educação
Traqueia/cirurgia
[Mh] Termos MeSH secundário: Competência Clínica
Educação de Pós-Graduação em Medicina
Avaliação Educacional
Seres Humanos
Internato e Residência
Modelos Anatômicos
Projetos Piloto
Estudos Prospectivos
Inquéritos e Questionários
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1708
[Cu] Atualização por classe:170822
[Lr] Data última revisão:
170822
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170412
[St] Status:MEDLINE
[do] DOI:10.1177/0194599817697048


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[PMID]:28388799
[Au] Autor:Toriumi DM
[Ad] Endereço:Division of Facial Plastic and Reconstructive Surgery, Department of Otolaryngology - Head and Neck Surgery, University of Illinois at Chicago, Chicago, Illinois.
[Ti] Título:Dorsal Augmentation Using Autologous Costal Cartilage or Microfat-Infused Soft Tissue Augmentation.
[So] Source:Facial Plast Surg;33(2):162-178, 2017 Apr.
[Is] ISSN:1098-8793
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Costal cartilage grafting is increasing in popularity with increased demand for augmentation rhinoplasty and increased need for grafting material for structure rhinoplasty techniques. Use of costal cartilage for dorsal grafting is both art and science. The art is demonstrated in the act of carving a dorsal graft that will reflect the actual contour of the nasal dorsum. The science is linked to the methodology of how the grafts are contoured to match the patient's desires and how the graft is fixed to the bony dorsum to minimize the risk of warping and displacement. Variations in dorsal graft design and methods of fixation are described. Use of the perichondrial interface between dorsal graft and perforated/rasped nasal dorsum acts to ossify the dorsal graft to the underlying bone, creating an immobile and natural appearing nasal dorsum. The fixation of the dorsal graft limits movement and hence decreases the likelihood of warping or deformity. Use of microfat in rhinoplasty has tremendous potential for camouflage and to promote healing of compromised tissues. Using microfat-infused soft tissue augmentation (MISTA), the surgeon is able to deliver microfat to an open surgical field, promote healing, and provide soft tissue augmentation. In this technique, microfat is injected into soft tissue carriers (perichondrium, temporalis fascia, etc.) and then implanted into the surgical field. MISTA has tremendous potential utility in many areas of cosmetic and reconstructive surgery.
[Mh] Termos MeSH primário: Tecido Adiposo/transplante
Cartilagem Costal/transplante
Rinoplastia/métodos
Coleta de Tecidos e Órgãos/métodos
[Mh] Termos MeSH secundário: Cartilagem Costal/cirurgia
Estética
Seres Humanos
Técnicas de Sutura
Transplante Autólogo
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1711
[Cu] Atualização por classe:171107
[Lr] Data última revisão:
171107
[Sb] Subgrupo de revista:D
[Da] Data de entrada para processamento:170408
[St] Status:MEDLINE
[do] DOI:10.1055/s-0037-159914


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[PMID]:28388797
[Au] Autor:Kridel RW; Sturm AK
[Ad] Endereço:Facial Plastic Surgery Associates,6655 Travis Street, Suite 900, Houston, Texas.
[Ti] Título:Dorsal Augmentation with Homologous Rib.
[So] Source:Facial Plast Surg;33(2):195-201, 2017 Apr.
[Is] ISSN:1098-8793
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Dorsal augmentation grafts are used to reconstruct and raise the nasal dorsum in patients with dorsal saddling due to trauma, infection, or previous nasal surgery, as well as in patients with a narrow, congenitally low, and/or wide dorsum. Alloplastic implants and various biomaterials are available for grafting, each with advantages and disadvantages. Although autologous septal cartilage is a preferable and often convenient source of cartilage, it is frequently not sufficient for large volume dorsal augmentation, nor is it available in patients who have had septoplasty, infection, previous rhinoplasty with grafting, or significant trauma. Ear cartilage may be used but it is difficult to make homogenous and smooth, and dorsal irregularities can be seen in the long term especially in thin-skinned patients. For these reasons, we frequently use irradiated costal cartilage from tissue banks as our grafting source, thereby eliminating the morbidity of harvesting the patient's own rib. Proper surgical techniques, the use of antibiotics, and proper sculpting and placement of the cartilage limits complications such as warping, resorption, infection, and extrusion. Irradiated homograft costal cartilage grafts have been used successfully in large numbers of patients with long-term follow-up with low complication rates and serve as a welcome alternative to harvesting a patient's rib cartilage.
[Mh] Termos MeSH primário: Cartilagem Costal/transplante
Rinoplastia/métodos
[Mh] Termos MeSH secundário: Cartilagem da Orelha/transplante
Seres Humanos
Cartilagens Nasais/transplante
Rinoplastia/efeitos adversos
Transplante Autólogo
Transplante Homólogo/efeitos adversos
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1711
[Cu] Atualização por classe:171107
[Lr] Data última revisão:
171107
[Sb] Subgrupo de revista:D
[Da] Data de entrada para processamento:170408
[St] Status:MEDLINE
[do] DOI:10.1055/s-0037-1598031


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[PMID]:28350674
[Au] Autor:Li G; Zhang F; Ding W; Wu Z; Hu Y; Luo T; Zhang B; Jiang X
[Ad] Endereço:Changsha, Hunan Province, People's Republic of China From the Department of Plastic and Cosmetic Surgery, Hunan Provincial People's Hospital, The First Affiliated Hospital of Hunan Normal University.
[Ti] Título:A New Microtia Reconstruction Method Using Delayed Postauricular Skin Flap.
[So] Source:Plast Reconstr Surg;139(4):946-955, 2017 Apr.
[Is] ISSN:1529-4242
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: This article presents a new microtia reconstruction method using a delayed postauricular skin flap. METHODS: The surgery is scheduled in three stages, the first of which delays the postauricular skin flap and deals with the remnant auricle. Three weeks later, the second stage is carried out. An erect, three-dimensional ear framework fabricated from autogenous rib cartilage is inserted between two flaps. The anterior auricular surface of the framework is draped with the delayed skin flap, and the postauricular surface is draped with postauricular fascia and overlying grafted skin. Six months later, the third stage reconstructs the tragus and shapes a hollow mimicking the external auditory meatus, and locally improves the reconstructed auricle. RESULTS: Ninety-six cases of microtia were reconstructed using the delayed skin flap. All ear reconstructions were successful, with good locations, sizes, and shapes, with few complications. CONCLUSIONS: The authors' method enables an adequately large, thin skin flap with sufficient blood supply, and also appropriately manages the remnant auricle. A delayed postauricular skin flap with a three-dimensional autologous costal cartilage framework represents a promising approach to microtia reconstruction.
[Mh] Termos MeSH primário: Microtia Congênita/cirurgia
Cartilagem Costal/transplante
Procedimentos Cirúrgicos Reconstrutivos/métodos
Retalhos Cirúrgicos
[Mh] Termos MeSH secundário: Adolescente
Adulto
Criança
Feminino
Seres Humanos
Masculino
Transplante de Pele
Fatores de Tempo
Adulto Jovem
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Em] Mês de entrada:1706
[Cu] Atualização por classe:170601
[Lr] Data última revisão:
170601
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170329
[St] Status:MEDLINE
[do] DOI:10.1097/PRS.0000000000003227


  8 / 120 MEDLINE  
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[PMID]:28350659
[Au] Autor:Deschamps-Braly JC; Sacher CL; Fick J; Ousterhout DK
[Ad] Endereço:San Francisco, Calif. From private practice, California Pacific Medical Center, University of California, San Francisco Benioff Children's Hospital Oakland, and the University of California, San Francisco Center for Craniofacial Anomalies.
[Ti] Título:First Female-to-Male Facial Confirmation Surgery with Description of a New Procedure for Masculinization of the Thyroid Cartilage (Adam's Apple).
[So] Source:Plast Reconstr Surg;139(4):883e-887e, 2017 Apr.
[Is] ISSN:1529-4242
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Although male-to-female transgender patients commonly seek facial feminization surgery, facial masculinization surgery in the female-to-male transgender population is unreported in the literature. This report documents the first known female-to-male facial masculinization surgery, including a new technique for creating an "Adam's apple" to enhance the facial masculine appearance of a natal female. The authors "reversed" the methods typically used to feminize male facial features, and modified the forehead, nose, and chin to masculinize the patient's natal female facial features. The authors devised a novel technique to augment the thyroid cartilage using autologous rib cartilage to create a visible Adam's apple. Initially, masculinization of the chin was accomplished with a multisegment chin osteotomy with grafts to vertically expand and widen the chin along with correcting pronounced microgenia. Subsequently, a second facial masculinization procedure was performed to masculinize the forehead, nose, and thyroid cartilage. Rib cartilage was harvested and carved into an appropriately shaped thyroid cartilage onlay graft and then attached and integrated with the native thyroid cartilage, creating a fully mobile cartilage that translocates up and down with swallowing and a visible Adam's apple. Previously described techniques to masculinize the facial features of natal male patients were adapted to masculinize the female-to-male patient. Those procedures were combined with the novel technique to create a visually perceptible and naturally mobile Adam's apple in the female-to-male transsexual patient. Collectively, these described procedures can now provide most female-to-male transsexual patients with a satisfying transformation of their facial features. CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, V.
[Mh] Termos MeSH primário: Cartilagem Costal/transplante
Face/cirurgia
Procedimentos Cirúrgicos Reconstrutivos/métodos
Cirurgia de Readequação Sexual/métodos
Cartilagem Tireóidea/cirurgia
[Mh] Termos MeSH secundário: Feminino
Seres Humanos
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1706
[Cu] Atualização por classe:170601
[Lr] Data última revisão:
170601
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170329
[St] Status:MEDLINE
[do] DOI:10.1097/PRS.0000000000003185


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[PMID]:28334327
[Au] Autor:Wee JH; Mun SJ; Na WS; Kim H; Park JH; Kim DK; Jin HR
[Ad] Endereço:Department of Otorhinolaryngology-Head and Neck Surgery, Bundang Jesaeng General Hospital, Deajin Medical Center, Seongnam, Korea.
[Ti] Título:Autologous vs Irradiated Homologous Costal Cartilage as Graft Material in Rhinoplasty.
[So] Source:JAMA Facial Plast Surg;19(3):183-188, 2017 May 01.
[Is] ISSN:2168-6092
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Importance: Studies comparing surgical results of rhinoplasty using autologous costal cartilage (ACC) and irradiated homologous costal cartilage (IHCC) are rare. Objectives: To compare the clinical results of major augmentation rhinoplasty using ACC vs IHCC and analyze the histologic properties of both types of cartilage. Design, Setting, and Participants: A retrospective clinical study was conducted among patients who had undergone rhinoseptoplasty using ACC or IHCC from January 1, 2009, to December 31, 2014. Patients were followed up for more than 1 year after surgery and the histologic characteristics of ACC and IHCC were compared. The details of the surgical procedures and complications, including warping, infection, resorption, and/or donor-site morbidity, were evaluated by reviewing medical records and facial photographs. Patients' subjective satisfaction with aesthetic and functional results was evaluated using a questionnaire. Main Outcomes and Measures: The details of the surgical procedures and complications, including warping, infection, resorption, and/or donor-site morbidity; patients' subjective satisfaction with aesthetic and functional results' objective evaluation of surgical outcomes, including symmetry, dorsal height, dorsal length, dorsal width, tip projection, tip rotation, tip width, and overall result; and histologic structures. Objective evaluation of surgical outcomes was graded using the Objective Rhinoplasty Outcome Score, which assessed symmetry, dorsal height, dorsal length, dorsal width, tip projection, tip rotation, tip width, and overall result. Histologic structures were evaluated using hematoxylin and eosin, Masson trichrome, Alcian blue, and Verhoeff elastic stains. Results: A total of 63 patients (27 males and 36 females; mean [SD] age, 30.6 [9.5] years) had rhinoseptoplasty using ACC and 20 (9 males and 11 females; mean [SD] age, 35.4 [15.4] years) had rhinoseptoplasty using IHCC. Among observed complications, only notable resorption occurred more frequently in patients using IHCC (6 [30%]) than with ACC (2 [3%]) (P = .002). In subjective evaluations of aesthetic satisfaction, patients who received ACC showed significantly greater satisfaction (37 of 51 patients [73%] were very satisfied) than did those who received IHCC (6 of 20 [30%]) (P = .001). However, there was no between-group difference in subjective functional outcomes: 4 of 51 patients receiving ACC (8%) and 5 of 20 receiving IHCC (25%) were satisfied (P = .50) and 45 of 51 receiving ACC (88%) and 15 of 20 receiving IHCC (75%) were very satisfied (P = .15). Regarding objective aesthetic outcomes, all scores for both ACC and IHCC were more than 3.1 (between good and excellent). Histologic analyses showed larger, more evenly distributed, uniform chondrocytes and more collagens and proteoglycan contents in ACC than in IHCC. Conclusions and Relevance: Compared with patients receiving IHCC, those receiving ACC for rhinoseptoplasty showed superior aesthetic satisfaction; ACC also had less frequent notable resorption. Autologous costal cartilage also had better histologic properties than IHCC did, suggesting it as an ideal graft material with less chance of long-term resorption. Level of Evidence: 3.
[Mh] Termos MeSH primário: Cartilagem Costal/transplante
Rinoplastia/métodos
[Mh] Termos MeSH secundário: Adolescente
Adulto
Cartilagem Costal/efeitos da radiação
Estética
Feminino
Seres Humanos
Masculino
Meia-Idade
Satisfação do Paciente
Complicações Pós-Operatórias
Reoperação
República da Coreia
Estudos Retrospectivos
Transplante Autólogo
Resultado do Tratamento
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1708
[Cu] Atualização por classe:170817
[Lr] Data última revisão:
170817
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170324
[St] Status:MEDLINE
[do] DOI:10.1001/jamafacial.2016.1776


  10 / 120 MEDLINE  
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[PMID]:28198774
[Au] Autor:Xu Z; Xu F; Zhang R; Zhang Q; Li D; Li Y
[Ad] Endereço:Shanghai, People's Republic of China From the Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital; and Shanghai JiaoTong University School of Medicine.
[Ti] Título:A New Classification of Helix Fabrication Methods with Autogenous Costal Cartilage in Microtia Reconstruction.
[So] Source:Plast Reconstr Surg;139(6):1315e-1324e, 2017 Jun.
[Is] ISSN:1529-4242
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Recreating the complex architecture of the auricle poses one of the most demanding challenges for the plastic surgeon. The fabrication of the prominent helix is crucial to the final contour of the constructed ear. The success of helix carving depends greatly on the complicated characteristics of the cartilage used, which is commonly the eighth costal cartilage. The authors elaborate on the relevant details for helix sculpting based on different qualities of cartilage. METHODS: A series of 415 microtia patients underwent autogenous costal cartilage auricular reconstruction between 2012 and 2015. Because the cartilage used for helix reconstruction is always imperfect or insufficient for the fabrication of anatomical structures, they have devised perfect helix duplication by using individualized eighth rib cartilage with different cartilage lengths, widths, and flexibilities. Four possible scenarios in helix fabrication have been elaborated, and the corresponding methods were introduced. RESULTS: Selective methods for different scenarios in helix fabrication have been shown to produce favorable results. The results reveal that a harmonious helix was achieved and provide a cohesive framework for the integrity of a reconstructed ear. CONCLUSIONS: A new classification of helix fabrication methods with autogenous costal cartilage is elaborated, and a favorable framework with harmonious proportions is achieved by precise carving using corresponding measures for different cartilage characteristics. This approach enhances helix aesthetics and helps attain a satisfactory contour of the auricle. CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, IV.
[Mh] Termos MeSH primário: Microtia Congênita/cirurgia
Cartilagem Costal/transplante
Pavilhão Auricular/cirurgia
Procedimentos Cirúrgicos Reconstrutivos/métodos
Coleta de Tecidos e Órgãos/métodos
[Mh] Termos MeSH secundário: Adolescente
Adulto
Criança
Estudos de Coortes
Microtia Congênita/diagnóstico
Cartilagem Costal/cirurgia
Orelha Externa/cirurgia
Estética
Feminino
Seguimentos
Seres Humanos
Masculino
Estudos Retrospectivos
Costelas/cirurgia
Medição de Risco
Transplante Autólogo/métodos
Resultado do Tratamento
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170901
[Lr] Data última revisão:
170901
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170216
[St] Status:MEDLINE
[do] DOI:10.1097/PRS.0000000000003375



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