The Biological Change Of Costal Cartilage Free Autograft And The Clinical Study Of Its Value In Reconstructed Ear

Normal external ear is a shell structure of complicated shape which is made by flimsy skin tissue that warps elastic cartilage. Ear reconstruction is one of the most difficult and complicated plastic surgery. When ear reconstruction is needed by various reasons,we should treat it respectively as the size and shape of each is different. The success of ear reconstruction is made by two factors:good framework of sculpted cartilage and enough integument of skin tissue to cover the framework.Now, the framework is often made by costal cartilage autograft and the skin tissue is provided by the skin in mastoid region . When the skin has been expanded with expander, Its quantity increases and the quality becomes thinner, which is better for the display of the four layer concept of the sculpted cartilage framework.Thus,the shape of the reconstructed ear can get more satisfied outcome.Now, the systemic report is not enough about the biological result of costal cartilage free autograft. There are different viewpoints about the live of costal cartilage autograt, the repair of offer region and the recovery style of the cartilage ,especially about the selection of surgical time in congenital microtia, the use of chondrium in the growth of cartilage autograft and the growth ability of the reconstructed ear in preschool children .With the use of skin expansion in the ear reconstruction, it is better to know the effect of the expanded skin flap on the cartilage framework.So we studied biological change of costal cartilage free autograft in reconstructed ear to offer advice in our clinical practice. This study includes three respects of animal experiment, clinical examination of autograft cartilage and followed cases.The experiment of costal cartilage autograft in three-month old pig has proved that autograft cartilage can live and grow after three or six months by gross observation, examinations of histology and TEM(transmission electron microscopy) and measurement of the content of GAG (glycosaminoglycan) and collagen in extracelluar matrix. If cartilage autograft with chondrium, the live and growth of autograft becomes more evident. It is mainly expressed in that the length, weight and volume of the graft cartilage increased strikingly (P<0. 001). The secretion of GAG and collagen increased after six months (P<0. 001) and there is young and viable cartilage cell in the examination of histology and TEM. At the same...