Effect Of Closing Costal Perichondrium On The Cartilage Repair And Regeneration

BackgroundMicrotia is the more common disease in auricle dysplasia,which morbidity just next to cheilopalatognathus in congenital deformity of maxillofacial region,often accompanied by ankylotia,middle ear deformity,hemifacial macrosomia and other system organ abnormalities.Surgical operation is still the only way to treat this disease,cartilage costalis has been recognized as the best source of reforge ear support due to its advantages of histocompatibility,have no rejection,easy to gain,better ability in stress tolerance.Owing to the poor regenerative capacity of cartilage,cut a large number of rib cartilage will damage the integrity and stability of the thorax.Reconstruction of auricle often underway in adolescence,more and more scholars have been concerned about this issue,and made a lot of research in order to reduce the complication of donor site in postop.It has been proven that cut rib cartilage while retaining intact perichondrium and costochondral junction is desirable.Some scholars propose to replant the fragment of cartilage after carving into perichondrium.Although the experiment was carried out research,its principle and effect is unclear not yet.Also this test still lacks of research data in clinical.In addition,another scholar suggested that replant the fragment of cartilage with biological material into perichondrium may be effective.But this method is still in animal experiments,has not been applied in clinical practice.In this experiment,3D CT reconstruction technique was used to observe whether suturing the costal perichondrium after cutting off the rib cartilage has effects on the growth of the rib cartilage and the development of the shape of the thoracic long term or not during auricular reconstruction.ObjectiveTake the patients with congenital microtia as the object of study,use the improved operative method of Nagata to reconstruct auricle,combined with 3D CT reconstruction technique,we can compare the different in length,width,curvature,inclination whether suturing the costal perichondrium after cutting off the rib cartilage.In order to observe the effects on the growth of the rib cartilage and the development of the shape of the thoracic long term or not during auricular reconstruction.MethodCollect 36 cases of microtia syndrome between June 2014 and October 2016 in henan province people's hospital.All patients were operated by the same operative method.They were divided into two groups according to whether the periosteum was closed or not.We use 3D CT reconstruction technique to help the patients before the operation,and one year after the operation in each group and observe the growth of the rib cartilage.ResultsThe closed group with 26 cases includes all visible tissue regeneration(100%),rib cartilage regeneration in 3 patients(11.5%)and calcified fibrous tissue in 23 cases(88.5%).All of them were in good Thoracic morphology,and no obvious subsidence or angulation deformity.the not closed group includes visible tissue regeneration with 2 cases(20%).Conclusion We can conclude that retaining the costal perichondrium which is closed with sleeve shape is beneficial to the regeneration of the fibrous tissue and reduce the incidence of postoperative thoracic deformity.The incidence of thoracic deformities after the removal of the costal cartilages gradually decreases with age.