Minimally Invasive Costal Cartilage Harvesting Incision for Chest Deformity in Microtia Reconstruction.

BACKGROUND: Chest deformity is a potential complication associated with auricular reconstruction using autologous costal cartilage. The impact of the incision size employed for costal cartilage harvesting on chest deformities remains unclear. This study aimed to investigate the correlation between the incision size used for harvesting costal cartilage and the occurrence of chest deformities. METHODS: We retrospectively analyzed patients who underwent ear reconstruction using autologous costal cartilage between June 2021 and September 2022. The patients were categorized into two groups based on the size of the costal cartilage incision: large and small. Chest computed tomography (CT) was performed 18-24 months postoperatively, followed by three-dimensional color map quantification to assess the degree of asymmetry of the chest surface. Subsequently, quantitative data analysis was performed to compare the extent of chest asymmetry between the large- and small-incision groups. The Visual Analog Scale (VAS) was used to assess patient satisfaction with chest morphology. RESULTS: This study included 62 patients, with an equal distribution of 31 in each group. The mean asymmetry value of the small and large incision groups was -3.15 ± 1.88 and -5.27 ± 3.63, respectively. Moreover, the mean VAS score for the small and large incision groups was 7.48 ± 0.72 and 5.09 ± 0.94, respectively. Statistically significant differences were observed between the two groups. CONCLUSIONS: Small incision costal cartilage harvesting can effectively alleviate the severity of chest deformities and significantly enhance patient satisfaction. LEVEL OF EVIDENCE IV: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Correlations Among Clinical Phenotypes, Radiological Examination Indexes, and Hearing Status in Congenital Microtia.

Microtia is a congenital malformation of the external ear that often presents with other anatomical abnormalities and ipsilateral hearing loss (HL). The aim of this study was to present the correlation among important phenotypic abnormalities in microtia and their relationship with HL in a clinical population in China. In this study, a retrospective analysis was conducted on 307 patients diagnosed with microtia who visited the Department of Auricular Reconstruction of the Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, for surgical auricle reconstruction from April 2021 to April 2022. Standardized classification of ear malformations, craniofacial CT scans, and pure tone audiometric data were collected, and statistical analyses were performed using the rank sum test, Kruskal-Wallis test, and Spearman's rank correlation coefficient. The results showed that group differences between ear malformation and variations in the development of mandible, external auditory canal (EAC), and mastoid pneumatization were statistically significant and each had a positive correlation. Among them, the correlation between development of ear and EAC was the most significant (Ρ=0.72). Besides, the severity of HL (97% were conductive) was positively correlated with ear and EAC dysplasia with or without mandibular hypoplasia. Based on the statistical analysis of the correlation between ear malformation and HL, the authors strongly recommend that facial phenotype reconstruction and hearing improvement of microtia should be considered comprehensively, regardless of whether children with microtia show HL or not, early diagnosis of audiology evaluation and appropriate intervention measures should be implemented.

The enhanced photocatalytic inactivation of marine microorganisms over ZnO supported Ag quantum dots by the synthesis of H2O2.

The production of hydroxyl radicals has been demonstrated to improve the antifouling of marine through a photocatalytic strategy. However, only relying on the valence band of the photocatalyst to generate hydroxyl radicals is inefficient and limits the application of photocatalytic technology in the field of marine-antifouling coatings. Herein, we reported a new strategy in which Ag quantum dots are used to synthesize hydrogen peroxide (H2O2) by photocatalysis in seawater. The decomposition of the generated H2O2 to hydroxyl radicals improves the antifouling ability. Interestingly, the prominent size effect of Ag quantum dots is closely related to the yield of H2O2. We synthesized Ag quantum dots supported on ZnO and found that Ag quantum dots approximately 4 nm in size have the highest activity for H2O2 generation and undergo a 1 h photocatalytic reaction in which the concentration of H2O2 can reach 124 µg/mL. The efficiency of ZnO in inactivating marine microorganisms increased from 72.3% to 99.4% in seawater. The synthesis of H2O2 through photocatalysis based on the medium of seawater can expand the application of photocatalytic technology in the field of marine antifouling.

Morphology modulation and performance optimization of nanopetal-based Ag-modified Bi2O2CO3 as an inactivating photocatalytic material.

The use of photocatalytic technology to kill bacteria on marine vessel surface coatings has been paid more attention by research scholars. In this paper, petal-like microspheres with Ag nanoparticles were prepared by a simple one-step process combining the hydrothermal method and photodeposition. The 0.7% Ag/Bi2O2CO3 composite photocatalyst exhibited the highest photocatalytic efficiency for bacterial removal under visible light irradiation and had the highest photogenerated carrier separation efficiency, and the sterilization rate was doubled compared with that of pure Bi2O2CO3, reaching 95%. Using X-ray photoelectron spectroscopy, scanning electron microscopy and transmission electron microscopy, the existence of Ag nanoparticles was confirmed, and their size was approximately 10 nm. The surface plasmon resonance (SPR) effect of Ag nanoparticles was investigated by ultraviolet-visible diffuse reflectance spectroscopy (DRS). It was shown that the surface plasmon resonance effect of Ag improved the spectral utilization of the Ag/Bi2O2CO3 composite photocatalyst and enhanced the stability of the catalyst. This caused the Ag/Bi2O2CO3 composite photocatalyst to have superior photocatalytic activity to pure Bi2O2CO3. The results of electrochemical impedance characterization and transient photocurrent response show that 0.7% Ag/Bi2O2CO3 has a high efficiency of photogenerated carrier separation. By the free radical capture test, hydroxyl radicals were the primary active substance, and Ag+ improved the photocatalytic sterilization activity.

Congenital heart defects in patients with isolated microtia: evaluation using colour Doppler echocardiographic image.

BACKGROUND: The objective of this study was to delineate the characteristics and incidence of congenital heart disease (CHD) in patients with isolated microtia and to determine whether the prevalence of CHD among patients with isolated microtia increases with the severity of microtia. METHODS: A total of 804 consecutive patients had a pre-operative colour Doppler echocardiographic examination. A retrospective study was performed with the clinical and imaging data from November, 2017 to January, 2019. The χ2 test was performed to analyse the interaction between isolated microtia and CHD. RESULTS: With the colour Doppler echocardiographic examination's data from 804 consecutive isolated microtia patients, we found CHD, including atrial septal defect, ventricular septal defect, tetralogy of Fallot, patent ductus arteriosus, and others, occurred in 52 of 804 patients (6.5%). Atrial septal defect prevalence in patients with isolated microtia was significantly higher than ventricular septal defect (24/804 versus 11/804, p < 0.05) and patent ductus arteriosus (24/804 versus 2/804, p < 0.001). Ventricular septal defect prevalence in patients with isolated microtia was significantly higher than patent ductus arteriosus (11/804 versus 2/804, p < 0.05). All four types of microtia (concha-type microtia, small concha-type microtia, lobule-type microtia, and anotia) had similar incidences of CHD with no difference in the incidences among these types (p > 0.05 respectively). Furthermore, there was no significant difference in the incidence of the atrial septal defect among the four subtypes (p > 0.05 respectively). Similarly, ventricular septal defect and patent ductus arteriosus also showed no differences (p > 0.05 respectively). CONCLUSIONS: The overall incidences of CHD and three most common CHD subtypes (atrial septal defect, ventricular septal defect, and patent ductus arteriosus) in patients with isolated microtia are higher than general population. The prevalence of CHD among patients with isolated microtia does not increase with the severity of microtia. According to our experience in this study, we suggest colour Doppler echocardiographic imaging should be performed for isolated microtia patients soon after birth if possible. Furthermore, for the plastic surgeon and anaesthesiologist, it is important to take pre-operative colour Doppler echocardiographic images which can help evaluate heart function to ensure the safety of the peri-operative period. Future studies when investigating CHDs associated with isolated microtia could focus on genetic and molecular mechanisms.

Clinical Application of Carving Template With 3D Reconstruction Technique for Personalized and Precise Treatment of Traumatic Ear Defects.

ABSTRACT: We explored the clinical application of a 3-dimensional (3D) digital reconstruction technique for personalized and precise traumatic ear defect treatment. A 3D scanner was used to obtain 3D images of the unaffected ear. The data were converted into an ear contour model through mirroring using the software, and imported to a rapid prototyping 3D printer to construct an ipsilateral ear model. For treating different types of ear defect patients with individualized treatment programs, the defective ear model was constructed with individualized autogenous costal cartilage carving. We constructed ipsilateral ear defect models in 16 cases and rebuilt the auricular with >10 outer ear substructure units, maintaining a stable cranial angle. At the 6-month follow-up, the reconstructed ear was similar to the unaffected one, and the patient satisfaction was high. Based on a paired t test, the differences in the width of both auricles was statistically significant, with P values of 0.023, respectively. The differences in the P values of the auricle length, circumference and height, at 0.261, 0.333, and 0.197, respectively, were not statistically significant. Compared to the model utilizing the traditional 2D film template of the ear, the 3D reconstruction technology was more intuitive and stereoscopic, and the personalized ear reconstruction was accurate. Thus, 3D digital technology can avail the most suitable personalized treatment for various traumatic ear defects. It can assist in precisely engraving the reconstructed cartilage stent and objectively analyzing the postoperative results. The therapeutic effect was significant.

Method of Reducing Thoracic Deformity in Auricular Reconstruction.

Autologous costal cartilage graft is an important material in orthopedic surgery. However, postoperative deformity of costal cartilage in donors is also a matter of concern. In our clinical experience, the preservation of the intercostal perichondrium, the replantation of part of the costal cartilage, and wearing an elastic chest strap for half a year are all ways to avoid thoracic deformity. Methods by which to avoid thoracic deformity is still the focus of our efforts.

Costal Cartilage Assessment in Surgical Timing of Microtia Reconstruction.

BACKGROUND: Rib cartilage growth is closely related to age and determines the feasibility and outcomes of auricular reconstruction. Ear reconstruction is performed as early as age 6 in efforts to treat children before school matriculation while allowing for sufficient rib growth. But there is controversy over the optimal timing of microtia reconstruction. This study employs CT imaging and surface scanning to guide the timing of auricular reconstruction in children. METHODS: A retrospective analysis was performed on 6-year-old microtia patients between January 2016 and June 2016. A total of 37 patients were underwent preoperative 3D rib-cage CT measurements and normal auricle scanning measurement including: the length of 6th, 7th, and 8th costal cartilage, the width of 6th,and 7th costal cartilage, and the length of normal auricle. Then the data of costal cartilage were compared with the data of the auricle. RESULTS: The average length of the 6th, 7th, and 8th rib cartilage on the right was 76.1 ±â€Š9.2 mm (range, 61.1-94.9 mm), 102.6 ±â€Š9.9 mm (range, 84.5-119.1 mm), and 75.4 ±â€Š19.3 mm (range, 47.3-118.5 mm), respectively, and the the average helical length was 90.5 ±â€Š6.8 mm (range, 76.9-101.5 mm). Comparing the above data, it was revealed that the age of 6 years was an optimal time for ear reconstruction with tissue-expanding technique. CONCLUSIONS: 3D rib-cage CT for preoperative measurement of costal cartilage could be a useful method for planning microtia reconstruction. According to our study, the amount of costal cartilage of almost all 6-year-old microtia patients is enough for ear reconstruction. So age 6 years is the optimal timing of auricular reconstruction with tissue-expanding method.

Efficient Charge Separation and Transport in Fullerene-CuPcOC8 Donor-Acceptor Nanorod Enhancing Photocatalytic Hydrogen Generation.

Photocatalytic hydrogen generation via water decomposition is a promising avenue in the pursuit of large-scale, cost-effective renewable hydrogen energy generation. However, the design of an efficient photocatalyst plays a crucial role in achieving high yields in hydrogen generation. Herein, we have engineered a fullerene-2,3,9,10,16,17,23,24-octa(octyloxy)copper phthalocyanine (C60-CuPcOC8) photocatalyst, achieving both efficient hydrogen generation and high stability. The significant donor-acceptor (D-A) interactions facilitate the efficient electron transfer from CuPcOC8 to C60. The rate of photocatalytic hydrogen generation for C60-CuPcOC8 is 8.32 mmol·g-1·h-1, which is two orders of magnitude higher than the individual C60 and CuPcOC8. The remarkable increase in hydrogen generation activity can be attributed to the development of a robust internal electric field within the C60-CuPcOC8 assembly. It is 16.68 times higher than that of the pure CuPcOC8. The strong internal electric field facilitates the rapid separation within 0.6 ps, enabling photogenerated charge transfer efficiently. Notably, the hydrogen generation efficiency of C60-CuPcOC8 remains above 95%, even after 10 h, showing its exceptional photocatalytic stability. This study provides critical insight into advancing the field of photocatalysis.

Structure and Mechanical Performance of Biomimetic Costal Cartilage Models for Ear Framework Handcrafting Simulation.

SUMMARY: Ear framework handcrafting simulation using costal cartilage models is crucially important for ear reconstruction surgery education. Fabrication of proper models that are mechanically and structurally comparable to their native counterparts is an unmet challenge. The authors developed structure and mechanical performance biomimetic costal cartilage models for practicing and simulating handcrafting of ear frameworks. High-tensile silicone and three-dimensional techniques were used to fabricate biomimetic models. The models well-replicated the three-dimensional structure of human costal cartilage. Comprehensive mechanical tests showed that high-tensile silicone models had stiffness, hardness, and suture retention ability similar to those of their native counterparts, and they were distinctly superior to commonly used materials for costal cartilage simulation. This model satisfied surgeons and contributed to creation of outstanding ear frameworks. The recreated models were used in ear framework handcrafting workshops. Novices' surgical simulation performance with different models was compared and analyzed. People who used high-tensile silicone models have greater progress and confidence after training. Using high-tensile silicone costal cartilage models is an excellent choice for practicing and simulating the fabrication of ear frameworks manually. The models benefit practitioners and students in practicing handcrafting ear frameworks and surgical skills.

Protein profile of ear auricle cartilage and the important role of ITGB1/PTK2 in microtia.

BACKGROUND: Microtia is a congenital malformation of the external ear that involves anything from a small reduction in size to a complete absence. The external ear is composed of elastic cartilage which is also the important skeleton of the outer ear. However no previous study explored the difference between abnormal elastic cartilage and normal cartilage in the molecular level. METHODS: Microtia cartilage and normal cartilage tissue samples from patients subjected to autologous costal cartilage reconstruction were obtained in surgery. Total proteins were extracted and purified, and then proteomic analyzed via LC-MS/MS using DDA/DIA data collection methods. Proteins were also isolated with lysis beads and then analyzed via antibody chip. Differentially expressed proteins were identified in both experiments and further analyzed with functional enrichment analysis and KEGG pathway analysis. Valuable regulatory gene expression level was verified by RT-PCR. RESULTS: A total of 4178 protein types were identified in the DDA experiment. A total of 2154 proteins were quantified, 172 of which were significantly upregulated and 82 downregulated in the microtia group (P < 0.05). Antibody chip detection allowed identification of 584 protein phosphorylation sites with 102 upregulation sites and 9 downregulation sites (P < 0.05). Differentially altered proteins were annotated to 143 KEGG pathways, while differentiated phosphate site-associated genes were annotated into 21 KEGG pathways. Two intersecting pathways, the PI3K/AKT/mTOR pathway and the focal adhesion pathway, may paly important role on ear auricle cartilage development. One item is significant in both differential protein expression and phosphorylation. Integrin beta-1, that is downregulated in protein quantification of the microtia group. The mean ITGB1 mRNA level of the microtia patient group was significantly lower than in the healthy control group (P = 0.0007 < 0.05). And the gene expression of downstream gene PTK2 was also decreased. (P = 0.0288 < 0.05). CONCLUSION: The research locates the key protein Integrin Beta-1, and verified it at the mRNA level. The increasing level of ITGB1 and decreasing of PTK2 may play an important role in congenital ear deformity. This research will inspire more otolaryngologists and orthopedics doctors to pay attention to the etiology and mechanism of microtia.

Two-stage surgical treatment of giant congenital melanocytic nevus around the auricle.

BACKGROUND: This study presents the results of complete excision of giant congenital melanocytic nevi (GCMN) on the auricle, forehead, or periorbital area combined with tissue expansion, and skin graft transplantation performed in two stages based on 10 years of experience. AIMS: To solve the giant congenital melanocytic nevi on the auricle, forehead, or periorbital area with two-stage operation. PATIENTS/METHODS: A total of 21 patients with GCMN were included in this study. The operation combined tissue expander and skin graft transplantation. RESULT: All GCMNs were successfully and completely excised. No patient in the study group had experienced skin contraction or auricular deformation at 3 years after treatment. CONCLUSION: Two-stage operation is effective for removing GCMN on the auricle or face and can achieve good oncological and cosmetic results.

Classification of the concha-type microtia and their new suitable treatment strategies without autogenous costal cartilage grafting.

OBJECTIVE: Numerous corrective methods have been successfully applied in concha-type microtia reconstruction over the past several decades, and autogenous rib cartilage grafting has become a routine technique in a two or three-stage operation. However, it still remains a challenge due to the effective use of the large volume of the remnant cartilage and skin involved. The objective of this study was to clarify how this remnant cartilage and skin could be manipulated for new suitable treatment strategies without autogenous costal cartilage grafting. METHODS: A total of 424 patients with concha-type microtia operated at our Center from January of 2012 to June of 2019 have been reviewed and analyzed cases. At the same time, a classification system for grading the severity of concha-type microtia was created on the basis of anatomical findings and ear size. RESULTS: A total of 436 ear cases (involving 424 patients), showing concha-type microtia, were included in our study and reviewed through medical records, photographs, analysis of surgical methods, and postoperative outcomes. The concha-type microtia were classified into four graded types: Grade I (n = 151), Grade II (n = 101), Grade III (n = 93), and Grade IV (n = 79). A total of 352 ears in 345 patients with Grade I to III concha-type microtia were followed up for 1 month to 7 years (average, 14.7 months). 329 patients (95.4%) were satisfied with the aesthetic outcomes of the corrected ear. CONCLUSIONS: Individual corrective methods and aesthetic outcomes for patients with Grade I to III of deformity were described in this study. The authors present new suitable approaches according to a progressive classification system which provide conservative and individualized methods of treatment in early stages of life.

New methods for specialized subjective and high-precision objective evaluation of constricted ears: A pilot study.

The effects of therapy on constricted ears are evaluated subjectively and objectively. However, previous methods are not specific, comprehensive, precise, or effective in diagnosing and predicting surgical outcomes. This study aimed to present a personalized, subjective evaluation scale and new objective indices utilizing a digital method for the accurate evaluation of constricted ears.Nine consecutive patients with constricted ears were selected. To perform subjective evaluations, the patients' parents were contacted by telephone within 3 to 6 months after surgery and asked to answer questions using a scale. To perform objective evaluations, the constricted and normal ears of each patient were scanned using a 3-dimensional scanner before and 14 days after surgery. The vertical height of the auricle (VHA), transverse diameter of the auricle, minimum length of the helix (MLH), length of the inner auricle (LIA), and transverse diameter of the inner auricle were calculated using Mimics software. The Wilcoxon matched pairs signed-rank test was used for data analysis.High satisfaction scores were reported. The folds of the ear and helix had the highest median scores, whereas the crus of the antihelix had the lowest. The difference in LIA and postoperative MLH was greater than that in VHA and preoperative MLH. The mean values of the 5 indices of the normal ear were greater than those of the indices of the preoperative constricted ear (P < .05).The specialized subjective scale reported in this study allows comprehensive and personalized assessment of constricted ears. The new objective indices are more effective than existing methods and the digital measurement method is precise and reliable. These methods will allow the treatment of constricted ears to be better evaluated, leading to improvements in patient management and treatment selection.

Differential expression of long noncoding RNAs in congenital microtia.

OBJECTIVE: To analyse lncRNA expression profiles in microtia using bioinformatics analysis. METHODS: We examined lncRNA expression profiles in residual ear cartilage and normal ear cartilage from individual congenital microtia patients. RESULTS: The gene chips used in this study included 30586 lncRNAs and 26109 mRNA probes. Intotal, 180 lncRNAs with differential expression weredetected in the residual ear cartilage compared with the normal cartilage, including 74 up-regulated and 106down-regulated lncRNAs. Signalling pathway analysis highlighted glyceride metabolism, osteoclast differentiation, andtumour growth. The results of qRT-PCR analysis were consistent with those of themicroarray. CONCLUSION: Differential expression of lncRNAs occurs in microtia. These lncRNAs and related signalling pathways may play an important role in the occurrence and development ofmicrotia.

Three-dimensional autologous cartilage framework fabrication assisted by new additive manufactured ear-shaped templates for microtia reconstruction.

BACKGROUND: During microtia reconstruction, the intraoperative design of the cartilage framework is important for the appearance and symmetry of the bilateral auricles. Templates (traditionally, the X-ray film template) are usually utilized to complete the task, which can provide cues regarding size, cranioauricular angle and positioning to the surgeons. With a combination of three-dimensional (3D) scanning and additive manufacturing (AM) techniques, we utilized two different ear-shaped templates (sheet moulding and 3D templates) during the fabrication of 3D-customized autologous cartilage frameworks for auricle reconstruction. METHODS: Forty unilateral microtia patients were included in the study. All the patients underwent auricle reconstruction using the tissue-expanding technique assisted by the new AM templates. Images were processed using computer-aided design software and exported to print two different AM ear-shaped templates: sheet moulding and 3D. Both templates were assisted by the 3D framework fabrication. The 3D images of each patient's head were captured preoperatively using a 3D scanner. X-ray film templates were also made for the patients. The lengths and widths of the contralateral auricles, X-ray film and sheet moulding templates were measured in triplicate. The error of the template and the contralateral auricle were used to compare the accuracy between the two templates. RESULTS: Between January and May 2014, 40 unilateral microtia patients aged 6-29 years were included in this study. All patients underwent auricle reconstruction using autogenous costal cartilage. The sterilized AM templates were used to assist in the framework fabrication. The operative time was decreased by an average of 15 min compared with the method assisted by the X-ray film template. Postoperative appearance evaluation (based on five indexes: symmetry, length, width, cranioauricular angle and the substructure of the reconstructed ear) was performed by both the doctors and the patients (or their parents). Follow-up (ranging from 9 to 18 months) showed that all of the patients obtained satisfactory results with life-like 3D configuration and symmetric cranioauricular angle. The follow-up showed that no surgery-related complications occurred. Comparing the accuracy of the X-ray film and sheet moulding templates, the average errors of length were 1.8 mm ± 1.44 mm and 0.39 mm ± 0.35 mm, respectively, and the average width errors were 1.32 mm ± 0.88 mm and 0.3 mm ± 0.47 mm, respectively. The new sheet moulding template was more accurate than the X-ray template. CONCLUSIONS: The new sheet-moulding template is much more accurate than the traditional X-ray film template. Framework fabrication assisted by accurate 3D and informative AM templates contributed to individualized cartilage framework fabrication and satisfactory results.

[Experimental research on DNA methylation profile in congenital microtia].

OBJECTIVE: To screen for abnormal methylation in CpG islands and CpG sites through whole genome of congenital microtia to identify their associated genes. To discuss the relationship between abnormal methylation level of genes and the etiology of congenital microtia. METHODS: Residual ear cartilage of 50 patients with microtia was collected with ear cartilage of 34 patients without ear malformations as control. Nimblegen CpG promoter array was chosen to screen the 28,226 CpG islands in the whole genome of both experimental and control groups. The genes with differential methylated CpG islands were selected. SpectroCHIP array was chosen to detect the methylation level of each CpG site in abnormal methyletion CpG islands of both experimental and control groups. The CpG sites with differential methylation level were selected. RESULTS: There were 36 CpG islands with differential methylated level in whole genome between experimental group and control group, among which 29 CpG islands were connected with 29 named genes. In the abnormal methylated CpG islands of COL18A1, MYH14, RBMY1A1 and ZIC3, 6 differentially methylated CpG sites were found with statistical significance. The methylation level of these 6 CpG sites in experimental group and control group were COL18A1_2_CpG_170.9783 +/- 0.0235 and 0.9526 +/- 0.0589; MYH14_CpG_170.9600 +/- 0.0414 and 0.9284 +/- 0.0655; RBMY1A1_1_CpG_3.40.9966 +/- 0.0055 and 0.9914 +/- 0.0069; RBMY1A1_1_CpG_130.9648 +/- 0.0118 and 0.9757 +/- 0.0127; ZIC3_3_CpG_150.0867 +/- 0.0212 and 0.0543 +/- 0.0399; ZIC3_2_CpG_270.3775 +/- 0.1816 and 0.472 3 +/- 0.0439. CONCLUSIONS: The DNA methylation profile of the entire genome is initially established. The abnormal methylated CpG islands of COL18A1, MYH14, RBMY1A1 and ZIC3 might be related to the pathogenesis of microtia.

[A surgical strategy and treatment outcome of acquired auricular defect].

OBJECTIVE: To investigate the clinical outcome of a surgical strategy by soft tissue expansion in treating acquired auricular defect. METHODS: Between January 2007 and December 2009, 136 patients with acquired auricular defect were treated with a surgical strategy by putting autoallergic costal framework after soft tissue expansion. There were 93 males and 43 females, aged 8-60 years (median, 20 years). Defects were caused by burn in 82 cases, by trauma in 47 cases, and by bite in 7 cases. Defect involved in almost the whole auricle and earlobe in 50 patients, 2/3 superior part of auricle in 35 patients, 1/3 superior part of auricle in 31 patients, 1/3 middle part of auricle in 9 patients, and 1/3 inferior part of auricle and earlobe in 11 patients. RESULTS: All the flaps had good blood supply, skin grafts all survived, and all the wounds healed by first intention after operation. All patients were followed up 6-24 months with an average of 14 months. All reconstructive auricle survived with good color, soft texture, and normal sensory function; the appearance had no enlargement and attrition, and the grafted costal cartilage framework had no melanosis, absorption, and deformation. The reconstructed ear had the same position, size, shape, and oto-cranium angle as normal ear. The curative effect was good according to ZHUANG Hongxing's evaluation standard of auricular reconstruction. CONCLUSION: To reconstruct auricle by soft tissue expansion is an effective method. The position of putting expander and the number of expanders are different in different patients.