Comparison of Polypropylene and Polydioxanone in the Hemitransdomal Suture: A Novel Rabbit Ear Cartilage Model.

BACKGROUND: Lower lateral cartilage reshaping is one of the basic steps in rhinoplasty. Hemitransdomal suture is frequently used for dome narrowing. Different suture materials can be used for hemitransdomal suture. In this study, we investigated the effectiveness of polypropylene and polydioxanone in hemitransdomal suture by designing a new experimental model in the rabbit ear cartilage. METHODS: Twelve young adult male New Zealand White rabbits were used. The bipedicled inverted-U-shaped cartilage was elevated in each ear of the rabbits. Two hemitransdomal sutures were applied using 5-0 polypropylene on one ear and 5-0 polydioxanone on the other ear randomly. A 5 mm high cartilage mound was created with two hemitransdomal sutures on each side. The sample size was twelve both in the polypropylene group and the polydioxanone group (n = 12). All animals were sacrificed after three months. Cartilage mound heights were measured. The samples were examined histologically regarding fibroadipose tissue, inflammation, foreign body granuloma, cartilage degeneration, and the presence of inclusion cyst. RESULTS: Cartilage mound height was significantly higher in the polypropylene group than in the polydioxanone group at the end of the third month [3.75 mm (± 0.68) vs. 3.03 mm (± 0.69); p < 0.05]. There was no significant difference between the two groups in histological analysis (p > 0.05). CONCLUSIONS: Polypropylene suture may be more effective in maintaining the shape given to the dome by hemitransdomal sutures in rhinoplasty. No Level Assigned This journal requires that authors assign a level of evidence to each submission to which Evidence-Based Medicine rankings are applicable. This excludes Review Articles, Book Reviews, and manuscripts that concern Basic Science, Animal Studies, Cadaver Studies, and Experimental Studies. For a full description of these Evidence-Based Medicine ratings, please refer to Table of Contents or the online Instructions to Authors www.springer.com/00266.

Advantages of the Cartilage-Sparing Technique in Prominent Ear Deformity Surgery: Comparison of a New Technique.

OBJECTIVE: Ear cartilage, crucial for maintaining ear shape and function, can sometimes undergo damage or deformation, requiring surgical intervention. This study aimed to compare the efficacy of a novel, less invasive cartilage-protective method with the traditional, more invasive cartilage-removal technique. METHODS: Our study included 64 patients (128 ears). The first group of 32 patients (64 ears) received the new cartilage-protective technique, while the second group of an equal number of patients and ears underwent the traditional method. The newer technique endeavors to retain as much healthy cartilage as possible, addressing only the issue at hand, while the traditional technique requires the removal of a substantial portion of cartilage. RESULTS: The cartilage-protective method demonstrated several notable advantages over the traditional one. First, it significantly reduced the operation duration due to its less invasive nature. Second, it caused less pain to the patients by minimizing trauma to surrounding tissues. Furthermore, this technique significantly lowered the risk of complications, probably due to the minimal disturbance or removal of healthy cartilage, hence reducing the likelihood of post-operative complications such as infections or deformities. CONCLUSION: The findings of our study propose the cartilage-protective method as a superior treatment option when surgical intervention becomes necessary to repair or restore the function of ear cartilage. This technique, being less invasive, not only results in less pain for the patients but also reduces the risk of complications. It promotes quicker patient recovery without any loss of sensation in the ear. Thus, it could potentially revolutionize the approach to dealing with ear cartilage issues. LEVEL OF EVIDENCE: Level four.

Correction of Mild-to-Moderate Constricted Ear Abnormality Using Mustardé Suture, Cartilage Onlay Graft, and Transposition Flap: A Case Report.

Constricted ear has a prevalence of 5.2 to 10% among ear abnormalities, and various surgical methods are suggested for treatment. We introduce a case of a constricted ear treated with a simple method using a novel concept cartilage graft and transposition flap, along with the well-known Mustardé suture, which is used for pediatric patients with mild to moderate constricted ears of Tanzer classification type IIA. A 10-year-old female patient visited the hospital complaining of an abnormality in the congenital right ear. Surgical approach was planned under the diagnosis of Tanzer classification type IIA constricted right ear. Posterior helix onlay graft and perichondrocutaneous transposition flap using excessive helical cartilage were performed along with the Mustardé suture. In the immediate postoperative period, ear contour was improved, and it was well-maintained without recurrence until 6 months' follow-up. In conclusion, the combination of Mustardé suture, and cartilage onlay graft and perichondrocutaneous transposition flap in the mild to moderate constricted ear would be a useful surgical option, producing aesthetically good results in a simple and effective method.

Two-Stage Pediatric Ear Reconstruction Using Preserved Native Cartilage After a Dog Bite.

Background: A dog bite causing an auricular avulsion is a rare cause of an outer ear defect. By nature of the high-energy trauma inflicted by canine bites and the anatomic variability of the outer ear, no two such avulsion injuries are the same. If the native cartilage cannot be preserved after trauma, placement of a graft capable of forming grooves and ridges is required to reconstruct the complex anatomy of the outer ear. Such intricacies often make postoperative results cosmetically disappointing. In select cases, the native cartilaginous framework of the avulsed ear segment may be preserved and used in reconstruction. Case Report: We report a case of a pediatric total auricular avulsion following a dog bite, reconstructed using prelaminated native ear cartilage. Conclusion: After traumatic avulsion of the outer ear when native cartilage is preserved, effective reconstruction can be achieved using a 2-stage technique of native cartilage lamination via posterior auricular pocket formation and placement of a skin graft.

Application of expanded polytetrafluoroethylene support combined with ear cartilage in rhinoplasty / 中华医学美学美容杂志

Objective:To explore the application of expanded polytetrafluoroethylene (ePTFE) as the main support combined with a small amount of ear cartilage in rhinoplasty.Methods:Through a nasal opening approach, the ePTFE was used as a support implant for the nasal dorsum and columella, and unilateral concha cartilage was used as a nasal tip modification graft.Results:This method was applied in 56 cases of rhinoplasty (36 cases of initial nose, 20 cases of silicone augmentation rhinoplasty). The wounds of 55 patients healed at one stage without complications, with satisfactory results (average follow-up of 6 months). In one case, nasal mucosa was damaged early after surgery, and the ePTFE was partially exposed, which healed after debridement and suture.Conclusions:For most primary rhinoplasty and simple repair of the nose, using ePTFE as the main support combined with a small amount of ear cartilage, has the advantages of fewer materials, rapid surgery, mild trauma, and stable postoperative results.

Clinical analysis of otoendoscopic myringoplasty with tragus perichondrium in 20 cases / 中国基层医药

Objective:To analyze the clinical application effect of otoendoscopic myringoplasty with tragus perichondrium.Methods:The clinical data of 20 patients with tympanic membrane perforation who received treatment in Suixian Traditional Chinese Medicine Hospital from March 2019 to March 2020 were retrospectively analyzed. Among the 20 patients, 6 patients had traumatic tympanic membrane perforation, and 14 patients had tympanic membrane perforation caused by chronic suppurative otitis media (stationary phase). All patients underwent otoendoscopic myringoplasty with tragus perichondrium. After surgery, the healing of tympanic membrane perforation and the improvement of hearing were evaluated.Results:After surgery, all patients were followed up for 12 months. Traumatic tympanic membrane perforation healed in six patients. The tympanic membrane grafts survived in 12 patients with tympanic membrane perforation caused by chronic suppurative otitis media (stationary phase). One patient had poor postoperative healing and the remaining small perforation healed after secondary treatment under local anesthesia. Healing from tympanic membrane perforation was not achieved in one patient because of perforation caused by otitis media. The healing rate of tympanic membrane perforation caused by chronic suppurative otitis media was 95%. Before surgery, the air conduction pure tone hearing threshold was (42 ± 11) dBHL, and it was (25 ± 10) dBHL 12 months after surgery. There was a significant difference in air conduction pure tone hearing threshold between before and after surgery ( t = 4.00, P < 0.05). No complications such as tragus cartilage infection, skin flap necrosis of external auditory meatus, peripheral facial paralysis, hearing loss, or tinnitus occurred in 20 patients with tympanic membrane perforation. Conclusion:Otoendoscopic myringoplasty with tragus perichondrium leads to a high perforation healing rate, improves healing greatly, has no serious complications, produces minimal trauma, and contributes to a rapid recovery from tympanic membrane perforation.

Cervical chondrocutaneous remnant: a case report.

Cervical chondrocutaneous branchial remnants are very rare congenital lesions of the lateral neck; thus, our knowledge of this condition derives almost entirely from occasional case reports in the literature. They are thought to originate from the branchial arches and, therefore, can be found anywhere on the pathway along which those branchial arches migrate during embryogenesis. We report the case of a 5-year-old girl presenting with a cervical chondrocutaneous branchial remnant on the right lateral neck that had existed since birth, with no other anomalies.

Auricular skin-cartilage sandwich graft technique for full-thickness eyelid reconstruction.

Full-thickness deficiency of eyelid tissues can result in coloboma or retraction or both. Here we report our initial experience on the use of auricular skin-cartilage sandwich graft technique for full-thickness eyelid deformities. Five patients (4-32 years) underwent the procedure. Patients with full-thickness eyelid deformity were included. Three patients were operated for large-sized coloboma and two for eyelid retraction. One patient had congenital, and four patients had acquired etiology. The following parameters were specifically assessed: correction of deformity, ocular surface problems, graft status, and epithelization of skin-cartilage graft. All the patients had a good correction of eyelid position, except one patient who had severe eyelid retraction (8 mm) at presentation. None of our patients had corneal erosion/defect, persistent ocular surface redness, or graft loss. The auricular skin-cartilage sandwich graft technique produces optimal results with no graft loss. Advancement of orbicularis muscle in between the auricular skin and cartilage grafts (sandwich technique) is an imperative step that leads to the survival of both grafts.

Congenital microtia patients: the genetically engineered exosomes released from porous gelatin methacryloyl hydrogel for downstream small RNA profiling, functional modulation of microtia chondrocytes and tissue-engineered ear cartilage regeneration.

BACKGROUND: Mesenchymal stem cells (MSCs) exosomes were previously shown to be effective in articular cartilage repairing. However, whether MSCs exosomes promote mature cartilage formation of microtia chondrocytes and the underlying mechanism of action remains unknown. Additionally, some hurdles, such as the low yield and unsatisfactory therapeutic effects of natural exosomes have emerged when considering the translation of exosomes-therapeutics to clinical practices or industrial production. Herein, we investigated the roles of human adipose-derived stem cells (ADSCs) exosomes in modulating microtia chondrocytes and the underlying mechanism of action. Special attention was also paid to the mass production and functional modification of ADSCs exosomes. RESULTS: We firstly used porous gelatin methacryloyl (Porous Gelma) hydrogel with pores size of 100 to 200 µm for 3D culture of passage 2, 4 and 6 ADSCs (P2, P4 and P6 ADSCs, respectively), and obtained their corresponding exosomes (Exo 2, Exo 4 and Exo 6, respectively). In vitro results showed Exo 2 outperformed both Exo 4 and Exo 6 in enhancing cell proliferation and attenuating apoptosis. However, both Exo 4 and Exo 6 promoted chondrogenesis more than Exo 2 did. Small RNA sequencing results indicated Exo 4 was similar to Exo 6 in small RNA profiles and consistently upregulated PI3K/AKT/mTOR signaling pathway. Notably, we found hsa-miR-23a-3p was highly expressed in Exo 4 and Exo 6 compared to Exo 2, and they modulated microtia chondrocytes by transferring hsa-miR-23a-3p to suppress PTEN expression, and consequently to activate PI3K/AKT/mTOR signaling pathway. Then, we designed genetically engineered exosomes by directly transfecting agomir-23a-3p into parent P4 ADSCs and isolated hsa-miR-23a-3p-rich exosomes for optimizing favorable effects on cell viability and new cartilage formation. Subsequently, we applied the engineered exosomes to in vitro and in vivo tissue-engineered cartilage culture and consistently found that the engineered exosomes could enhance cell proliferation, attenuate apoptosis and promote cartilage regeneration. CONCLUSIONS: Taken together, the porous Gelma hydrogel could be applied to exosomes mass production, and functional modification could be achieved by selecting P4 ADSCs as parent cells and genetically modifying ADSCs. Our engineered exosomes are a promising candidate for tissue-engineered ear cartilage regeneration.

Quality of life outcome in revision rhinoplasty in regards to number of revision surgeries and cartilage donor site.

OBJECTIVES: Rhinoplasty with or without combined septoplasty is one of the most frequently performed procedures in facial plastic surgery. Patient satisfaction and improvement in quality of life (QoL) is the primary goal. This prospective study was conducted to analyse Qol outcome in revision rhinoplasty in regards to number of revision surgeries and cartilage donor site using patient-reported outcome measures (PROMs). METHODS: Preoperative and at least 12-months postoperative scores on the Nasal Obstruction Symptome Evaluation (NOSE) questionnaire (range 0-100, lower scores indicate better outcome) and the Rhinoplasty Outcomes Evaluation (ROE) questionnaire (range 0-100, higher scores indicates better outcome) were obtained. Additionally, data on age, gender and number of previous rhinoplasties were assessed. All revision rhinoplasties were performed by one surgeon (author, F.R.) between 2014 and 2017. RESULTS: Sixty-four patients (11 (17.2%) male, 53 (82.8%) female) prospectively enrolled in this study. In 41 (64.1%) cases septal cartilage and in 23 (35.9%) patients ear cartilage was the donor site in revision surgery. Patients with more than one previous surgery (n=18) started with a lower preoperative ROE score (28.2 ± 12.8) compared to patients who had received only one previous surgery. The difference however was not significant (p=0.06). This subgroup still showed significant postoperative improvement (ROE-postop 61.9 ± 24.2; p<0.05). Both cohorts (septal cartilage and ear cartilage) improved significantly in regards to their ROE and NOSE scores after surgery and therefore showed improved health-related QoL. We could not detect any differences in health-related QoL postoperatively in regards to cartilage donor site in revision surgery. CONCLUSION: Revision rhinoplasty improves health-related QoL. There are no differences in ROE- or NOSE-scores postoperatively in regards to graft material (ear- versus septal cartilage). Both subgroups show significantly higher scores postoperatively.

Anterior and posterior auricular approach for ear cartilage harvesting rhinoplasty: a comparative study / 中华医学美学美容杂志

Objective:To compare the pros and cons of harvesting ear cartilage through anterior and posterior auricular approaches during rhinoplasty.Methods:From January 2017 to December 2018, 63 patients with otochondral rhinoplasty in our hospital were enrolled in this study, 60 were female and 3 were male; the average age was 31.6 years (range, 18 to 43) . They were randomly divided into anterior auricular approach group with 32 cases (64 sides) and posterior auricular approach group with 31 cases (62 sides). Surgical duration, complications and postoperative scar of the two methods were analyzed.Results:The average time for harvesting the ear cartilage through posterior auricular approach and anterior auricular approach was (20.8±1.7) min and (12.6±1.1) min, respectively ( P<0.01). The overall complication rate was 15.6% for posterior auricular approach group and 4.8% for anterior auricular approach group. The wound healed well in both groups, and there was no significant difference in postoperative scar between the two groups during an average 13 months follow-up period. Conclusions:While both the anterior and the posterior auricular approaches present with similar inconspicuous scarring, the use of anterior auricular approach alone to harvest ear cartilage during rhinoplasty provides both the surgeons and the patients with easier access, shorter surgical duration, and fewer complications. Hence, we believe that the anterior auricular approach possesses greater advantages than the posterior auricular approach.

Clinical effects of " bionics" augmentation rhinoplasty with auricular cartilage and expended polytetrafluoroethylene / 中华医学美学美容杂志

Objective:To discuss the principle and effect of augmentation rhinoplasty with auricular cartilage and expanded polytetrafluoroethylene.Methods:From January 2018 to January 2020, 161 patients (10 males and 151 females; aged from 19 to 48 years, with an average of 26 years) underwent " auricular cartilage plus expanded polytetrafluoroethylene" augmentation rhinoplasty in Nanfang Hospital of Southern Medical University. The expended polytetrafluoroethylene was carved into a willow leaf shape (I Shape) to fill the nasal dorsum, and the cartilage taking from cymba concha was constructed into an arched bridge shape for the nasal tip shaping. Pre-operative and 1-year post-operative measurements nasal length, nasal height, nasal depth, nasal columella height, nasal tip width, nasofrontal angle, nasolabial angle, survey of satisfaction and complication rate 1-2 years after operation were taken. The statistical analysis of nasal morphological indicators and nasal aesthetic indicators were employed.Results:The nose shape of 161 patients was improved to varying degree. All morphological indicators were improved, and difference was statistically significant ( P<0.05). The nasofrontal angle reached the standard in 90 cases, accounting for 55.9%; The nasolabial angle reached the standard in 143 cases, accounting for 88.8%. 2 cases had prosthesis (ePTFE) deviation and were corrected by surgical repair; 1 case had prosthesis (ePTFE) rejection and was corrected by prosthesis (ePTFE) removal surgery. Conclusions:Corresponding to the anatomical characteristics of the external nose, the prosthesis material is designed and made to correspond to the dorsum shape of the nasal stent. The shape of the alar cartilage, the prefabricated arched bridge shape of the cymba concha cartilage are used to reconstruct the nasal tip, which can effectively elevate the nasal dorsum, improve the protruding degree and rotation degree of the nasal tip, and have good long-term support. The flexibility and activity of the nasal tip are similar to the biological nose.

Conformal Fabrication of an Electrospun Nanofiber Mat on a 3D Ear Cartilage-Shaped Hydrogel Collector Based on Hydrogel-Assisted Electrospinning.

Electrospinning is a common and versatile process to produce nanofibers and deposit them on a collector as a two-dimensional nanofiber mat or a three-dimensional (3D) macroscopic arrangement. However, 3D electroconductive collectors with complex geometries, including protruded, curved, and recessed regions, generally caused hampering of a conformal deposition and incomplete covering of electrospun nanofibers. In this study, we suggested a conformal fabrication of an electrospun nanofiber mat on a 3D ear cartilage-shaped hydrogel collector based on hydrogel-assisted electrospinning. To relieve the influence of the complex geometries, we flattened the protruded parts of the 3D ear cartilage-shaped hydrogel collector by exploiting the flexibility of the hydrogel. We found that the suggested fabrication technique could significantly decrease an unevenly focused electric field, caused by the complex geometries of the 3D collector, by alleviating the standard deviation by more than 70% through numerical simulation. Furthermore, it was experimentally confirmed that an electrospun nanofiber mat conformally covered the flattened hydrogel collector with a uniform thickness, which was not achieved with the original hydrogel collector. Given that this study established the conformal electrospinning technique on 3D electroconductive collectors, it will contribute to various studies related to electrospinning, including tissue engineering, drug/cell delivery, environmental filter, and clothing.

A new technique in Asian nasal tip plasty: Non-incisional double-layered conchal cartilage graft.

BACKGROUND: The columellar strut graft based on the use of back-to-back autogenous conchal cartilage is one of the most commonly employed invisible grafts used for nasal tip projection. This graft provides an effective means of achieving nasal tip projection but is limited by its flexibility, especially with respect to cephalic rotation. We designed an effective technique that addresses these limitations. METHOD: A total of 38 patients received augmentation rhinoplasty with non-incisionally bent double-layered conchal cartilage columellar strut graft with nasal tip onlay graft. Projection and location of the nasal tip, nasal length, and nasolabial angle were measured using lateral view photographs. Pre- and postoperative results were compared. RESULT: Pre- and postoperative nasal tip projection ratios and nasal tip location ratios were significantly different. Revision surgery was not required in any case and no direct graft-associated complication occurred. CONCLUSION: We performed tip plasty with a modified columellar strut graft, that is, a non-incisionally bent double-layered conchal cartilage columellar strut graft. In most cases, this method resulted in a significant tip projection increase.

Clinical effect of rhinoplasty with ear cartilage and silicone prosthesis: a three-dimensional scanning study / 中华医学美学美容杂志

Objective:To use three-dimensional (3D) scanning to measure the preoperative and postoperative nasal parameters of the patients received rhinoplasty with ear cartilage and silicone prosthesis, and to evaluate the clinical effect of the surgery.Methods:Sixteen female patients with an average age of 28.3 years, ranged from 21 to 35 years, received rhinoplasty with ear cartilage and silicone prosthesis in Wuhan Tongji Hospital from June 2018 to February 2019. Preoperative and postoperative 3D scanning was performed to measure nasal parameters, including linear length, angle, and proportional index.Results:All patients were satisfied with the postoperative outcomes. The postoperative nasal length, nasal height, and nasal depth increased significantly, and the postoperative nasal width and nasal tip width decreased. The postoperative nasolabial angle and nasofrontal angle were statistically improved, while the preoperative and postoperative data of columellar facial angle, nasal tip angle, and nasal column-lobular angle were not significantly different. The ratios of nasal depth and nasal width, nasal index and nasal tip protrusion were improved after surgery, while the postoperative ratios of nasal columella and nasal lobules length were not statistically improved.Conclusions:The 3D scanning allows for comprehensive and accurate measurement of the nasal parameters. The rhinoplasty with ear cartilage and silicone prosthesis is more effective in improving the overall contour of the nose, but less effective in improving the aesthetics of the nasal tip.

Reversal of ochronotic pigmentation in alkaptonuria following nitisinone therapy: Analysis of data from the United Kingdom National Alkaptonuria Centre.

BACKGROUND: Increased homogentisic acid (HGA) causes ochronosis. Nitisinone decreases HGA. The aim was to study the effect of nitisinone on the ochronosis progression. METHODS: Photographs of the eyes and ears were acquired from patients attending the National Alkaptonuria Centre (NAC) at V-1 (pre-baseline visit), V0 (baseline visit when 2 mg nitisinone was commenced), and yearly at V1, V2, and V3 visits. Photographs were inspected for evolution of ochronotic pigment and also scored categorically to derive eye, ear, and combined ochronosis scores. An ear cartilage biopsy was also carried out at V0 and one year after V3 (V4) and ochronotic pigment was assessed and quantitated. Visits were compared for changes in pigment. Fasting blood and 24-hour urine samples were collected for measurement of HGA. RESULTS: There were 80 AKU patients at V0, and 52, 47, and 40 at V1, V2, and V3 in the group with variable numbers (VAR Group) respectively; 23 patients attended once before V0, in the V-1 visit. Photographs of patients show increase in eye pigment between V-1 and V0, followed by decrease post-nitisinone at V1, V2, and V3. Ear and combined ochronosis semiquantitative scoring showed an increase between V-1 and V0 (P < .01), followed by a decrease at V1, V2, and V3, in the VAR group (P < .01). Ochronotic pigment in ear biopsy between V0 and V4 showed a 19.1% decrease (P < .05). CONCLUSIONS: Nitisinone decreases HGA and partially reverses ochronosis.

Leucemia mieloide aguda y policondritis recurrente ¿casualidad o relación causal? / Acute myeloid leukemya and relapsing polychondritis. Chance or causal relationship?

La policondritis recurrente o recidivante es una enfermedad sistémica crónica autoinmune, caracterizada por la inflamación de tejidos cartilaginosos asociada en pocos casos a enfermedades malignas hematológicas. Presentamos el caso de una paciente femenina de 26 años que cursaba concomitantemente con leucemia mieloide aguda (LMA). La manifestación inicial fue una afección cutánea en forma de eritema nodoso, y posteriormente se diagnosticó LMA; durante la fase de aplasia posquimioterapia desarrolló inflamación bilateral del cartílago auricular (condritis auricular) y síndrome vertiginoso con evolución clínica satisfactoria al tratamiento inmunosupresor con glucocorticoides. Conclusiones: Es difícil definir si existe asociación entre la policondritis recidivante y la leucemia mieloide aguda, la quimioterapia o la sumatoria de las dos noxas. Una vez que se establece el diagnóstico se debe iniciar oportunamente la administración de glucocorticoide a altas dosis, ya que pudieran aparecer complicaciones como la necrosis del cartílago y la pérdida de la región afectada. En contraste, el uso de los glucocorticoides tiene una excelente respuesta con modulación completa de la enfermedad, tal como se muestra en el caso presentado(AU)

Relapsing polychondritis is a systemic, chronic and autoimmune disease characterized by the inflammation of cartilaginous tissues. This disease is associated in a few cases with malignant hematological diseases. We present a case of a patient with relapsing polychondritis and concomitantly with acute myeloid leukemia. A 26-year-old female patient, with cutaneous affection as initial manifestation categorized as erythema nodosum. Then she was diagnosed with acute myeloid leukemia. In the aplasia post-chemotherapy phase, the patient developed bilateral inflammation of the ear cartilage (auricular chondritis) and a vertiginous syndrome with satisfactory clinical evolution to immunosuppressive treatment with glucocorticoids. Conclusion: Relapsing polychondritis usually presents with cartilaginous involvement, such as bilateral atrial chondritis, as shown in the case. Early diagnosis and timely treatment are necessary to achieve a good clinical response. Subsequent studies are necessary to evaluate the association between relapsing polychondritis and hematological alterations such as acute myeloid leukemia and the use of chemotherapy(AU)