Tissue-resident macrophages specifically express Lactotransferrin and Vegfc during ear pinna regeneration in spiny mice.

The details of how macrophages control different healing trajectories (regeneration vs. scar formation) remain poorly defined. Spiny mice (Acomys spp.) can regenerate external ear pinnae tissue, whereas lab mice (Mus musculus) form scar tissue in response to an identical injury. Here, we used this dual species system to dissect macrophage phenotypes between healing modes. We identified secreted factors from activated Acomys macrophages that induce a pro-regenerative phenotype in fibroblasts from both species. Transcriptional profiling of Acomys macrophages and subsequent in vitro tests identified VEGFC, PDGFA, and Lactotransferrin (LTF) as potential pro-regenerative modulators. Examining macrophages in vivo, we found that Acomys-resident macrophages secreted VEGFC and LTF, whereas Mus macrophages do not. Lastly, we demonstrate the requirement for VEGFC during regeneration and find that interrupting lymphangiogenesis delays blastema and new tissue formation. Together, our results demonstrate that cell-autonomous mechanisms govern how macrophages react to the same stimuli to differentially produce factors that facilitate regeneration.

Auricular leishmaniasis mimicking squamous cell carcinoma of the pinna.

Cutaneous leishmaniasis can occur on any exposed area of the body; however, the pinna is an exceptionally rare site for the disease. Caused by the parasite Leishmania, cutaneous leishmaniasis has a wide range of presentations and thus is very easy to misdiagnose or mistake for a neoplastic lesion. Here, we report the case of a middle-aged male patient presenting with a painful, ulcerated lesion on the left auricle initially suspected to be a malignancy with histopathology eventually revealing a diagnosis of auricular leishmaniasis. The patient received appropriate therapy and was found to be disease free at follow-up. These isolated lesions of the pinna often resemble neoplastic lesions and thus may escape diagnosis for months at a time, increasing patient stress as well as expenditure. In addition, prompt recognition may also help mitigate recurrence of the disease, making it worthwhile to include cutaneous leishmaniasis as part of the differential, especially in endemic areas.

Nodular Fasciitis in the Cavity of Auricular Concha: A Case Report.

Nodular fasciitis (NF) has a low incidence, many classification subtypes and large histological variations. We describe a 17-month-old child who presented with a mass in the right cavity of auricular concha that was successfully cured by 2 procedures. In pediatric patients with fibroproliferative lesions, the possibility of NF should be excluded to avoid misdiagnosis and overtreatment.

A successful reconstruction of the upper antihelix defect via postauricular pull-through pedicle flap.

The auricle is a complex anatomic structure with a three-dimensional configuration proper reinstating that poses a substantial reconstructive challenge. The postauricular pull-through flap is perfectly suitable method for the reconstruction of helical and antihelical auricle defects; however, due to its difficult harvest technique, it is not commonly used in a practice. Here we describe a case of a patient with an antihelix defect following basal cell carcinoma (BCC). In our case, the reconstruction was performed via postauricular pull-through pedicle flap, and a satisfactory result was achieved.

An Algorithmic Approach for the Reconstruction of Extended Upper-Third Auricular Soft Tissue Defects.

ABSTRACT: Auricular defects are demanding to reconstruct due to the complex anatomy and the three-dimensional shape of the ear. The functional perspective needs to be addressed without neglecting aesthetic outcomes though, given that it is a prominent facial landmark. In this report the reconstruction of a sizable soft tissue defect of the helical crus and upper third of the right auricle, following surgical excision of a skin tumor, is presented. A variety of treatment options is explored, and a relevant algorithm is proposed. This defect was reconstructed using a transposition flap from the postauricular area, accomplishing single-stage full defect coverage combined with optimal postoperative aesthetic results. High patient satisfaction levels were achieved, avoiding more complicated and prolonged procedures. This case exemplifies the proposed algorithmic approach of upper-third auricular defects, addressing these defects in a systematic and logical manner.

A longitudinal study of changes of congenital auricular deformity regarding self-correction.

This study aimed to investigate the factors associated with congenital auricular deformities and evaluate the long-term frequency of their self-correction. Ninety newborns were enrolled in the study, and data were collected within 2 weeks after birth and at 1 year. The shape of the auricle was classified into seven categories using a digital image. At 2 weeks after birth, several birth-related factors were evaluated in the auricular deformity and normal groups. At 1 year after birth, the images of auricles were compared with the images at birth, and the changes in the auricle shape were investigated. Congenital auricular deformities were observed in 139 out of 180 ears, and the major type noted was helix rim deformity (47 ears), followed by normal ears (41 ears), and cup ears (33 ears). Male sex was found to have a statistically significant association with the occurrence of auricular deformity. In the longitudinal study, among 43 neonates (86 ears) followed-up 12 months later, the self-correction rate was approximately 50%. The normal auricle and prominent ear increased, helix rim deformity and cup ear decreased significantly. The prognosis of deformity varied depending on the type of deformity. Considering the low self-correction rate in the prominent and cup ears, newborns with these deformities might be recommended to undergo management such as auricle molding technique, as required.

The Relationship Between Earlobe Creases and the Presence, Extent, and Severity of Coronary Artery Atherosclerosis: A Regional Population-Based Autopsy Study.

ABSTRACT: The association between earlobe crease(s) and coronary artery atherosclerosis has stimulated debate and controversy over the years. Most available published studies have been conducted on living patients. Although these studies offer valuable insight into such associations in patients who exhibit symptoms, no information is available from these studies on the prevalence of earlobe creases among an asymptomatic population. Postmortem studies offer the advantage of including individuals free of symptomatic cardiovascular disease, thus providing an inbuilt control group. The atherosclerotic pathological findings of 1298 individuals who underwent coronial postmortem examination at Wellington Regional Hospital, New Zealand, between 2006 and 2013 were retrospectively studied. Earlobe creases and atherosclerosis involving the coronary arteries were semiquantitatively appraised. The presence of an earlobe crease was found to be significantly associated with coronary artery atherosclerosis.

Hybrid Three-Dimensional-Printed Ear Tissue Scaffold With Autologous Cartilage Mitigates Soft Tissue Complications.

OBJECTIVES/HYPOTHESIS: To analyze the use of highly translatable three-dimensional (3D)-printed auricular scaffolds with and without novel cartilage tissue inserts in a rodent model. STUDY DESIGN: Preclinical rodent animal model. METHODS: This prospective study assessed a single-stage 3D-printed auricular bioscaffold with or without porcine cartilage tissue inserts in an athymic rodent model. Digital Imaging and Communications in Medicine computed tomography images of a human auricle were segmented to create an external anatomic envelope filled with orthogonally interconnected spherical pores. Scaffolds with and without tissue inset sites were 3D printed by laser sintering bioresorbable polycaprolactone, then implanted subcutaneously in five rats for each group. RESULTS: Ten athymic rats were studied to a goal of 24 weeks postoperatively. Precise anatomic similarity and scaffold integrity were maintained in both scaffold conditions throughout experimentation with grossly visible tissue ingrowth and angiogenesis upon explantation. Cartilage-seeded scaffolds had relatively lower rates of nonsurgical site complications compared to unseeded scaffolds with relatively increased surgical site ulceration, though neither met statistical significance. Histology revealed robust soft tissue infiltration and vascularization in both seeded and unseeded scaffolds, and demonstrated impressive maintenance of viable cartilage in cartilage-seeded scaffolds. Radiology confirmed soft tissue infiltration in all scaffolds, and biomechanical modeling suggested amelioration of stress in scaffolds implanted with cartilage. CONCLUSIONS: A hybrid approach incorporating cartilage insets into 3D-printed bioscaffolds suggests enhanced clinical and histological outcomes. These data demonstrate the potential to integrate point-of-care tissue engineering techniques into 3D printing to generate alternatives to current reconstructive surgery techniques and avoid the demands of traditional tissue engineering. LEVEL OF EVIDENCE: NA Laryngoscope, 131:1008-1015, 2021.