Using Auricular Cartilage-fascia Composite Tissue Free Grafting Technique to Improve Cartilage Survival Outcomes.

OBJECTIVES: Auricular cartilage graft has a wide range of applications in plastic and reconstructive surgery. However, there is still a risk of absorption of the grafts over time. Intrinsic postauricular fascia (IPF) with a rich vascular network may play an important role in the nutrition and repair of auricular cartilage. This study aimed to investigate the effect of IPF on the survival viability of free auricular cartilage grafts. METHODS: 24 auricular cartilages were obtained from 6 New Zealand white rabbits which were divided into the cartilage-fascia composite graft group (FC group, n=12) and the cartilage without fascia group (C group, n=12). Two groups of cartilage were implanted into each side of the subcutaneous pocket of the rabbit's dorsum. The rabbits were sacrificed after 3 months and all cartilage grafts were obtained. Macroscopic observation, histopathological staining, and biomechanical testing were performed on all specimens. RESULTS: There were significant differences between the 2 groups regarding proliferating chondrocytes, apoptotic chondrocytes, vascularization, and matrix collagen. Compared to the auricular cartilage grafts without fascia, the auricular cartilage-fascia composite grafts had more neovascularization, proliferative chondrocytes, and type II collagen, with a homogeneous cartilage matrix and no obvious areas of heterogeneous staining. Young's modulus and ultimate tensile strength of cartilage were reduced in both groups compared to pretransplantation, but the composite graft group was superior to the fascia-free group. CONCLUSIONS: Auricular cartilage-fascial composite tissue free graft could improve cartilage survival outcomes with higher viability and mechanical properties.

Analysis of Obstructive Sleep Apnoea in Craniofacial Microsomia Based on Polysomnography.

OBJECTIVE: This study aimed to investigate the prevalence of obstructive sleep apnoea (OSA) in patients with craniofacial microsomia (CFM) through polysomnography (PSG) and the relationship with the severity of CFM. METHODS: This study reviewed patients of CFM with pre-operative PSG data between January 2005 and September 2023. Patients were grouped according to the Pruzansky-Kaban classification. OSA was diagnosed and severity was assessed by the obstructive apnea-hypopnea index. The Pediatric Sleep Questionnaire was used to investigate OSA-related signs and symptoms. The χ 2 test and Fisher's exact test were used to compare between groups. Univariate logistic regression was used to identify risk factors associated with OSA. A p-value less than 0.05 was considered statistically significant. RESULTS: A total of 121 patients with CFM were included in the study with 3 bilateral and 118 unilateral patients. In total, 86 patients (71.07%) were diagnosed with OSA. The prevalence of OSA in type IIa, type IIb and type III was 72.97%, 78.33%, and 47.62%. There was no statistically significant difference in the prevalence of OSA between type IIa and type IIb (p > .05). The difference in the prevalence of OSA between type III and type II was statistically significant (p < .05). Snoring was the most common symptom among the patients of CFM with OSA. CONCLUSIONS: Patients with CFM have a higher incidence of OSA based on PSG in type II and type III patients. The incidence of OSA did not correlate positively with the severity of CFM, with type III patients having certain particularities.

3D-CT measurements of facial symmetry in severe CFM patients: A comparative study between mandibular ascending ramus distraction osteogenesis and bone grafting.

This study aims to compare the effects of mandibular distraction osteogenesis (MDO) and bone grafting on the facial symmetry of children with Pruzansky-Kaban type IIB and III craniofacial microsomia (CFM). Medical records and three-dimensional computed tomography (3D-CT) data of CFM patients who had primarily undergone MDO and bone grafting were collected. A retrospective analysis of pre-and post-operative 3D imaging data was conducted to compare the improvement rate in facial symmetry between the two groups based on occlusal cant, affected/unaffected ramus height ratio and chin point deviation. The data were tested for normality using the Shapiro-Wilk test. When the data followed a normal distribution, a paired sample t-test was employed for the comparison between preoperative and postoperative data. When the data did not follow a normal distribution, the Wilcoxon signed-rank test for paired samples was used for preoperative and postoperative comparison. The study included 18 children with type IIB and III CFM, 11 in the MDO group and 7 in the bone grafting group. In the MDO group, postoperative Gn-FH and Gn-Cor distances increased significantly, whereas the postoperative Gn-Mid distance decreased significantly. Occlusal cant decreased significantly and ramus height affected/unaffected ratio increased significantly after MDO. In the bone graft group, there was no statistically significant difference in the postoperative ratios of chin deviation, occlusal cant, and ramus height affected/unaffected compared to the preoperative values. Compared to bone grafting, MDO can significantly enhance ramus height ratio, level occlusal plane, and centralize the chin point among patients with CFM. Furthermore, MDO achieves superior enhancements in facial symmetry.

Fresh amniotic membraneversus acellular amniotic membrane for repair of the tendon sheath and prevention of tendon adhesion / 中国组织工程研究

BACKGROUND: Amniotic membrane has a unique structure that can block the penetration of certain substances, to ensure normal nutrition supply for the surrounded tissues, and is also characterized by anti-adhesion, good tissue compatibility, mild inflammatory reaction, few fibers and biodegradability. OBJECTIVE: To compare the effects of fresh amniotic membrane and acellular amniotic membrane to prevent adhesion and promote tendon healing during the repair of tendon sheath defects. METHODS: Sixty healthy male leghorn chickens were selected, and the model of tendon injury and tendon sheath defects was established at the third toes. The animal models were then randomly divided into three groups and underwent repair with fresh amniotic membrane (group A), acellular amniotic membrane (group B), and no treatment in control group (group C), respectively. Histological observation and biomechanical analysis of the third toes were performed after repair. RESULTS AND CONCLUSION: (1) Histological observation. Congestive edema and inflammatory response were found in all animals at 2 weeks after repair, but mildest in the group A and severest in the group C. These inflammatory responses gradually alleviated over time in the three groups. At 12 weeks after repair, the new tendon sheath formed in all the animals, which was more mature than that at 4 weeks after repair. The synovial cells on the surface of the tendon sheath were arrayed tidily with dense structure in the groups A and B, but in the group C, the synovial cells were distributed disorderly with loose structure and prominent fibrous tissues. (2) Biomechanical analysis. Tendon sliding distance in the groups A and B was significantly larger than that in the group C at 4, 8, 12 weeks after repair (P < 0.05), but there were no significant difference in the distance between the groups A and B (P > 0.05). At 4 and 8 weeks after repair, the maximum tensile strength was largest in the group A, sequentially followed by group B and group C (P < 0.05), but there were no significant difference among the three groups at 12 weeks after repair (P > 0.05). To conclude, both fresh amniotic membrane and acellular amniotic membrane can promote tendon healing and prevent the adhesion of tendon through tendon sheath reconstruction, but the fresh amniotic membrane is preferred to promote early tendon healing compared with acellular amniotic membrane.

Fresh amniotic membraneversus acellular amniotic membrane for repair of the tendon sheath and prevention of tendon adhesion / 中国组织工程研究

BACKGROUND: Amniotic membrane has a unique structure that can block the penetration of certain substances, to ensure normal nutrition supply for the surrounded tissues, and is also characterized by anti-adhesion, good tissue compatibility, mild inflammatory reaction, few fibers and biodegradability. OBJECTIVE: To compare the effects of fresh amniotic membrane and acellular amniotic membrane to prevent adhesion and promote tendon healing during the repair of tendon sheath defects. METHODS: Sixty healthy male leghorn chickens were selected, and the model of tendon injury and tendon sheath defects was established at the third toes. The animal models were then randomly divided into three groups and underwent repair with fresh amniotic membrane (group A), acellular amniotic membrane (group B), and no treatment in control group (group C), respectively. Histological observation and biomechanical analysis of the third toes were performed after repair. RESULTS AND CONCLUSION: (1) Histological observation. Congestive edema and inflammatory response were found in all animals at 2 weeks after repair, but mildest in the group A and severest in the group C. These inflammatory responses gradually alleviated over time in the three groups. At 12 weeks after repair, the new tendon sheath formed in all the animals, which was more mature than that at 4 weeks after repair. The synovial cells on the surface of the tendon sheath were arrayed tidily with dense structure in the groups A and B, but in the group C, the synovial cells were distributed disorderly with loose structure and prominent fibrous tissues. (2) Biomechanical analysis. Tendon sliding distance in the groups A and B was significantly larger than that in the group C at 4, 8, 12 weeks after repair (P < 0.05), but there were no significant difference in the distance between the groups A and B (P > 0.05). At 4 and 8 weeks after repair, the maximum tensile strength was largest in the group A, sequentially followed by group B and group C (P < 0.05), but there were no significant difference among the three groups at 12 weeks after repair (P > 0.05). To conclude, both fresh amniotic membrane and acellular amniotic membrane can promote tendon healing and prevent the adhesion of tendon through tendon sheath reconstruction, but the fresh amniotic membrane is preferred to promote early tendon healing compared with acellular amniotic membrane.