Epidemic Study Of Long-Term Changes After Auricular Reconstruction

Epidemic Study of the Growth of Reconstructed Auricles and Effect Factors of Cranioauricular AngleObjective: To define the behavior of the reconstructed ear by a long-term follow-up. This information serves to clarify the issue of proper size of the reconstructed ear, to give evidence of the early age at which reconstruction can be began and to prevent the deformation of the reconstructed ear.Methods: A retrospective study was performed. A total of 107 patients of gradeⅢunilateral microtia who underwent costal cartilage auricular reconstruction between 1994 and 2003 were reviewed after an interval of 2.5 years at least by following up patients and looking up the primitive medical record. The name, gender, age, and the follow-up time are included in the content of the study. Also, tracing to the original ear plates (from original medical records), the reconstructed ear platesat present and normal present ear plates using exposed x-ray film were carried out. The plates of each patients were evaluated by micro-electronics area measure instrument. At the same time to evaluate the Cranioauricular angle and scar of the reconstructed ear, the patients or families were asked to evaluate that if their reconstructed ears were often pressed when they were sleeping. The mean auricular size was examined for significance of interval change using the two-sample student's t tests assuming unequal variances and using Logistic regression model to analyze the influencing factors of the Cranio-auricular angle.Result: 1. In 107 cases, 66 cases aged 5～25 years, followed-up 2.5～10 years met the inclusion criteria of the study of reconstructed ear growth.(1) the study revealed an average increase of 4.4cm~2 (13.51%) in reconstructed ear(R) and an average increase of 2.01cm~2 (6.17%) in normal ear(N) in 66 cases. The area of the reconstructed ear was 89.39% greater than the original ear and the area of the normal ear was 81.82% greater than the original ear. Both the grown reconstructed ear and the grown normal ear showed significant difference relative to the area of the original ear( t=-8.869, p＜0.001, and t=-4.4109, p＜0.001, respectively). (2)the study revealed an average increase of 4.67cm~2 (14.29%) in reconstructed ear(R) and an average increase of 2.6cm~2 (7.95%) in normal ear(N) in the patients under 13 years. The area of the reconstructed ear was 88.89% greater than the original ear and the area of the normal ear was 80.00% greater than the original ear. Both the grown reconstructed ear and the grown normal ear showed significant difference relative to the area of the original ear(t=-7.756,p＜0.001, and t=4.692, p＜0.001,respectively) (3) the study revealed an average increase of 3.86cm~2 (11.94%) in reconstructed ear(R) and an average increase of 0.77cm~2 (2.38%) in normal ear(N) in the patients under 13 years. The area of the reconstructed ear was 90.48% greater than the original ear and the area of the normal ear was 85.71% greater than the original ear. The grown reconstructed ear showed significant difference relative to the area of the original ear (t=-4.6695,p＜0.001) and the grown normal ear showed no significant difference relative to the area of original ear ( t=-1.0125, p=0.3234). 2. In 107 cases, 87 cases met the inclusion criteria of the study of influencing factors of Cranio-auricular angle, aged 5 to 25 years. (1) compared to the control group, the pressed group showed no significant difference(P=0.812, OR=0.8766). (2) compared to the control group, the scar group showed significant difference(P=0.001, OR=7.5789).Conclusion: 1.The growith of reconstructed ear is larger than the growth of normal ear. 2. Both the reconstructed ear and the normal ear are growing in early age. The growth of reconstructed ear may be more quickly than that of normal ear. 3. The pressure of the reconstructed ear during sleeping is no related to the poor of Cranio-auricular angle. Scar hyperplasia of the reconstructed ear is the risk factors contributing to the poor cranioauricular angle. Epidemic Study of Changing of Chest Contour after Harvesting of Costal CartilageObjective: To evaluate the deformity of chest after cutting of costal cartilage for total ear reconstruction. This information serves to prevent donor-site morbidity.Methods: A retrospective study was performed. A total of 107cases of patients of gradeⅢunilateral microtia who underwent costal cartilage auricular reconstruction between 1994 and 2003 were reviewed after an interval of at least 2.5 years. We were able to review the patients and medical records by the chance of the third-stage operation. The name, gender, age, and the follow-up time are included in the content of the study. The chest retrusion were evaluated as the degree of normal, mild and serious. The costal margin contour was evaluated by the degree of normal, mild and severe. The results were related to patients' ages at operation, gender, postoperative interval and cutting of different costal cartilages. The available data were analyzed by Pearson'X~2 test.Result: 1. In 107 cases, 87 cases met the inclusion criteria of the study of the deformity of chest, aged 5～25years old, followed-up 2.5～10 years (1). In 87 cases, 29 donor-site normal were observed(32.96%); 12 chest retrusion were observed(12.5%); 11 the costal margin contour deformities were observed(32.96%); 36(40.91%) cases that have both the chest retrusion and the costal margin contour deformities were observed. (2). In 59 cases (under 13 years old), 10 donor-site normal were observed(16.95%); 10 chest retrusion were found(16.95%); 6 the costal margin contour deformities were found(10.17%); 33 (55.93%) cases that have both the chest retrusion and the costal margin contour deformities were observed. (3).In 29 cases (older than 13), 19 donor-site normal were observed (65.52%); 2 chest retrusion were observed(6.9%); 2 the costal margin contour deformities were observed(6.9%); the cases that have both the chest retrusion and the costal margin contour deformities were observed were 3(10.34%). 2. The relationship between patient's age at operation gender, postoperative interval and cutting of different costal cartilages in chest deformity. (1).the difference between different stages(＜13 years and=13 years) showed statistically significant difference in the chest retrusion and the costal margin contour deformities (x~2=24.28 P＜0.001, x~2=10.57 P=0.001).(2). the difference between different postoperative interval (＜4 years and=4 years) showed no statistically significant difference in the chest retrusion and the costal margin contour deformities (x~2=1.10 P=0.294, x~2=1.47 P=0.225). (3).The difference of the gender showed statistically significant difference in the chest retrusion (x~2=13.52 P＜0.001) and in the costal margin contour deformities (x~2=0.25 P=0.619) (4). The difference of cutting of different costal cartilage(6.7th or 7.8th)showed no statistically significant difference in the chest retrusion (x~2=0.10 P=0.657) and in the costal margin contour deformities (x~2=6.92 P＜0.001).Conclusion: 1.Early surgery increases the risk of chest deformities. 2. Male patients more likely show the chest retrusion than female patients. 3. Harvesing of 6.7th costal cartilage has higher risk of costal margin contour deformities than cutting of 7.8th costal cartilage. 4. The chest deformities is no related to postoperative interval.