Study On Application Of Autologous Costal Cartilage And Medpor In Auricular Reconstruction

Objective To compare the clinical characteristics of autologous costal cartilage and porous high-density linear polyethylene(Medpor)in total auricular reconstruction,and analysis their clinical effects and complications.Methods We analyzed the data of patients undergoing auricular reconstruction in our hospital in 2017,and analyzed the clinical application,the therapeutic effects and incidence of complications of autologous costal cartilage and Medpor by comparison with other literature.Results A total of 439 cases in this group were followed up for 4-16 months.All operations were performed with autologous costal cartilage.430 cases(97.9%)acieved satisfatory results in the apperance of reconstructed ear.Complications occured in 9 cases(2.05%),including 5 cases(1.13%)of partial skin ulceration and 3 cases(0.68%)of the implanted graft or framework exposure and one case(0.22%)of dilator infection.The total number of cases in which the Medpor framework was used in the literature was 1,355 and the age range was 5-61 years old.The operation method used the iliac fascia flap-wrapped stent and the skin grafting method to reconstruct the auricle.In the follow-up period.112 cases(8.26%)of stent complications were observed,including 52 cases(7.29%)in the phase I method,60 cases(9.34%)in the phase ? method,and 17 cases in other complications.Including 4 cases with poor auricular morphology(1.4%),2 cases of facial swelling(1.9%),2 cases of unclear ear(7.6%),2 cases of stent infection(5.8%),6 cases of skin ulceration(21.4%)and 1 case of hematoma after ear(3.5%).From the comparison of the two groups of data,it can be concluded that the age of patients with autocostal cartilage is 4-47 years old,the postoperative complication rate is 2.05%,the age of Medpor patients is 5-61 years old,and the postoperative complication rate is 9.52%.In comparison,the incidence of postoperative complications of autologous costal cartilage was significantly lower than that of Medpor framework,but there was no obvious limitation on the age of patients with Medpor framework.For patients over 60 years of age,auricular reconstruction was still possible with physical conditions.Conclusion Autologous costal cartilage is currently the most commonly used material for auricular reconstruction.It has the advantages of no postoperative rejection,low infection rate,good tissue compatibility,and long-term stability.It is currently the first choice for auricular reconstruction stent materials.Medpor framework has the characteristics of non-toxicity,good tissue compatibility,easy shaping and high toughness,but its material texture is hard,and the risk of stent exposure is high after surgery.For patients who have no contraindications to autologous costal cartilage,autologous costal cartilage is the preferred ear support material.Medpor is a more suitable ear support material for patients who cannot access autologous costal cartilage due to age,scarring,or severe chest wall disease.