Objective:To compare the rate of graft uptake and postoperative hearing outcomes of Type I tympanoplasty with perichondrium reinforced cartilage palisade to temporalis fascia for large tympanic membrane(TM)perforation...Objective:To compare the rate of graft uptake and postoperative hearing outcomes of Type I tympanoplasty with perichondrium reinforced cartilage palisade to temporalis fascia for large tympanic membrane(TM)perforations over 5 years follow-up period.Materials and methods:This was a retrospective comparative study involving patients with chronic otitis media with large TM perforations.The patients underwent type I tympanoplasty using either perichondrium reinforced cartilage palisade(CP group)or temporalis fascia(TF group)as the graft via a transmeatal approach and under local anesthesia.Morphological and functional results were recorded at three-and five years follow-up.Demographic profiles including age and sex,surgery side,contralateral disease and graft uptake rate,as well as hearing outcomes,were compared between the two groups.Results:At three years follow-up,graft uptake was 94.87%for perichondrium reinforced cartilage palisade and 80.7%for fascia,respectively,(p¼0.67).At five years follow-up,the uptake rate dropped to 87.17%in the CP group,but to 66.6%in the TF group(p¼0.019).Hearing improved after surgery in both groups,and showed no significant difference between the two groups.Conclusion:Over long-term,perichondrium reinforced palisade showed a statistically significant better outcome regarding graft uptake than temporalis fascia in type Itympanoplasty for large TM perforations with comparable audiometric results.展开更多
Objective To evluate the outcome of arthropiasty with transplantation of autogenous rib perichondrium for reconstruction of the metacarpophalangeal joint. Methods From 1982 to 2000,15 patients undergoing arthropiasty ...Objective To evluate the outcome of arthropiasty with transplantation of autogenous rib perichondrium for reconstruction of the metacarpophalangeal joint. Methods From 1982 to 2000,15 patients undergoing arthropiasty with autogenous rib perichondrium were analyzed retrospectively. The pain, range of motion and stability of the joint was assessed. Results Thirteen patients were followed up with 2 in loss. The average follow-up was 4 years. The pain at the metacarpophalangeal joint disappeared after operation. The active range of motion in metacarpophalangeal joint was 40° -82°(average 58. 5°), with an average increase of 46°(35°-58°) when compared with those before operation. The patients all went to the original job. Conclusion The arthropiasty with autogenous rib perichondrium transplantation is an efficient and practical method for reconstruction of the metaracrpophalangeal joint. 5 refs.展开更多
The construction and regeneration of tissue-engineered auricles are pacesetters in tissue engineering and have realized their first international clinical application.However,the unstable regeneration quality and insu...The construction and regeneration of tissue-engineered auricles are pacesetters in tissue engineering and have realized their first international clinical application.However,the unstable regeneration quality and insufficient mechanical strength have become significant obstacles impeding its clinical promotion.The perichondrium is indispensable for the nutritional and vascular supply of the underlying cartilage tissue,as well as for proper anatomical functioning and mechanical performance.This study presents a novel strategy for integrated con-struction of bioengineered perichondrium with bioprinted cartilage to enhance the regeneration quality and mechanical properties of tissue-engineered auricles.Simulating the anatomical structure of the native auricle designs a sandwich construction model containing bilateral perichondrium and intermediate cartilage,employing a photocrosslinkable acellular cartilage matrix and gelatin bionics matrix microenvironment,applying co-cultured auricular chondrocytes and adipose-derived stem cells creates functional cell populations,designing hatch patterns imitates microscopic arrangement structures,utilizing sacrificial materials forms interlaminar network traffic to enhance the tight connection between layers,and finally,assessing the regen-erative quality of the constructs explores their feasibility and stability.The multi-level and multi-scale bio-mimetic construction strategy overcomes the technical limitation of the integrated construction of perichondrium-wrapped auricles and realizes biomimicry in morphology,structure,and biomechanics.Alto-gether,this study provides a technical reference for the hierarchical construction of complex tissues and pro-motes the clinical translation and application of engineered tissues or organs.展开更多
Background The main risk factors for postoperative failure in tympanoplasties are large perforations that are difficult to repair, annular perforations, and a tympanic membrane （TM） with extensive granular myringiti...Background The main risk factors for postoperative failure in tympanoplasties are large perforations that are difficult to repair, annular perforations, and a tympanic membrane （TM） with extensive granular myringitis that require middle ear exploration and mastoidectomy. The aim of this study was to investigate a novel technique of perichondrium/cartilage composite graft for repairing the large TM perforation in the patient of otitis media. Methods Retrospective chart reviews were conducted for 102 patients with large tympanic membrane perforations, who had undergone tympanoplasty from August 2005 to August 2008. Tympanoplasty or tympanomastoidectomy using a perichondrium/cartilage composite graft was analyzed. The tragal or conchal perichondrium/cartilage was used to replace the tympanic membrane in patients. Results Patients aged from 13 to 67 years were followed up in average for 24 months （10-36 months）. Seventy-four ears （72.61%） were used the tragal perichondrium/cartilage as graft material and 27 ears （27.39%） were used the conchal perichondrium/cartilage. Graft take was successful in all patients. Postoperative complications such as wound infection, hematoma, or sensorineural hearing loss were not identified. Nine patients （8.82%） had the partial ossicular replacement prosthesis, 14 patients （13.72%） using the autologous curved incus and 79 patients （77.45%） without prosthesis. Successful closure occurred in 92% of the ears. A total of 85.8% patients achieved a postoperative hearing improvement. Conclusions The graft underlay tympanoplasty using perichondrium/cartilage composite is effective for the majority of patients with large perforation. The hearing was improved even if the mastoidectomy was required in the patients with otitis media with extensive granulation.展开更多
Background:Autologous costal grafts are used universally in clinical practice for rhinoplasty and reconstruction.However,surgeons worldwide have not agreed on the details of graft harvesting,including rib selection,si...Background:Autologous costal grafts are used universally in clinical practice for rhinoplasty and reconstruction.However,surgeons worldwide have not agreed on the details of graft harvesting,including rib selection,side preference,operation mode,cutting methods,and handling of the periosteum and perichondrium.This study aimed to provide an overview of the novel techniques used for auto-rib harvesting in rhinoplasty within the past 5 years and identify potential avenues for future research.Methods:We searched for related articles in PubMed,Embase,and Web of Science from 2019 to 2023,summa-rized crucial but controversial steps in recent practice,and analyzed their theoretical basis and clinical feasibility.Results:Auto-rib and cartilage open harvest is still mainstream in rhinoplasty and reconstruction,with the 5th to 8th ribs and cartilage being the most used.The laparoscopic harvest is gaining attention,being second only to the open harvest,with the 9th/10th ribs and cartilages being particularly convenient.The clinical applications of full-cut and split-cut methods differ in their advantages.Except for some special reasons,almost all studies tended to preserve the periosteum and perichondrium in situ,and few surgeons chose to harvest the grafts on the left side.Conclusion:Multiple techniques have emerged,requiring surgeons to balance the benefits and risks of various strategies at each step.New theories and techniques should be fully tested promptly and in clinical practice before wide application.Overall,a professional consensus is needed for better directivity,precision,and stability in clinical practice.展开更多
文摘Objective:To compare the rate of graft uptake and postoperative hearing outcomes of Type I tympanoplasty with perichondrium reinforced cartilage palisade to temporalis fascia for large tympanic membrane(TM)perforations over 5 years follow-up period.Materials and methods:This was a retrospective comparative study involving patients with chronic otitis media with large TM perforations.The patients underwent type I tympanoplasty using either perichondrium reinforced cartilage palisade(CP group)or temporalis fascia(TF group)as the graft via a transmeatal approach and under local anesthesia.Morphological and functional results were recorded at three-and five years follow-up.Demographic profiles including age and sex,surgery side,contralateral disease and graft uptake rate,as well as hearing outcomes,were compared between the two groups.Results:At three years follow-up,graft uptake was 94.87%for perichondrium reinforced cartilage palisade and 80.7%for fascia,respectively,(p¼0.67).At five years follow-up,the uptake rate dropped to 87.17%in the CP group,but to 66.6%in the TF group(p¼0.019).Hearing improved after surgery in both groups,and showed no significant difference between the two groups.Conclusion:Over long-term,perichondrium reinforced palisade showed a statistically significant better outcome regarding graft uptake than temporalis fascia in type Itympanoplasty for large TM perforations with comparable audiometric results.
文摘Objective To evluate the outcome of arthropiasty with transplantation of autogenous rib perichondrium for reconstruction of the metacarpophalangeal joint. Methods From 1982 to 2000,15 patients undergoing arthropiasty with autogenous rib perichondrium were analyzed retrospectively. The pain, range of motion and stability of the joint was assessed. Results Thirteen patients were followed up with 2 in loss. The average follow-up was 4 years. The pain at the metacarpophalangeal joint disappeared after operation. The active range of motion in metacarpophalangeal joint was 40° -82°(average 58. 5°), with an average increase of 46°(35°-58°) when compared with those before operation. The patients all went to the original job. Conclusion The arthropiasty with autogenous rib perichondrium transplantation is an efficient and practical method for reconstruction of the metaracrpophalangeal joint. 5 refs.
基金supported by the National Key R&D Program of China(Grant No.2024YFA1107800)the Chinese Academy of Medical Sci-ences Innovation Fund for Medical Sciences(2021-I2M-1-052)+2 种基金the National Natural Science Foundation of China(82371796)the Beijing Natural Science Foundation(7244400)the Fundamental Research Funds for the Central Universities(3332024056).
文摘The construction and regeneration of tissue-engineered auricles are pacesetters in tissue engineering and have realized their first international clinical application.However,the unstable regeneration quality and insufficient mechanical strength have become significant obstacles impeding its clinical promotion.The perichondrium is indispensable for the nutritional and vascular supply of the underlying cartilage tissue,as well as for proper anatomical functioning and mechanical performance.This study presents a novel strategy for integrated con-struction of bioengineered perichondrium with bioprinted cartilage to enhance the regeneration quality and mechanical properties of tissue-engineered auricles.Simulating the anatomical structure of the native auricle designs a sandwich construction model containing bilateral perichondrium and intermediate cartilage,employing a photocrosslinkable acellular cartilage matrix and gelatin bionics matrix microenvironment,applying co-cultured auricular chondrocytes and adipose-derived stem cells creates functional cell populations,designing hatch patterns imitates microscopic arrangement structures,utilizing sacrificial materials forms interlaminar network traffic to enhance the tight connection between layers,and finally,assessing the regen-erative quality of the constructs explores their feasibility and stability.The multi-level and multi-scale bio-mimetic construction strategy overcomes the technical limitation of the integrated construction of perichondrium-wrapped auricles and realizes biomimicry in morphology,structure,and biomechanics.Alto-gether,this study provides a technical reference for the hierarchical construction of complex tissues and pro-motes the clinical translation and application of engineered tissues or organs.
文摘Background The main risk factors for postoperative failure in tympanoplasties are large perforations that are difficult to repair, annular perforations, and a tympanic membrane （TM） with extensive granular myringitis that require middle ear exploration and mastoidectomy. The aim of this study was to investigate a novel technique of perichondrium/cartilage composite graft for repairing the large TM perforation in the patient of otitis media. Methods Retrospective chart reviews were conducted for 102 patients with large tympanic membrane perforations, who had undergone tympanoplasty from August 2005 to August 2008. Tympanoplasty or tympanomastoidectomy using a perichondrium/cartilage composite graft was analyzed. The tragal or conchal perichondrium/cartilage was used to replace the tympanic membrane in patients. Results Patients aged from 13 to 67 years were followed up in average for 24 months （10-36 months）. Seventy-four ears （72.61%） were used the tragal perichondrium/cartilage as graft material and 27 ears （27.39%） were used the conchal perichondrium/cartilage. Graft take was successful in all patients. Postoperative complications such as wound infection, hematoma, or sensorineural hearing loss were not identified. Nine patients （8.82%） had the partial ossicular replacement prosthesis, 14 patients （13.72%） using the autologous curved incus and 79 patients （77.45%） without prosthesis. Successful closure occurred in 92% of the ears. A total of 85.8% patients achieved a postoperative hearing improvement. Conclusions The graft underlay tympanoplasty using perichondrium/cartilage composite is effective for the majority of patients with large perforation. The hearing was improved even if the mastoidectomy was required in the patients with otitis media with extensive granulation.
文摘Background:Autologous costal grafts are used universally in clinical practice for rhinoplasty and reconstruction.However,surgeons worldwide have not agreed on the details of graft harvesting,including rib selection,side preference,operation mode,cutting methods,and handling of the periosteum and perichondrium.This study aimed to provide an overview of the novel techniques used for auto-rib harvesting in rhinoplasty within the past 5 years and identify potential avenues for future research.Methods:We searched for related articles in PubMed,Embase,and Web of Science from 2019 to 2023,summa-rized crucial but controversial steps in recent practice,and analyzed their theoretical basis and clinical feasibility.Results:Auto-rib and cartilage open harvest is still mainstream in rhinoplasty and reconstruction,with the 5th to 8th ribs and cartilage being the most used.The laparoscopic harvest is gaining attention,being second only to the open harvest,with the 9th/10th ribs and cartilages being particularly convenient.The clinical applications of full-cut and split-cut methods differ in their advantages.Except for some special reasons,almost all studies tended to preserve the periosteum and perichondrium in situ,and few surgeons chose to harvest the grafts on the left side.Conclusion:Multiple techniques have emerged,requiring surgeons to balance the benefits and risks of various strategies at each step.New theories and techniques should be fully tested promptly and in clinical practice before wide application.Overall,a professional consensus is needed for better directivity,precision,and stability in clinical practice.
