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
目的探讨耳内镜下耳屏软骨-软骨膜重建外耳道后壁或上鼓室外侧壁的临床应用及术后效果。方法回顾性分析2015年8月~2019年8月期间住院手术的52例(52耳)外耳道及中耳胆脂瘤患者的临床资料,病变均累及上鼓室及鼓窦,其中45例为中耳胆脂瘤,7...目的探讨耳内镜下耳屏软骨-软骨膜重建外耳道后壁或上鼓室外侧壁的临床应用及术后效果。方法回顾性分析2015年8月~2019年8月期间住院手术的52例(52耳)外耳道及中耳胆脂瘤患者的临床资料,病变均累及上鼓室及鼓窦,其中45例为中耳胆脂瘤,7例为外耳道胆脂瘤,均在耳内镜下行上鼓室开放术同期行鼓室成形,术中用耳屏软骨-软骨膜重建上鼓室外侧壁或外耳道后壁,分析手术技术要点、观察术后干耳时间、鼓膜愈合、上鼓室外侧壁塌陷及听力疗效等相关情况。结果52例(52耳)术后平均随访时间26.3±7.2个月,术后平均干耳时间27.5±8.8天;鼓膜完全愈合47耳(90.4%,47/52),其中鼓膜完全愈合且形态正常41耳(78.8%,41/52),鼓膜愈合但内陷6耳(11.5%,6/52);复发5耳(9.6%,5/52),其中紧张部内陷穿孔1耳(1/52,1.9%),松弛部内陷伴穿孔4耳(4/52,7.7%);无一例面瘫和外耳道狭窄。术后12个月,0.5、1、2、4 kHz平均气导听阈(32.1±5.8 dB HL)较术前(53.2±10.4 dB HL)明显降低(P<0.001),ABG(15.6±7.6 dB)值较术前(41.5±7.4 dB)明显降低(P<0.001)。结论对于累及上鼓室的外耳道或中耳胆脂瘤,可经耳内镜行上鼓室开放术清除病变,用耳屏软骨-软骨膜重建上鼓室外侧壁或外耳道后壁,依靠软骨的支撑,可维持鼓室、鼓窦及乳突腔含气腔,减少鼓膜松弛部内陷的发生,保持上鼓室外侧壁的基本形态。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.
文摘目的探讨耳内镜下耳屏软骨-软骨膜重建外耳道后壁或上鼓室外侧壁的临床应用及术后效果。方法回顾性分析2015年8月~2019年8月期间住院手术的52例(52耳)外耳道及中耳胆脂瘤患者的临床资料,病变均累及上鼓室及鼓窦,其中45例为中耳胆脂瘤,7例为外耳道胆脂瘤,均在耳内镜下行上鼓室开放术同期行鼓室成形,术中用耳屏软骨-软骨膜重建上鼓室外侧壁或外耳道后壁,分析手术技术要点、观察术后干耳时间、鼓膜愈合、上鼓室外侧壁塌陷及听力疗效等相关情况。结果52例(52耳)术后平均随访时间26.3±7.2个月,术后平均干耳时间27.5±8.8天;鼓膜完全愈合47耳(90.4%,47/52),其中鼓膜完全愈合且形态正常41耳(78.8%,41/52),鼓膜愈合但内陷6耳(11.5%,6/52);复发5耳(9.6%,5/52),其中紧张部内陷穿孔1耳(1/52,1.9%),松弛部内陷伴穿孔4耳(4/52,7.7%);无一例面瘫和外耳道狭窄。术后12个月,0.5、1、2、4 kHz平均气导听阈(32.1±5.8 dB HL)较术前(53.2±10.4 dB HL)明显降低(P<0.001),ABG(15.6±7.6 dB)值较术前(41.5±7.4 dB)明显降低(P<0.001)。结论对于累及上鼓室的外耳道或中耳胆脂瘤,可经耳内镜行上鼓室开放术清除病变,用耳屏软骨-软骨膜重建上鼓室外侧壁或外耳道后壁,依靠软骨的支撑,可维持鼓室、鼓窦及乳突腔含气腔,减少鼓膜松弛部内陷的发生,保持上鼓室外侧壁的基本形态。
