조형된 연골막판을 사용한 이개재건에 대한 실험적 연구 = AN EXPERIMENTAL STUDY FOR EAR RECONSRTUCTION USING THE PERICHONDRIAL FLAP

다국어 초록 (Multilingual Abstract)

Although carved cartilage grafts from rib are commonly used for ear reconstruction, it is difficult to mimic a normal pinna and these reconstructions are so firm and unnatural. Therefore, we had a basic experimental study for a new technique of ear reconstruction. We tried to creat a cartilage framework by moulding the perichondrial flap experimentally. The perichondrial flap with the vascular pedicle of the central vessels was elevated in rabbit ear and placed between the leaves of a silastic mould. This preparation was placed in a pocket under adjacent scalp and sic and eight weeks later the preparations was harvested and assessed gross and histological findings.
The moulded perichondrial flap was well developed and a thin cartilage layer was recognized within the convolutions created by the mould. Grossly, it was not so firm but relatively soft and there was little difference between at six and eight weeks. Histologically, viable new chondrocytes and active cartilage formation were demonstrated in the perichondrium at both six and eight weeks. The moulded cartilage which was harvested after 6 weeks was irregular in thickness and it's chondrocytes were not completely developed. However, the cartilage which was harvested after eight weeks was relatively regular in thickness and it's cells, especially centrally located, were fully developed.
Clinically, ear reconstructive may be completed by implantation of this moulded cartilage as traditional reconstructive method. Otherwise, this moulded cartilage can be harvested with its vascular pedicle and the pedicle can be anastomosed with superficial temporal artery. And then a split thickness skin graft on the perichondrium enveloping the moulded cartilage or covering with skin flap which was expanded with tissue expander may complete the ear reconstruction in single stage operation. If further investigations for materials of the mould, optimal period for maximum cartilage synthesis and durability of moulded cartilage are studied, this moulded perichondrial flap technique provides the potential advantage of ear reconstructions.