Preliminary study on microdissection needle-assisted ear cartilage reshaping <i>in vivo</i> rabbit models_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

GUO Fengfeng ¹ , YU Xiaobo ¹ , SUN Zhongyang ² , PAN Bo ¹ ,  JIANG Haiyue ¹

1. The Seventh Department of Plastic Surgery, Plastic Surgery Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, 100144, P.R.China;
2. Department of Plastic Surgery, Beijing Hospital, Beijing, 100730, P.R.China;

Corresponding author：

JIANG Haiyue, Email: jianghaiyue_psh@163.com

Keywords：

Ear deformity; cartilage reshaping; microdissection needle; rabbit

DOI：

10.7507/1002-1892.201807032

Video：

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Objective To preliminarily investigate morghological changes of rabbits reshaping ear cartilage assisted by microdissection needle and explore feasibility of new therapy for ear deformity.Methods The bilateral ears of 5 male New Zealand rabbits (aged, 5-6 months) were fixed maintaining the curvature and randomly divided into 2 groups (5 ears in each group). The ears were stimulated by microdissection needle in experimental group and were not treated with stimulation in control group. The skin reaction in the experimental group was observed immediately and at 4 weeks after stimulation. Then, the fixtures were removed at 4 weeks, and the shapes of the ears were observed. The cartilages were harvested from the ears to examined morphological changes after HE staining, and measured the chondrocyte layer thickness.Results All rabbits survived until the end of the experiment. The skin has healed completely after 4 weeks in experimental group. After removing fixtures, the ears in the two groups all maintained certain forms momentarily; while 24 hours later, the ears in the control group mostly recovered original form, and the ears in the experimental group still maintained certain molding form until 8 weeks. HE staining showed there were smooth cartilage and uniform distribution of cells in the control group; the matrix staining was basically consistent; and the skin was normal appearance with epidermis, dermis, and cartilage of normal aspect. But the proliferation of chondrocyte with more layers of cells were observed in the experimental group. In addition, there were degeneration and injury of cartilage cells and connective tissue with necrotic cells and inflammatory cells at needle insertion sites. The chondrocyte layer thickness was (385.714±2.027) μm in the control group and (1 594.732±1.872) μm in the experimental group, there was significant difference between the two groups (t=–759.059, P=0.000).Conclusion Rabbit ear cartilage can be effectively reshaped by microdissection needle. Proliferation of chondrocyte and changes in matrix can be found during the reshaping process.

Citation： GUO Fengfeng, YU Xiaobo, SUN Zhongyang, PAN Bo, JIANG Haiyue. Preliminary study on microdissection needle-assisted ear cartilage reshaping in vivo rabbit models. Chinese Journal of Reparative and Reconstructive Surgery, 2019, 33(5): 601-605. doi: 10.7507/1002-1892.201807032 Copy

1.	Helidonis E, Sobol E, Kavvalos G, et al. Laser shaping of composite cartilage grafts. Am J Otolaryngol, 1993, 14(6): 410-412.
2.	Trelles MA, Mordon SR. Correction of ear malformations by laser-assisted cartilage reshaping (LACR). Lasers Surg Med, 2006, 38(7): 659-662.
3.	Leclère FM, Petropoulos I, Mordon S. Laser-assisted cartilage reshaping (LACR) for treating ear protrusions: a clinical study in 24 patients. Aesthetic Plast Surg, 2010, 34(2): 141-146.
4.	Leclère FM, Trelles M, Mordon SR. Cartilage reshaping for protruding ears: a prospective long-term follow-up of 32 procedures. Lasers Surg Med, 2011, 43(9): 875-880.
5.	Leclère FM, Mordon S, Alcolea J, et al. 1064 nm Nd:YAG laser-assisted cartilage reshaping for treating ear protrusions. Laryngoscope, 2015, 125(11): 2461-2467.
6.	Ragab A. Carbon dioxide laser-assisted cartilage reshaping otoplasty: a new technique for prominent ears. Laryngoscope, 2010, 120(7): 1312-1318.
7.	Wong BJ, Milner TE, Kim HH, et al. Stress relaxation of porcine septal cartilage during Nd:YAG (λ=1.32 mm) laser irradiation: mechanical, optical, and thermal responses. J Biomed Opt, 1998, 3(4): 409-414.
8.	Keefe MW, Rasouli A, Telenkov SA, et al. Radiofrequency cartilage reshaping: efficacy, biophysical measurements, and tissue viability. Arch Facial Plast Surg, 2003, 5(1): 46-52.
9.	Zemek AJ, Protsenko DE, Wong BJ. Mechanical properties of porcine cartilage after uniform RF heating. Lasers Surg Med, 2012, 44(7): 572-579.
10.	Manuel CT, Foulad A, Protsenko DE, et al. Needle electrode-based electromechanical reshaping of cartilage. Ann Biomed Eng, 2010, 38(11): 3389-3397.
11.	Wu EC, Protsenko DE, Khan AZ, et al. Needle electrode-based electromechanical reshaping of rabbit septal cartilage: a systematic evaluation. IEEE Trans Biomed Eng, 2011, 58(8): 2378-2383.
12.	Hussain S, Manuel CT, Protsenko DE, et al. Electromechanical reshaping of ex vivo porcine trachea. Laryngoscope, 2015, 125(7): 1628-1632.
13.	Badran K, Manuel C, Waki C, et al. Ex vivo electromechanical reshaping of costal cartilage in the New Zealand white rabbit model. Laryngoscope, 2013, 123(5): 1143-1148.
14.	Mordon S, Wang T, Fleurisse L, et al. Laser cartilage reshaping in an in vivo rabbit model using a 1.54 microm Er:Glass laser. Lasers Surg Med, 2004, 34(4): 315-322.
15.	Sobol E, Sviridov A, Omeltchenko A, et al. Laser reshaping of cartilage. Biotechnol Genet Eng Rev, 2000, 17: 553-578.
16.	Protsenko DE, Zemek A, Wong BJ. Temperature dependent change in equilibrium elastic modulus after thermally induced stress relaxation in porcine septal cartilage. Lasers Surg Med, 2008, 40(3): 202-210.
17.	Hajiioannou JK, Nikolidakis A, Naumidi I, et al. In vitro enzymatic treatment and carbon dioxide laser beam irradiation of morphologic cartilage specimens. Arch Otolaryngol Head Neck Surg, 2006, 132(2): 1363-1370.
18.	Manuel CT, Tjoa T, Nguyen T, et al. Optimal electromechanical reshaping of the auricular ear and long-term outcomes in an in vivo rabbit model. JAMA Facial Plast Surg, 2016, 18(4): 277-284.
19.	Yau AY, Manuel C, Hussain SF, et al. In vivo needle-based electromechanical reshaping of pinnae: New Zealand White rabbit model. JAMA Facial Plast Surg, 2014, 16(4): 245-252.
20.	Holden PK, Chlebicki C, Wong BJ. Minimally invasive ear reshaping with a 1450-nm diode laser using cryogen spray cooling in New Zealand white rabbits. Arch Facial Plast Surg, 2009, 11(6): 399-404.
21.	Chlebicki CA, Protsenko DE, Wong BJ. Preliminary investigations on therapy thresholds for laser dosimetry, cryogen spray cooling duration, and treatment cycles for laser cartilage reshaping in the New Zealand white rabbit auricle. Lasers Med Sci, 2014, 29(3): 1099-1109.
22.	Mo JH, Kim JS, Lee JW, et al. Viability and regeneration of chondrocytes after laser cartilage reshaping using 1,460 nm diode laser. Clin Exp Otorhinolaryngol, 2013, 6(2): 82-89.
23.	郭凤凤, 于晓波, 蒋海越. 激光辅助软骨重塑形技术矫正招风耳的临床应用进展. 中国修复重建外科杂志, 2018, 32(6): 769-772.
24.	Leclère FM, Mordon S, Trelles MA. 1540 nm-Er/Glass laser-assisted cartilage reshaping for protruding ears (LACR)//Biomedical optics in otorhinolaryngology: head and neck surgery. Berlin: Springer, 2016: 203-212.

1. Helidonis E, Sobol E, Kavvalos G, et al. Laser shaping of composite cartilage grafts. Am J Otolaryngol, 1993, 14(6): 410-412.
2. Trelles MA, Mordon SR. Correction of ear malformations by laser-assisted cartilage reshaping (LACR). Lasers Surg Med, 2006, 38(7): 659-662.
3. Leclère FM, Petropoulos I, Mordon S. Laser-assisted cartilage reshaping (LACR) for treating ear protrusions: a clinical study in 24 patients. Aesthetic Plast Surg, 2010, 34(2): 141-146.
4. Leclère FM, Trelles M, Mordon SR. Cartilage reshaping for protruding ears: a prospective long-term follow-up of 32 procedures. Lasers Surg Med, 2011, 43(9): 875-880.
5. Leclère FM, Mordon S, Alcolea J, et al. 1064 nm Nd:YAG laser-assisted cartilage reshaping for treating ear protrusions. Laryngoscope, 2015, 125(11): 2461-2467.
6. Ragab A. Carbon dioxide laser-assisted cartilage reshaping otoplasty: a new technique for prominent ears. Laryngoscope, 2010, 120(7): 1312-1318.
7. Wong BJ, Milner TE, Kim HH, et al. Stress relaxation of porcine septal cartilage during Nd:YAG (λ=1.32 mm) laser irradiation: mechanical, optical, and thermal responses. J Biomed Opt, 1998, 3(4): 409-414.
8. Keefe MW, Rasouli A, Telenkov SA, et al. Radiofrequency cartilage reshaping: efficacy, biophysical measurements, and tissue viability. Arch Facial Plast Surg, 2003, 5(1): 46-52.
9. Zemek AJ, Protsenko DE, Wong BJ. Mechanical properties of porcine cartilage after uniform RF heating. Lasers Surg Med, 2012, 44(7): 572-579.
10. Manuel CT, Foulad A, Protsenko DE, et al. Needle electrode-based electromechanical reshaping of cartilage. Ann Biomed Eng, 2010, 38(11): 3389-3397.
11. Wu EC, Protsenko DE, Khan AZ, et al. Needle electrode-based electromechanical reshaping of rabbit septal cartilage: a systematic evaluation. IEEE Trans Biomed Eng, 2011, 58(8): 2378-2383.
12. Hussain S, Manuel CT, Protsenko DE, et al. Electromechanical reshaping of ex vivo porcine trachea. Laryngoscope, 2015, 125(7): 1628-1632.
13. Badran K, Manuel C, Waki C, et al. Ex vivo electromechanical reshaping of costal cartilage in the New Zealand white rabbit model. Laryngoscope, 2013, 123(5): 1143-1148.
14. Mordon S, Wang T, Fleurisse L, et al. Laser cartilage reshaping in an in vivo rabbit model using a 1.54 microm Er:Glass laser. Lasers Surg Med, 2004, 34(4): 315-322.
15. Sobol E, Sviridov A, Omeltchenko A, et al. Laser reshaping of cartilage. Biotechnol Genet Eng Rev, 2000, 17: 553-578.
16. Protsenko DE, Zemek A, Wong BJ. Temperature dependent change in equilibrium elastic modulus after thermally induced stress relaxation in porcine septal cartilage. Lasers Surg Med, 2008, 40(3): 202-210.
17. Hajiioannou JK, Nikolidakis A, Naumidi I, et al. In vitro enzymatic treatment and carbon dioxide laser beam irradiation of morphologic cartilage specimens. Arch Otolaryngol Head Neck Surg, 2006, 132(2): 1363-1370.
18. Manuel CT, Tjoa T, Nguyen T, et al. Optimal electromechanical reshaping of the auricular ear and long-term outcomes in an in vivo rabbit model. JAMA Facial Plast Surg, 2016, 18(4): 277-284.
19. Yau AY, Manuel C, Hussain SF, et al. In vivo needle-based electromechanical reshaping of pinnae: New Zealand White rabbit model. JAMA Facial Plast Surg, 2014, 16(4): 245-252.
20. Holden PK, Chlebicki C, Wong BJ. Minimally invasive ear reshaping with a 1450-nm diode laser using cryogen spray cooling in New Zealand white rabbits. Arch Facial Plast Surg, 2009, 11(6): 399-404.
21. Chlebicki CA, Protsenko DE, Wong BJ. Preliminary investigations on therapy thresholds for laser dosimetry, cryogen spray cooling duration, and treatment cycles for laser cartilage reshaping in the New Zealand white rabbit auricle. Lasers Med Sci, 2014, 29(3): 1099-1109.
22. Mo JH, Kim JS, Lee JW, et al. Viability and regeneration of chondrocytes after laser cartilage reshaping using 1,460 nm diode laser. Clin Exp Otorhinolaryngol, 2013, 6(2): 82-89.
23. 郭凤凤, 于晓波, 蒋海越. 激光辅助软骨重塑形技术矫正招风耳的临床应用进展. 中国修复重建外科杂志, 2018, 32(6): 769-772.
24. Leclère FM, Mordon S, Trelles MA. 1540 nm-Er/Glass laser-assisted cartilage reshaping for protruding ears (LACR)//Biomedical optics in otorhinolaryngology: head and neck surgery. Berlin: Springer, 2016: 203-212.

Chinese Journal of Reparative and Reconstructive Surgery

Preliminary study on microdissection needle-assisted ear cartilage reshaping in vivo rabbit models

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