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Why do I choose costal cartilage when I do ear reconstruction for microtia?
"Dr. Zhuang, do this operation with costal cartilage, will it be absorbed in the future?" Parents of patients who receive outpatient service every week basically ask me this question. Here, let me answer it for you.

Ear reconstruction with costal cartilage does have the possibility of absorption

Why is this? Because autologous costal cartilage is the autologous tissue of human body, it needs enough nutrition to survive in the ear. If the blood circulation of the reconstructed ear is insufficient and the costal cartilage cannot absorb nutrients, then the costal cartilage may be absorbed.

Another situation is postoperative infection. As far as bacteria are concerned, costal cartilage is a good nutrient, and some bacteria like to eat cartilage. If the reconstructed ear is infected, bacteria may destroy the costal cartilage, leading to its absorption and deformation.

The last case is otitis media. If normal ears have otochondritis, the ears will also absorb deformation.

Since costal cartilage may be absorbed, why do I insist on using costal cartilage as an ear?

First of all, costal cartilage has strong anti-ischemia ability and low requirements for blood circulation. Under normal circumstances, the reconstructed ear will not have ischemic problems. The possibility of reconstructed ear infection exists, but the probability is very low.

Secondly, costal cartilage has the lowest absorption rate among all human cartilages, usually around 1% ~ 5%, which is related to personal physique. I have done a lot of ear surgery with costal cartilage, and few cases have been absorbed after operation.

After ear reconstruction, special attention should be paid to prevent frostbite, which will affect cartilage.

Advantages of autologous soft tissue compared with biomaterials

Autogenous soft rib has certain elasticity and strength, strong anti-infection ability, self-repair ability and can grow synchronously with human development. But for the human body, biomaterials are foreign bodies and the texture is too rigid. As a whole ear stent, the skin can't bear the pressure, which leads to ulcer necrosis and material exposure, so its clinical application is limited.

Up to now, after 100 years of experiments, doctors have found that no artificial material is superior to self-made materials, especially supporting materials with certain hardness. Autologous soft ribs with good histocompatibility are still commonly used materials for ear reconstruction.