A New Method of Costal Cartilage Harvest for Total Auricular Reconstruction: Part II. Evaluation and Analysis of the Regenerated Costal Cartilage

Abstract

The authors established the hypothesis that chest wall deformity can be absolutely avoided by leaving the perichondrium completely intact at the donor site for cartilage regeneration. As described in Part I, on the new method of costal cartilage harvest, the authors were able to confirm regeneration of cartilage visually and with palpation at 6 months postoperatively. The regenerated cartilage of four patients at 6, 8, 10, and 12 months, respectively, after the first-stage operation was harvested for morphological and histological evaluation and analyses during the second-stage operation. Morphological findings revealed the regenerated cartilage to be cylindrical in shape, and histological findings confirmed transformation of regenerated cartilage to normal costal (hyaline) cartilage with respect to time. The authors' findings revealed that not only is postoperative chest wall deformity avoided with the new method of costal cartilage harvest but the major scientific merit lies in the fact that the regenerated cartilage can be used as demonstrated during the second-stage operation. This gives hope to bilateral microtia patients requiring secondary auricular reconstruction, which was thought to be impossible because of the lack of costal cartilage for fabrication of a three-dimensional costal cartilage framework.