Cartilage Reshaping Research Articles

Comparison of Polypropylene and Polydioxanone in the Hemitransdomal Suture: A Novel Rabbit Ear Cartilage Model.

Lower lateral cartilage reshaping is one of the basic steps in rhinoplasty. Hemitransdomal suture is frequently used for dome narrowing. Different suture materials can be used for hemitransdomal suture. In this study, we investigated the effectiveness of polypropylene and polydioxanone in hemitransdomal suture by designing a new experimental model in the rabbit ear cartilage. Twelve young adult male New Zealand White rabbits were used. The bipedicled inverted-U-shaped cartilage was elevated in each ear of the rabbits. Two hemitransdomal sutures were applied using 5-0 polypropylene on one ear and 5-0 polydioxanone on the other ear randomly. A 5mm high cartilage mound was created with two hemitransdomal sutures on each side. The sample size was twelve both in the polypropylene group and the polydioxanone group (n=12). All animals were sacrificed after three months. Cartilage mound heights were measured. The samples were examined histologically regarding fibroadipose tissue, inflammation, foreign body granuloma, cartilage degeneration, and the presence of inclusion cyst. Cartilage mound height was significantly higher in the polypropylene group than in the polydioxanone group at the end of the third month [3.75mm (±0.68) vs. 3.03mm (±0.69); p<0.05]. There was no significant difference between the two groups in histological analysis (p>0.05). Polypropylene suture may be more effective in maintaining the shape given to the dome by hemitransdomal sutures in rhinoplasty. No Level Assigned This journal requires that authors assign a level of evidence to each submission to which Evidence-Based Medicine rankings are applicable. This excludes Review Articles, Book Reviews, and manuscripts that concern Basic Science, Animal Studies, Cadaver Studies, and Experimental Studies. For a full description of these Evidence-Based Medicine ratings, please refer to Table of Contents or the online Instructions to Authors www.springer.com/00266.

1064nm Nd:YAG laser promotes chondrocytes regeneration and cartilage reshaping by upregulating local estrogen levels.

Cartilage is frequently used as a scaffolds for repairing and reconstructing body surface organs. However, after successful plastic surgery, transplanted cartilage scaffolds often exhibit deformation and absorption over time. To enhance the shaping stability of cartilage scaffolds and improve patients' satisfaction after reconstructions, we employed the ear folding models in New Zealand rabbits to confirm whether the 1064nm neodymium-doped yttrium aluminum garnet (Nd:YAG) laser could promote cartilage reshaping. There was an increase in collagen and aromatase (Cyp19) expression within the ear cartilage after laser treatment. Moreover, we have found that the Cyp19 inhibitor can inhibit the laser's effect on cartilage shaping and reduce collagen and Cyp19 expression. The overall findings suggest that treatment with 1064nm Nd:YAG laser irradiation can enhance estrogen levels in local cartilage tissues by upregulating Cyp19 expression in chondrocytes through photobiomodulation, thereby promoting the proliferation and collagen secretion of chondrocytes to improve cartilage reshaping and stability.

Personal Evolution in Rhinoplasty Tip Shaping: Beyond the Tri-pod Concept

Introduced over 50 years ago, the "tripod concept" has long been the foundation of our understanding of tip dynamics in rhinoplasty. Modern approaches to rhinoplasty have built on these principles and seen the evolution of several operative techniques to address tip aesthetics. This article and accompanying case video detail our algorithmic approach to tip shaping, based on the use of complete lower lateral cartilage reshaping and tensioning, clarified use of medial crural transection and overlap, with stabilization on a fixed-floating septal extension graft, and deliberate management of the soft-tissue envelope. The intraoperative sequencing, key technical considerations, relevant classification schemes, and global decision-making processes are reviewed. .

Hyaluronic Acid Dermal Filler Promotes Cartilage Reshaping in Rabbit Ears.

Neonatal ear is more malleable and soft, allowing the correction of deformities by using external molding. This is mainly attributed to high concentration of the proteoglycan aggregate and hyaluronic acid. In this study, HA dermal filler was injected in rabbit ear as a long acting HA source to investigate the biological impact of HA in reshaping the ear cartilage. Ears of twelve rabbits were divided into 4 groups. Control group was the left ears of 6 animals which were left intact. Group 2 was the right ears of the same animals, which received saline solution injection. Group 3 was the left ears of the other 6 animals, which were given 1 mL of HA. Group 4 was the right ears of them, which were given 2 mL of HA in both sites of the ear. All ears were folded and splinted for 4 weeks. Then, the angle of each ear was calculated. Following an additional 4 weeks, a cartilage biopsy was taken for histological examination. The ear angles did not show any statistical difference at week 4. There was a significant difference among the groups at the 8th week. In the 3rd and 4th groups, mean angles were higher than the group 1 and group 2. Thickening in the cartilage and ectopic cartilage formation was observed in the contact areas to hyaluronic acid. Significant difference was also found between the peak and mean cartilage thicknesses. HA dermal filler can stimulate cartilage regeneration by increasing the synthesis of extracellular matrix and chondrogenesis especially where it is in direct contact with the ear cartilage. This journal requires that authors assign a level of evidence to each submission to which Evidence-Based Medicine rankings are applicable. This excludes Review Articles, Book Reviews, and manuscripts that concern Basic Science, Animal Studies, Cadaver Studies, and Experimental Studies. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Cartilage Curvature Reshaping: A Quantitative Assessment.

Horizontal mattress suturing is frequently performed during rhinoplasty and otoplasty procedures to control the curvature of the cartilages. Despite the popularity of this technique, there are no quantitative methods for determining the effects of mattress sutures in the cartilage reshaping. The aim of this experimental study was to quantify the straightening effect of mattress suturing on the convexity of ear cartilage in a rabbit model. Eleven young adult male New Zealand white rabbits were used in this study. A horizontal mattress suture with spacing 3 mm × 6 mm was placed in a rectangle demarcated on the left ear in the area with maximum convexity. Preoperative and postoperative photographs were taken before and immediately after surgery, respectively. The radius of curvature (ROC), the first-order derivative (FOD), and the second-order derivative (SOD) were calculated to quantify the net cartilage reshaping, the changes in each point, and the homogeneity of the newly shaped cartilage, respectively. The mean ROCs were 1.112 cm and 2.169 cm before and after surgery, respectively, and this increase was statistically significant. The mean FOD for each point slope index was statistically lower after surgery (0.269 before surgery vs 0.135 after surgery). The mean SOD also significantly decreased after surgery (0.007 before surgery vs 0.003 after surgery). The values of the SOD remained positive after surgery, indicating that changes in the curvature were homogeneous. A quantitative measurement method was introduced to directly quantify the controlling effect of a mattress suture. This method makes it possible to achieve the important task of comparing the effect of horizontal mattress suturing with that of other cartilage-reshaping techniques.

Surgical Management of Stahl’s Ear Deformity: Cartilage Reshaping Technique Via Open Otoplasty

Surgical Management of Stahl’s Ear Deformity: Cartilage Reshaping Technique Via Open Otoplasty

Lasers in Rhinology-An Update.

A wide and evolving range of lasers and their applications often makes it difficult for a busy surgeon to choose the ideal laser for a specific indication. With this in mind, this article aims to summarize the most recent literature concerning laser application in rhinology. A literature search from 2000 to 2020 using the PubMed database was employed. Keywords used included "laser," "rhinology," "endonasal endoscopic surgery," "hereditary haemorrhagic telangiectasia," "rhinitis," "refractory rhinitis," "Inferior turbinate hypertrophy," "dacryocystorhinostomy," "septoplasty," "cartilage reshaping" and "choanal atresia." The most up to date studies published for each rhinology condition that could potentially be treated with laser surgery was included. Rhinological conditions appropriate for laser applications are discussed. We identified articles related to a number of applications including hereditary hemorrhagic telangiectasia, rhinitis, turbinate surgery, dacryocystorhinostomy, septoplasty, choanal atresia, and sphenopalatine artery ligation, paying attention to the outcomes of the studies and their limitations. There is currently no one-size-fits-all laser and therefore being up to date on the latest clinical application results can help the clinician decide which are the best treatments to offer their patients.

Infrared Laser Effect on Healthy and Ossified Costal Cartilage: The Development of Stable Load-Bearing Autoimplants.

The laser-induced stress relaxation provides new prospects to obtain stable long fragments of costal cartilage for autoimplantation avoiding the risk of spontaneous deformation and poor engraftment. However, the age-related alterations of cartilage may sufficiently influence its interaction with infrared (IR) laser radiation and disrupt the effectiveness and safety of the technique. The aim of the work is to study the influence of the structural quality of costal cartilage on its interaction with IR laser and efficiency of obtaining of curved implants for trachea surgery. Healthy costal cartilage was taken from pigs and human. Ossified costal cartilage was taken from humans of age 65 ± 7. The cartilage slices with a mean thickness of 3 mm were mechanically curved and processed to stress relaxation by laser irradiation with the wavelength 1.56 µm. The structure and mineral content were studied by X-ray microtomography and element analysis. The optical measurements included the study of the propagation of IR radiation, speckle interferometry, and IR radiometry. The aged cartilage demonstrates a high level of heterogeneity in structure and properties and decreased water content. The presence of dense inclusions consisting of amorphous calcined volumes makes the tissue more fragile and less elastic. The IR radiation propagation intensity for aged cartilage is at least twice higher than that for healthy cartilage. The thermal-induced motion of scatterers in aged cartilage is slower. X-ray microtomography showed the cartilage-like and the bone-like structures within the ossified samples. The main challenge for laser reshaping of aged cartilage is the presence of ossifications. However, the new stable curvature can be obtained with adjustment of laser power. To obtain the satisfying stable curvature of an implant the ossified volumes should be avoided The laser-induced stress-relaxation mechanism for aged cartilage can be particularly different from that of healthy tissue and the optimal laser regimes should be specified. Lasers Surg. Med. © 2020 Wiley Periodicals, Inc.

Dynamic changes in nasal symmetry after presurgical nasoalveolar molding in infants with complete unilateral cleft lip and palate.

Background:Presurgical nasoalveolar molding (PNAM) technique gave a new perspective to presurgical infant orthopedics. Nasal reconstruction presents a challenge for the plastic surgeons in case of patients with unilateral cleft lip and palate (UCLP). PNAM facilitates the reshaping of the nasal cartilage and molding of maxillary arch preoperatively. This therapy not only aids the surgical repair of lip but also enhances the overall postsurgical results with negligible postoperative scar.Aim:The aim of the study was to analyze nasal changes before and after PNAM in patients with complete UCLP.Materials and Methods:This was a retrospective review of 22 ULCP patients who underwent PNAM before lip surgeries. A series of standard basilar view photographs in 1:1 ratio were taken, and linear measurements were done directly on the photographs.Results:After PNAM therapy, there was highly significant increase in the nostril height, nostril dome height, and columella length (P < 0.001*) and highly significant reduction in the nostril width and nasal basal width (P < 0.001*).Conclusion:Significant improvement in the nasal symmetry was found after PNAM therapy in patients with complete UCLP.

Anisotropy of bovine nasal cartilage measured by Fourier transform infrared imaging

Fourier transform infrared imaging (FTIRI) can be used to obtain the composition and structure information of sample. Here, FTIRI combined with spectral polarization analysis method was applied to investigate the fine anisotropy of bovine nasal cartilage (BNC). The upper BNC tissue was sliced into a three-dimensional (3D) block with three planes (XY, YZ, and XZ) parallel to horizontal section, forward section, and lateral section, respectively. The anisotropy of collagen fiber in BNC was represented by the absorbance of amide II (1590–1500 cm−1) at different polarization directions. It was found that collagen fiber showed little anisotropy in plane XY, XZ, and along the direction Z in plane YZ. It was more important that collagen fiber showed strong anisotropy along direction Y in plane YZ (transverse axis) of BNC, possibly including arched or wavy fiber orientation even a mixture of both in nasal septum top end. Two anisotropic deflections ranging from 600 to 930 μm and from 2680 to 2980 μm were quantitatively calculated. This study is of important significance for further understanding the physiological structure of nasal septum and provides remarkable experimental support for being a good transplant material in cartilage reshaping studies.

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

To preliminarily investigate morghological changes of rabbits reshaping ear cartilage assisted by microdissection needle and explore feasibility of new therapy for ear deformity. 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. 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). Rabbit ear cartilage can be effectively reshaped by microdissection needle. Proliferation of chondrocyte and changes in matrix can be found during the reshaping process.

Statistical Analysis of Instantaneous Effect of Polarized He-Ne Laser Radiation on the Elastic Modulus of Soft Biological Tissue

Introduction: This work is dedicated to investigating the effect of applying polarized He-Ne laser beam (λ= 632 nm, 10 mW, 1 j/cm2) with polarization direction perpendicular to the stress direction on the tensile strength of biological tissue (elasticity index of the Pleura 10*4*0.1 mm). Method and Material: The optimized characteristics of the laser illumination in the minimum times of radiation is detected here through some series of designed experiments and the results are completely applicable to the new investigations. To achieve the purpose, the experiments are designed in full factorial design model to study the effecting factor of viscoelastic modules of the pleura. The employed factor is time duration of the exposure. different irradiation timing is 5 s, 10 s, 15 s and 20 s. Result: Through the variance analysis it is found that time duration of radiation plays very important role on its viscoelastic characteristics. Additionally, it is revealed that a special condition, the time of exposure =10 sec, leads to the highest value of relative elastic modulus, i.e., the most increase in the tensile strength of the Pleura because of dehydration of cells is happened in longer time irradiation than 10s and no effect in less duration than 10s. Conclusion: This conclusion can be useful in dealing with wound scars, reforming the shape of the cornea, cartilage reshaping and et.

Control of optical transparency and infrared laser heating of costal cartilage via injection of iohexol.

Infrared (IR) laser impact has no analogues for rapid and safe cartilage reshaping. For better penetration of radiation optical clearing agents (OCAs) can be applied. In present work, the effect of low-osmolality agent iohexol on costal cartilage is studied. Specifically, it is shown that ½ of total increase of optical transparency occurs in 20 minutes of immersion. Maximally, cartilage transparency on 1560 nm can be increased in 1.5 times. Injection of iohexol results in increased tissue hygroscopicity, lower drying rate and higher percentage of bound water. Effective diffusion coefficients of water liberation at 21°C are (5.3 ± 0.4) × 10-7 and (3.3 ± 0.1) × 10-7 cm2 /s for untreated and iohexol-modified tissue, respectively. Raman spectroscopy of irradiated iohexol solution reveals its photo and thermo-stability under clinically used IR laser energies up to 350 W/cm2 for exposure times of several seconds. At energies higher than 500 W/cm2 [Correction added on 5 September 2018, after first online publication: This unit has been changed] decomposition of iohexol occurs rapidly through formation of molecular iodine and fluorescent residue.

Current progress of laser-assisted cartilage reshaping for prominent ear

To summarize the current progress of laser-assisted cartilage reshaping (LACR) for prominent ear. The domestic and abroad article concerning the LACR in treatment of prominent ear was reviewed and analyzed. As a new technique, there were three types of LACR therapies that been used for prominent ear. LACR with the 1 064 nm Nd/YAG laser is painful and the penetration depth of the 1 064 nm Nd/YAG laser is greater than that of the 1540 nm Er/Glass laser which is caused more tissue injury. LACR with the 1 540 nm Er/Glass laser has high absorption by the ear cartilage and produce less injury to the surrounding tissue. Use of the CO 2 laser permitted cartilage reshaping combined with both vaporization and incisions, which complicates the technique, although, with low recurrence rate and definite effect. Insisting on wearing ear mold is the key to get satisfactory effectiveness for postoperative patients. The complications of LACR for prominent ear, such as the dermatitis, perforation of the skin, hematoma, or infection, should be noticed. Application of LACR for prominent ear just has a short period of time, limited number of cases, and few relevant literature reports. Its effectiveness needs to be further studied and clarified.

Achievement in Nasal Symmetry after Cheiloplasty in Unilateral Cleft Lip and Palate Infants Treated with Presurgical Nasoalveolar Molding.

Background:The presurgical nasoalveolar molding (PNAM) technique gave a new perspective to presurgical infant orthopedics. Nasal reconstruction presents a challenge for the treating surgeons in case of patients with unilateral cleft lip and palate (UCLP). PNAM facilitates the reshaping of the nasal cartilage and molding of maxillary arch preoperatively.Aims and Objective:The aim and objective of the present retrospective study was to analyze two-dimensional nasal changes before and after PNAM in patients with complete UCLP.Materials and Method:Twenty-two ULCP patients who underwent PNAM before lip surgery were considered in this study. A series of standard basilar view photographs in 1:1 ratio were taken and linear measurements were done digitally.Results:After PNAM therapy, there was a significant increase in nostril height (P = 0.003) and highly significant increase in columella length (P = 0.001). There was also a highly significant decrease in nostril width (P = 0.001) and a significant decrease in nasal basal width (P = 0.02).Conclusion:There was a significant increase in nostril height and columella length and a significant decrease in nostril width and nasal basal width on the cleft side when treated with PNAM therapy in patients with complete UCLP. Hence, this therapy helps in improving the nasal symmetry in such patients and also aids in surgical procedures.

Injectable chondroplasty: Enzymatic reshaping of cartilage grafts

Objective/hypothesisTo develop an injection-based enzymatic technique that selectively softens cartilage tissue for reshaping cartilaginous structures in the head and neck. Materials and methodsTwo groups were formed using fresh rabbit ears: (1) whole rabbit ear group; (2) composite graft group (2.5mm×3.0cm specimens sectioned from the central region of the pinna). Subperichondrial injections using three enzymes (hyaluronidase, pronase, and collagenase II) in sequence were performed for the experimental specimens from both groups. In the control specimens, phosphate buffered saline was injected in a similar fashion. The whole ear specimens were then photographed while held upright in the anatomical vertical position to evaluate for buckling, which corresponds to the integrity of the cartilage. In addition, backlight photography was performed for all specimens to further evaluate the effect of the enzymes, such that increased light intensity represents increased cartilage digestion. ResultsThe application of the digestive enzymes resulted in marked reduction of cartilage tissue matrix resiliency, while preserving overlying skin layers. Enzymatically treated whole pinnae buckled at the site where enzymes were delivered. Backlit images revealed increased local light intensity at the regions of digestion. There was no obvious destruction of the overlying skin upon visual inspection. ConclusionsThis study demonstrates the feasibility of injectable chondroplasty as a potential alternative method to conventional surgery for auricular cartilage reshaping. Sequential injection of hyaluronidase, pronase, and collagenase II into the subperichondrial space can be performed to digest and soften cartilage structure with minimal involvement of surrounding tissue. Future studies will need to include chondrocyte viability testing and optimization of delivery techniques.

Superficial cells are self-renewing chondrocyte progenitors, which form the articular cartilage in juvenile mice.

Articular cartilage has little regenerative capacity. Recently, genetic lineage tracing experiments have revealed chondrocyte progenitors at the articular surface. We further characterized these progenitors by using in vivo genetic approaches. Histone H2B-green fluorescent protein retention revealed that superficial cells divide more slowly than underlying articular chondrocytes. Clonal genetic tracing combined with immunohistochemistry revealed that superficial cells renew their number by symmetric division, express mesenchymal stem cell markers, and generate chondrocytes via both asymmetric and symmetric differentiation. Quantitative analysis of cellular kinetics, in combination with phosphotungstic acid-enhanced micro-computed tomography, showed that superficial cells generate chondrocytes and contribute to the growth and reshaping of articular cartilage. Furthermore, we found that cartilage renewal occurs as the progeny of superficial cells fully replace fetal chondrocytes during early postnatal life. Thus, superficial cells are self-renewing progenitors that are capable of maintaining their own population and fulfilling criteria of unipotent adult stem cells. Furthermore, the progeny of these cells reconstitute adult articular cartilage de novo, entirely substituting fetal chondrocytes.-Li, L., Newton, P. T., Bouderlique, T., Sejnohova, M., Zikmund, T., Kozhemyakina, E., Xie, M., Krivanek, J., Kaiser, J., Qian, H., Dyachuk, V., Lassar, A. B., Warman, M. L., Barenius, B., Adameyko, I., Chagin, A. S. Superficial cells are self-renewing chondrocyte progenitors, which form the articular cartilage in juvenile mice.

Effect of anisotropy and drying of costal cartilage on its optical transmittance in laser reshaping of implants with 1, 2, and 3 mm in thickness.

Laser reshaping of cartilage is a prospective technique which can be applied for manufacturing the natural implants for otolaryngology and reconstructive surgery. Optical properties and optimal laser settings for laser reshaping of costal cartilage depend on its thickness, water content, and structural anisotropy of the tissue, in particular, the distinct orientation of collagen packing. The aim of the work is to study the effect of different collagen orientation, thickness, and drying of costal cartilage on its interaction with laser radiation. Costal cartilage was cut along and crosswise the distinct collagen orientation. The dried and normal cartilage was used for the comparative analysis. The collagen package was studied using atomic force microscopy. The dried tissue was analyzed with thermogravimetry-differential scanning calorimetry (TG-DSC) analysis to reveal the residual water content. The optical transmittance was measured for two wavelengths λ: 1,560 and 532 nm. The reshaping of cartilage of 1-3 mm in thickness was performed with infrared laser with λ = 1560 nm while, the radiation with λ = 532 nm was used to determine the location of the IR beam. The transmittance of 532 nm radiation does not depend on collagen orientation and tissue drying. The IR radiation transmits better along the distinct collagen direction in dried cartilage while in normal cartilage the intensity of transmitted IR radiation increases intermittently passing crosswise and does not change dramatically with time along the collagen orientation. The effect of structural anisotropy of costal cartilage reveals itself in the increasing scattering of IR radiation with λ = 1,560 nm passing crosswise the collagen orientation when tissue water content is decreased. The radiation with λ = 1,560 nm is effective to perform the reshaping for cartilage of 1-3 mm in thickness; however, for 3 mm, the residual mechanical stress should be taken into account. Lasers Surg. Med. 48:887-892, 2016. © 2016 Wiley Periodicals, Inc.

Monitoring of Biological Changes in Electromechanical Reshaping of Cartilage Using Imaging Modalities.

Electromechanical reshaping (EMR) is a promising surgical technique used to reshape cartilage by direct current and mechanical deformation. It causes local stress relaxation and permanent alterations in the shape of cartilage. The major advantages of EMR are its minimally invasive nature and nonthermal electrochemical mechanism of action. The purpose of this study is to validate that EMR does not cause thermal damage and to observe structural changes in post-EMR cartilage using several imaging modalities. Three imaging modality metrics were used to validate the performance of EMR by identifying structural deformation during cartilage reshaping: infrared thermography was used to sense the temperature of the flat cartilages (16.7°C at 6 V), optical coherence tomography (OCT) was used to examine the change in the cartilage by gauging deformation in the tissue matrix during EMR, and scanning electron microscopy (SEM) was used to show that EMR-treated cartilage is irregularly arranged and the thickness of collagen fibers varies, which affects the change in shape of the cartilage. In conclusion, the three imaging modalities reveal the nonthermal and electromechanical mechanisms of EMR and demonstrate that use of an EMR device is feasible for reshaping cartilage in a minimally invasive manner.

Handheld-Level Electromechanical Cartilage Reshaping Device.

We have developed a handheld-level multichannel electromechanical reshaping (EMR) cartilage device and evaluated the feasibility of providing a means of cartilage reshaping in a clinical outpatient setting. The effect of EMR on pig costal cartilage was evaluated in terms of shape change, tissue heat generation, and cell viability. The pig costal cartilage specimens (23 mm × 6.0 mm × 0.7 mm) were mechanically deformed to 90 degrees and fixed to a plastic jig and applied 5, 6, 7, and 8 V up to 8 minutes to find the optimal dosimetry for the our developed EMR device. The results reveal that bend angle increased with increasing voltage and application time. The maximum bend angle obtained was 70.5 ± 7.3 at 8 V, 5 minutes. The temperature of flat pig costal cartilage specimens were measured, while a constant electric voltage was applied to three pairs of electrodes that were inserted into the cartilages. The nonthermal feature of EMR was validated by a thermal infrared camera; that is, the maximum temperate of the flat cartilages is 20.3°C at 8 V. Cell viability assay showed no significant difference in cell damaged area from 3 to 7 minutes exposure with 7 V. In conclusion, the multichannel EMR device that was developed showed a good feasibility of cartilage shaping with minimal temperature change.