Biomedical subjects
Publications and source records attributed to Gregory Renner.
The eyes and periorbital structures are principle components of the upper region of the face. A thorough understanding of orbital and periorbital anatomy and function is important for anyone wishing to perform reconstructive surgery in this region. This article discusses the unique challenges presented to the surgeon when performing reconstruction of the eyelids and periorbital structures.
PURPOSE OF REVIEW: One of the greatest challenges in facial plastic surgery is total auricular reconstruction. The ability to construct a fully satisfactory complete external ear has for centuries been an elusive goal. With advancing standards and expectations in plastic surgery, greater focus is being directed to this arena of reconstruction as well. RECENT FINDINGS: With advances both in surgical technique and biotechnology, an expanding range of options is available to the reconstructive surgeon who is willing to take on this still formidable task. While progress continues to be made in the detailing of costal cartilage grafts and soft-tissue rearrangement, it is also being made with the use of alloplastic implants and prostheses. The most promising field of advances, with the hope of eventual clinical utility, lies in the realm of bioengineering with cultured cartilage. SUMMARY: Review of the literature over the past year reveals several reports describing advances made in the development of cultured chondrocytes with attempts to direct special shape to the manufactured neocartilage. Though advances continue to be made, actual clinical applicability of this technology is still insufficient while expectation continues that this will eventually become integral to total auricular reconstruction.
OBJECTIVE: To continue investigation regarding the efficacy of hyperbaric oxygen (HBO) therapy in improving survival of reattached auricular composite grafts. DESIGN: A prospective, randomized, double-blind study using 20 New Zealand albino rabbits randomized to a treatment or control group. The treatment group received 30 HBO treatments over 19 days following amputation and reattachment of composite auricular grafts. The control group received standard care. Ears were examined grossly and microscopically on postoperative day 21 to determine the percentage of graft survival. RESULTS: The mean percentage of graft survival for the 2 separate grafts (a larger 1.5 x 4.0-cm and a smaller 1.0 x 3.0-cm graft) in the treatment group was 26.5% and 27.9%, respectively. The mean percentage of graft survival for the larger and smaller graft in the control group was 9.7% and 14.0%, respectively. An analysis of variance test was used to evaluate this difference, which was found to be statistically significant (P =.001). CONCLUSIONS: This study represents a continued investigation following a pilot study, which suggested some enhancement of composite graft survival with the use of HBO therapy in the rabbit ear. Both experiments have demonstrated a slight survival benefit using HBO therapy in auricular composite grafts in the rabbit model.