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Objective: To explore the fabrication and application of three-dimensional autogenous cartilage framework in auricular reconstruction., Methods: The process of fabrication of three-dimensional cartilage framework consisted of cartilage harvesting, carving and assembling the cartilage. The rib cartilage was harvested separately. The three-dimensional framework was composed of three main parts:the helix, the base and the pad, at different layer. The framework was fabricated according to the development of rib cartilage and contour and height of the reconstructed ear., Results: From January 1992 to December 2006, 5,248 patients of microtia were treated with 6,252 autogenous cartilage frameworks., Conclusions: The three-dimensional framework is easily manipulated. The reconstructed ears look natural and had an erect contour. This method can effectively use the cartilage.

Objective: To study the difference of histologic examination and type II collagen expression in the rib cartilage of patients at different age., Methods: The patients were divided into three groups, as children group (5 to 10 years old), teenager group (11 to 17 years old), and adult group (18 to 29 years old). Histologic examination of rib cartilage and quantitative analysis of type II collagen with immunohistochemical stain were carried out in the three groups. Motic Med 6.0 A system was used to quantitate immunohistochemical image through measurement of mean photodensity. The results were statistically analyzed., Results: Among the three groups, the children's rib cartilage had the most blood vessels, the most chondrocytes, well-distributed stain of matrixes, and the type II collagen was expressed actively and highest in photodensity. The rib cartilage of teenager group had less blood vessels, unhomogeny distributed stain of matrixes, the enlarged and separated cartilage lacunae. The rib cartilage in adult group showed the least blood vessels, the least chondrocytes, the hyalinization of perichondrium, the most deposition of calcium salt, and the type II collagen was expressed at the lowest level in photodensity. Statistical analysis showed significant differences among the three groups (P < 0.01)., Conclusions: Histologic structure in human rib cartilage changes during the aging process and the type II collagen is decreased with the increase of age.

Objective: To investigate the chest contour deformities after harvesting of costal cartilage for total ear reconstruction, so as to prevent donor site morbidity., Methods: 107 cases of microtia who underwent ear reconstruction with costal cartilage during the period from 1994 to 2003, were retrospectively studied. Both the chest depression deformity and the costal arch deformity were evaluated. The possible related factors to the chest contour deformities were analyzed statistically with Stata software., Results: The incidence of chest depression was 54.55% (48/88), including 35 cases of mild depression (39.77%) and 13 cases of severe depression (14.77% ). The incidence of costal arch deformity was 52.77% (46/88), including 33 cases of mild deformity (37.50%) and 13 cases of severe deformity (14.77%). The incidence of both deformities was significantly different at different age (P < 0.01), but not at different follow-up period (P = 0.294 and P = 0.225, respectively). Gender was related to the incidence of chest depression (P < 0.01), but not to the costal arch contour deformity (P = 0.619). Comparing resection of the 6th and 7th rib cartilage with resection of 7th and 8th rib cartilage, the incidence of costal arch deformity was significantly different (P < 0.01), but the incidence of depression deformity was not (P = 0.657)., Conclusions: The incidence of chest deformities increases with early operation time (< 13 years old). The male patients have higher incidence of depression deformity than female. The arch deformity is higher when the 6th and 7th rib cartilage were resected. The follow-up period is not related to the chest deformities.

Objective: To investigate the age-related change in biomechanical properties of the costal cartilage and its relevance to the timing of ear reconstruction with costal cartilage framework., Methods: The patients of 5 to 25 years old were divided into three groups according to their age. The biomechanical properties of costal cartilage harvested from these patients during ear reconstruction were tested, including stree-strain relationship, stress relaxation and creep, tensile strength. All the results were analyzed statistically., Results: The costal cartilage from children group had the best biomechanical properties, while the costal cartilage from the adolescent group had the worst. The difference had a statistically significance (P < 0.05)., Conclusions: The biomechanical properties of costal cartilage are age-related. So it is recommended that ear reconstruction with costal cartilage framework should be performed in childhood when the costal cartilage has the best biomechanical properties.