Haberal Can Ilknur, Atilla Pergin, Cakar A Nur, Onerci Metin
Ministry of Health Ankara Education and Research Hospital, Camlica Bulvar Sitesi, F Blok, and No 19, Umitköy, Ankara 06800, Turkey.
Eur Arch Otorhinolaryngol. 2008 Mar;265(3):307-11. doi: 10.1007/s00405-007-0455-1. Epub 2007 Oct 6.
We investigated the effect of different surgical procedures on cartilage healing, using auricular cartilage as a model, which would be useful to create a rationale for septal cartilage surgery. Different kinds of manipulations were performed on the auricular cartilage of six female New Zealand white rabbits. Histopathological investigations were performed under light microscopy 4 months postoperatively. The autologous cartilage grafts survived well under the forehead skin regardless of the presence of the perichondrium. The response of perichondrium to either incomplete or complete trauma was not only new cartilage formation but also ossification. When incomplete incisions were made on the non-perichondrial side, new cartilage formation was stimulated whereas ossification was induced when there was perichondrium on the cartilage. If the cartilage with perichondrium was sliced into small pieces and planted back in its original place, many ossification areas occurred. The crushed cartilage was usually absorbed but sometimes replaced by bony plates. The traumatized cartilage with perichondrium undergoes ossification. This finding may be important clinically in that surgeons should not traumatize septal cartilage with perichondrium and work under the perichondrium. This ossification of traumatized cartilage may later result in thickening of the septal cartilage which we sometimes face in revision surgery.
我们以耳软骨为模型,研究了不同手术操作对软骨愈合的影响,这将有助于为鼻中隔软骨手术提供理论依据。对六只雌性新西兰白兔的耳软骨进行了不同类型的操作。术后4个月在光学显微镜下进行组织病理学检查。无论是否存在软骨膜,自体软骨移植物在前额皮肤下均存活良好。软骨膜对不完全或完全创伤的反应不仅是新软骨形成,还包括骨化。当在无软骨膜侧进行不完全切口时,会刺激新软骨形成,而当软骨上有软骨膜时则会诱导骨化。如果将带有软骨膜的软骨切成小块并放回原位,会出现许多骨化区域。粉碎的软骨通常会被吸收,但有时会被骨板替代。带有软骨膜的创伤性软骨会发生骨化。这一发现可能在临床上具有重要意义,因为外科医生不应损伤带有软骨膜的鼻中隔软骨,而应在软骨膜下操作。这种创伤性软骨的骨化可能随后导致鼻中隔软骨增厚,这是我们在翻修手术中有时会遇到的情况。