Division of Facial Plastic Surgery, Department of Otolaryngology–Head and Neck Surgery, University of California-Irvine, 101 The City Drive S, Orange, CA 92868, USA.
JAMA Facial Plast Surg. 2013 Jan;15(1):34-8. doi: 10.1001/2013.jamafacial.2.
To report the first successful study to date of in vivo electromechanical reshaping of ear cartilage in a rabbit model.
Ears of New Zealand white rabbits were reshaped using percutaneous needle electrode electromechanical reshaping (5 V for 4 minutes) and were then bolstered for 4 weeks. Ten ears were treated, with 2 undergoing sham procedures and serving as controls. The treatment was performed using a platinum array of electrodes consisting of 4 parallel rows of needles inserted across the region of flexures in the ear. After 4 weeks, the animals were killed, and the ears were photographed and sectioned for conventional light microscopy and confocal microscopy (live-dead fluorescent assays).
Significant shape change was noted in all the treated ears (mean, 102.4°; range, 87°-122°). Control ears showed minimal shape retention (mean, 14.5°; range, 4°-25°). Epidermis and adnexal structures were preserved in reshaped ears, and neochondrogenesis was noted in all the specimens. Confocal microscopy demonstrated a localized zone of nonviable chondrocytes (<2.0 mm in diameter) surrounding needle sites in all the treated ears.
Electromechanical reshaping can alter the shape of the rabbit auricle, providing good creation and retention of shape, with limited skin and cartilage injury. Needle electrode electromechanical reshaping is a viable technique for minimally invasive tissue reshaping, with potential applications in otoplasty, septoplasty, and rhinoplasty. Further studies to refine dosimetry parameters will be required before clinical trials.
报告首例在兔模型中体内重塑耳软骨的机电重塑的成功研究。
采用经皮针电极机电重塑(5V 持续 4 分钟)对新西兰白兔的耳朵进行重塑,并在 4 周内进行支撑。10 只耳朵接受了治疗,其中 2 只进行了假手术作为对照。该治疗采用由 4 排平行针组成的铂阵列电极进行,这些针插入到耳朵弯曲部位。4 周后,处死动物,对耳朵进行拍照和切片,进行常规光镜和共聚焦显微镜(活死荧光检测)检查。
所有接受治疗的耳朵都出现明显的形状变化(平均 102.4°;范围 87°-122°)。对照耳朵的形状保持最小(平均 14.5°;范围 4°-25°)。重塑耳朵中保留了表皮和附属结构,所有标本均观察到新生软骨。共聚焦显微镜显示,所有治疗耳朵的针位周围均存在直径<2.0mm 的局灶性无活力软骨细胞区。
机电重塑可以改变兔耳廓的形状,提供良好的形状创建和保持,同时对皮肤和软骨的损伤有限。针电极机电重塑是一种可行的微创组织重塑技术,可能在耳成形术、鼻中隔成形术和鼻成形术中具有应用前景。在进行临床试验之前,需要进一步研究来优化剂量参数。