In Vivo Needle-Based Electromechanical Reshaping of Pinnae: New Zealand White Rabbit Model
Open accessAbstract
IMPORTANCE: Electromechanical reshaping (EMR) is a low-cost, needle-based, and simple means to shape cartilage tissue without the use of scalpels, sutures, or heat that can potentially be used in an outpatient setting to perform otoplasty. OBJECTIVES: To demonstrate that EMR can alter the shape of intact pinnae in an in vivo animal model and to show that the amount of shape change and the limited cell injury are proportional to the dosimetry. DESIGN, SETTING, AND SPECIMENS: In an academic research setting, intact ears of 18 New Zealand white rabbits underwent EMR using 6 different dosimetry parameters (4 V for 5 minutes, 4 V for 4 minutes, 5 V for 3 minutes, 5 V for 4 minutes, 6 V for 2 minutes, and 6 V for 3 minutes). A custom acrylic jig with 2 rows of platinum needle electrodes was used to bend ears at the middle of the pinna and to perform EMR. Treatment was repeated twice per pinna, in proximal and distal locations. Control pinnae were not subjected to current application when being bent and perforated within the jig. Pinnae were splinted for 3 months along the region of the bend using soft silicon sheeting and a cotton bolster. MAIN OUTCOMES AND MEASURES: The ears were harvested the day after splints were removed and before euthanasia. Photographs of ears were obtained, and bend angles were measured. Tissue was sectioned for histologic examination and confocal microscopy to assess changes to microscopic structure and cellular viability. RESULTS: Treated pinnae were bent more and retained shape better than control pinnae. The mean (SD) bend angles in the 7 dosimetry groups were 55° (35°) for the control, 60° (15°) for 4 V for 4 minutes, 118° (15°) for 4 V for 5 minutes, 88° (26°) for 5 V for 3 minutes, 80° (17°) for 5 V for 4 minutes, 117° (21°) for 6 V for 2 minutes, and 125° (18°) for 6 V for 3 minutes. Shape change was proportional to electrical charge transfer, which increased with voltage and application time. Hematoxylin-eosin staining of the pinnae identified localized areas of cell injury and fibrosis in the cartilage and in the surrounding soft tissue where the needle electrodes were inserted. This circumferential zone of injury (range, 1.5-2.5 mm) corresponded to dead cells on cell viability assay, and the diameter of this region increased with total electrical charge transfer to a maximum of 2.5 mm at 6 V for 3 minutes. CONCLUSIONS AND RELEVANCE: Electromechanical reshaping produced shape change in intact pinnae of rabbits in this expanded in vivo study. A short application of 4 to 6 V can achieve adequate reshaping of the pinnae. Tissue injury around the electrodes increases with the amount of total current transferred into the tissue and is modest in spatial distribution. This study is a critical step toward evaluation of EMR in clinical trials. LEVEL OF EVIDENCE: NA.
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Electromechanical reshaping produced significant auricular changes with minimal injury, including promising applications to costal cartilage.
“electromechanical reshaping produced significant auricular changes with minimal injury, including promising applications to costal cartilage.45–47”
From Otoplasty Surgical Techniques and Clinical Outcomes: A Practical Review (2026) · cites this paper as [46]
The Discussion reports dose-dependent reshaping of rabbit ears with tissue injury limited to small regions around needle insertions, supporting the auricular-change and minimal-injury portions. The paper mentions cartilage grafts and lists prior costal-cartilage studies in its References, but it does not itself evaluate costal cartilage or identify it as a promising application. (LLM, conf=0.84)
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- Authors
- Yau, A. Y. Y., Manuel, C., Hussain, S. F., Protsenko, D. E., & Wong, B. J. F.
- Affiliations
- University of California, Irvine (US)
- Corresponding author
- Wong, Brian J. F.
- ORCID
- Wong, Brian J. F.
- Venue
- JAMA Facial Plastic Surgery
- Publisher
- SAGE Publications
- Published
- 2014-07
- Volume
- 16
- Issue
- 4
- Pages
- 245-252
- ISSN
- 2168-6076 (ISSN-L)
- 2168-6092
- PMC
- PMC4123460
- OpenAlex
- W2098657865
- Cited by
- 25
- References
- 34
- Citations by year
- 2026: 2 · 2025: 1 · 2024: 2 · 2023: 2 · 2022: 2 · 2021: 3 · 2020: 1 · 2019: 2 · 2018: 1 · 2017: 3 · 2016: 2 · 2015: 3 · 2014: 1
- FWCI
- 2.97
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- JAMA Facial Plastic Surgery (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- eScholarship (California Digital Library) (submittedVersion, cc-by)
- Funders
- U.S. Department of Defense (W81XWH)
- National Institutes of Health (W81XWH, EB015890)
- National Heart, Lung, and Blood Institute (R01HL103764, R01HL105215)
- National Cancer Institute (P30CA062203)
- National Institute of Biomedical Imaging and Bioengineering (P41EB015890)
- National Institute of Dental and Craniofacial Research (R21DE019026)
- Topics
- Health Sciences › Medicine › Surgery › Reconstructive Facial Surgery Techniques
- Health Sciences › Medicine › Surgery › Nasal Surgery and Airway Studies
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Biotechnology › Microbial Inactivation Methods
- Keywords
- otoplasty, pinnae, needle electrode, rabbit ear model, cell damage, tissue viability, confocal microscopy, histology, splinting, outpatient surgery, auricular cartilage, cartilage regeneration, cartilage grafting
- MeSH terms
- Animals, Biomechanical Phenomena, Cell Survival, Electrodes, Electric Stimulation Therapy, Feasibility Studies, Needles, Rabbits, Microscopy, Confocal, Chondrocytes, Ear Auricle
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