Nonsurgical correction of congenital auricular deformities

Congenital auricular deformities are found in 55.2 per cent of neonates at birth. When the deformities are not hypoplastic, nonsurgical correction is very easy and reliable. Lop ear and Stahl's ear respond well to the nonsurgical correction only during the neonatal period, while protruding ears and cryptotia respond until approximately 6 months of age. We noticed that there are variations in the time period for response to nonsurgical correction in the different types of auricular deformities. We have continually observed the natural changes in 1000 babies' auricular shapes from birth to 1 year of age. Lop ear and Stahl's ear were auricular deformities that appeared in 47 per cent of all newborn babies. Eighty-four per cent of these deformities disappeared spontaneously during the first year of life. They were present in 7 per cent of the 1000 babies at 1 year of age. On the other hand, the percentage of protruding ears increases from 0.4 per cent at birth to 5.5 per cent at 1 year of age. Our observations show that most of the protruding ears are acquired deformities. If a baby is placed in a supine position, the weight of the baby's head will fold the ear forward when the baby turns its head to one side; this is the mechanism presented as the probable cause for the acquired protruding ear.     

改良Nagata法耳郭再造术治疗先天性小耳畸形

目的 探讨改良Nagata法耳郭再造术的临床应用效果.方法 对110例先天性小耳畸形耳后皮肤松,且残耳组织多的患者,采用改良Nagata法实施耳郭再造术,手术分3期完成.Ⅰ期:取同侧肋软骨,采用第6、7肋联合部的方法 雕刻耳郭支架,耳后皮下埋植、耳垂换位;Ⅱ期:再造耳竖立;Ⅲ期:再造耳修整、耳甲腔加深.结果 经6个月至3年的随访,术后短期恢复及长期随访效果好,再造耳形态逼真.结论 改良Nagata法耳郭再造术是一种行之有效的耳郭再造术式,可减少肋软骨的切取,降低胸廓畸形的发病率,具有操作简便、治疗周期短的优点,是耳后皮肤松的患者首选的治疗方法.     

Reconstruction of congenital and acquired auricular scaphal deficiencies

Although complications from piercing of the helical rim are unusual, infections in this area after piercing can produce devastating changes in the cartilaginous framework. Scaphal height is also reduced in certain congenital pinna anomalies. We developed a method of scaphal reconstruction that uses a composite graft harvested from the ipsilateral conchal bowl. The conchal bowl defect is repaired with an ipsilateral full-thickness graft of postauricular skin. This technique restores scaphal height and helical contour with minimal donor site morbidity.     

Correction of congenital 'triple lobe type' auricular cleft.

Congenital cleft earlobe is a rare auricular malformation. Various techniques have been reported for the correction of this deformity. Few papers deal with surgical techniques to correct the triple lobe sub-type cleft. This anomaly presents more technical difficulties in the three-dimensional rearrangement than other sub-types. We describe the technique used to correct a triple lobe deformity in a 5-year-old boy. The postoperative result was satisfactory at one year follow-up.     

耳廓复合组织游离移植矫治中度杯状耳畸形

目的:探讨采用健侧耳廓复合组织游离移植矫治中度先天性杯状耳畸形的新术式。方法:采用健侧耳廓复合组织游离移植,治疗中度杯状耳畸形患者48例,共48只畸形耳。结果:48例患者的复合组织全部成活,耳轮延长,耳舟显露,整个外耳形态满意,双侧基本对称。结论:采用健侧耳廓复合组织游离移植矫治中度先天性杯状耳畸形的手术方法简单易行,基本纠正了杯状耳的全部解剖缺陷。     

The question mark ear (congenital auricular cleft): a familial case

We describe here 2 patients with question mark ears in one family. They had the peculiar auricular deformities bilaterally. Both patients had a cleft between the helix and earlobe respectively. The upper portion of the auricle showed marked prominence. The mother also showed notching between the helix and earlobe. The literature is reviewed and discussed.     

先天性小耳畸形Ⅰ期耳再造48例临床分析

目的 探讨利用健侧耳后全厚皮片移植进行先天性小耳畸形Ⅰ期耳郭再造的方法.方法 选择48例先天性单侧小耳畸形患者,应用自体肋软骨或Medpor材料做耳支架,利用患侧颞浅筋膜瓣反转包裹耳支架,并将蒂在前的残耳皮瓣覆盖于包裹耳支架的颞浅筋膜瓣表面,再将蒂在前面的残耳上方的三角形皮瓣覆盖在耳轮缘上方的颞浅筋膜瓣表面,其余颞浅筋膜表面移植健侧耳后全厚皮片.结果 利用该方法进行Ⅰ期耳郭再造48例,手术均成功.随访1个月至1.5年,再造耳外形满意.结论 用该方法进行Ⅰ期耳郭再造,具有疗程短、并发症较少、临床效果佳等优点.该方法切实可行.可于临床推广应用.     

Spontaneous auricular seroma

We present a case of spontaneous seroma of the ear, which can be encountered in the plastic surgery clinic. We describe our management and briefly review the literature regarding this interesting condition.     

Congenital auricular clefts

Summary Four cases termed congenital auricular cleft and the surgical technique used for correction are presented.     

一期全耳廓再造耳支架覆盖组织瓣的模板设计

目的研究耳支架覆盖组织瓣的模板设计，探讨一种精确可靠的组织瓣设计方法。方法运用工程图学理论和CT三维测量技术，对40只发育正常耳廓的表面三维形态进行近似平面展开，据此展开图形设计耳支架覆盖组织瓣模板。结果健康人耳廓表面三维形态的展开图形具有大致相似的基本形状，据此基本图形的关键点可绘制出SMAS组织瓣的简化模板。结论应用CT三维测量模板设计耳支架覆盖组织瓣准确可靠。     

Reconstruction of traumatic auricular defect]

Auricle is liable to be injured, owing to its position and structural conditions. Since 1977, 48 cases (52 ears) with traumatic auricular defect have been reconstructed by the use of different operative techniques. The results have been satisfactory for most of them. Loss of a major portion of the auricle or the entire ear itself can be reconstructed by use of framework of costal cartilage graft (autologous or homologous). The joint between remaining auricle and framework must be smooth and secure. Helical defect can be repaired by the use of advancement of auricular skin and cartilage, composite graft, free skin graft with subdermal vascular plexus or tube flap according to specific conditions. Unnecessary injury to tissue should be avoided during the operation. Earlobe defect can be repaired by the use of double subcutaneous pedicle skin flaps. The retroauricular subcutaneous pedicle composite flap including conchal cartilage and the pretragus subcutaneous skin flap are formed. They pass through respective subcutaneous tunnels to reach the defect area. The two flaps and remained auricular fresh edge are sutured together. A flat, new earlobe is reconstructed. The earlobe reconstructed by the use of this technique overcomes the unsightly "spherical earlobe". This technique is an ideal operative method. In brief, there are many forms of traumatic auricular defects. According to the size and extent of defect, careful planning is essential before the actual surgery takes place.     

Surgical reconstruction of auricular relapsing polychondritis

Relapsing polychondritis (RP) is a multiple system disease of unknown cause characterized by episodic inflammation of cartilage and potentially progressive degeneration of cartilaginous tissue. Solitary auricular cartilage involvement without any inflammatory symptoms is very uncommon and surgical treatment is rarely recommended. We present a 53-year-old Chinese male patient who had undergone a mass resection on the right ear in December 2008 and 1 year later had developed another mass at the same spot. A mass resection and reconstructive surgery were performed and the pathologic result of the mass was auricular RP. Although RP is rarely seen by plastic surgeons, we should have sufficient information about this disease. This case demonstrates a simple and straight surgical approach to obtain an excellent ear appearance.     

Team approach to total auricular reconstruction

The surgery of microtia is a procedure that demands surgical and artistic skills, as well as precise planning of interventions. In cases where a functioning inner ear is present, functional and esthetic reconstruction is performed jointly with ear, nose, and throat surgeons. The middle ear plasty is performed through a transmastoidial approach at the time of the second stage of the outer ear reconstruction. We demonstrate the special requirements of this team approach and also pay a tribute to Burt Brent, who has set the standards of modern ear reconstruction.