Park Chul
Seoul, Korea From the Seoul Center for Developmental Ear Anomalies and the Department of Plastic and Reconstructive Surgery, Korea University Anam Hospital.
Plast Reconstr Surg. 2009 Apr;123(4):1209-1219. doi: 10.1097/PRS.0b013e31819e2644.
The group IIB constricted ear, as defined by Tanzer, shows a short helical length and an accompanying deficiency of the upper antihelix or scapha, and a cup or tubular form. The author proposes in this article a new corrective method for the deformity.
Ten ears in eight patients were corrected with the author's new method. Three small transverse skin incisions were made along the helix, and a subcutaneous helical tunnel was prepared through the skin incision sites. A piece of split eighth or ninth costal cartilage was inserted into the tunnel. In each case, two to four auxiliary procedures were performed to make an effective helical expansion, as follows: (1) the fasciocutaneous Grotting flap was transposed on an intentionally induced gap at the incision site of the otobasion superius; (2) a marginally based scapha skin flap was elevated and advanced toward the inserted helical cartilage; (3) to prevent an excessive widening of the inserted helical cartilage, an additional costal cartilage bar was inserted through the postantihelical tunnel and connected between points on the ascending and descending helices of the inserted cartilage; (4) to correct ear prominence, a 4-0 nylon mattress suture was placed between the descending helix and the conchal wall.
All reconstructed ears showed well-expanded helices. The reconstructed ears in unilateral cases showed the same shape and size as their opposite normal ears on follow-up views.
The presented method was relatively simple and safe, and offered consistently effective results.
按照坦泽的定义，IIB型缩窄耳表现为耳轮长度短，伴有上耳轮或耳舟缺失，呈杯状或管状形态。本文作者提出一种针对该畸形的新矫正方法。
采用作者的新方法对8例患者的10只耳朵进行了矫正。沿耳轮做3个小的横向皮肤切口，通过皮肤切口部位制备皮下耳轮隧道。将一块劈开的第八或第九肋软骨插入隧道。在每种情况下，进行2至4种辅助手术以实现有效的耳轮扩张，如下：（1）将筋膜皮瓣转移至耳上基点切口处有意制造的间隙上；（2）掀起并向插入的耳轮软骨推进以边缘为基底的耳舟皮瓣；（3）为防止插入的耳轮软骨过度增宽，通过耳后隧道插入一根额外的肋软骨条，并连接在插入软骨的耳轮升支和降支上的点之间；（4）为矫正耳廓突出，在降耳轮和耳甲壁之间放置一根4-0尼龙褥式缝线。
所有重建耳均显示耳轮充分扩张。单侧病例的重建耳在随访时与其对侧正常耳形状和大小相同。
所提出的方法相对简单且安全，并且始终能提供有效的结果。
