Department of Plastic and Reconstructive Surgery, Marmara University, Faculty of Medicine, Istanbul, Turkey.
Aesthetic Plast Surg. 2011 Aug;35(4):545-52. doi: 10.1007/s00266-011-9661-8. Epub 2011 Feb 27.
Auricular surgery is a challenging subject in plastic surgery due to the complicated surface topography of the external ear. Although various techniques for ear reduction and helical rim reconstruction have been reported in the literature, an ideal method is yet to be defined. Double helical rim advancement flaps with scaphal resection presented in this report represent a practical technique for correcting macrotia and reconstructing helical rim defects.
The amount of full-thickness resection at the helical rim is planned according to the desired reduction or extent of tumor. After helical excision, an incision that transects all the layers of the ear is carried out along the helical sulcus inferiorly and superiorly to yield two advancement flaps. Using scissors, a crescent from the scapha is excised through the full thickness of the ear. The flaps are approximated and sutured to the scapha by means of stitches that pass through skin and cartilage.
The described technique has been performed successfully since 1998. It has been used for 12 cases of macrotia, 28 cases of tumor surgery, and 7 cases of ear reduction for asymmetric ears. No major complications have been encountered. Three cases are reported as examples of the procedure.
Double helical rim advancement flaps with scaphal resection represent a versatile and safe technique that can be used for ear reduction, helical rim reconstruction, and correction for discrepancy in size of ears.
由于外耳表面结构复杂，耳整形术是整形外科中的一个具有挑战性的课题。尽管文献中已有各种耳缩小和耳轮缘重建技术的报道，但仍缺乏一种理想的方法。本文报告的带有部分耳舟切除的双耳轮缘推进皮瓣技术是一种矫正耳畸形和重建耳轮缘缺损的实用技术。
根据所需的缩小量或肿瘤范围，规划耳轮缘的全厚切除量。耳轮切除后，沿耳轮下缘和上缘的耳轮沟作一贯穿所有层次的切口，形成两个推进皮瓣。用剪刀从耳舟的全层作一新月形切除。皮瓣靠拢，通过穿过皮肤和软骨的缝线与耳舟缝合。
自 1998 年以来，我们成功地应用该技术治疗了 12 例耳畸形、28 例肿瘤手术和 7 例双侧耳大小不对称的耳缩小术。未发生重大并发症。本文报告了 3 例患者的手术情况。
带部分耳舟切除的双耳轮缘推进皮瓣是一种灵活、安全的技术，可用于耳缩小、耳轮缘重建和矫正耳大小差异。
