Han Kihwan, Kim Jinhan, Kim Junhyung, Son Daegu, Kim Sukwha, Choi Tae Hyun
From the *Department of Plastic and Reconstructive Surgery, Keimyung University Dongsan Medical Center, Daegu; and †Department of Plastic and Reconstructive Surgery, Institute of Dermatological Science, Seoul National University College of Medicine, Seoul, Republic of Korea.
Ann Plast Surg. 2015 May;74(5):549-56. doi: 10.1097/SAP.0b013e3182a1e701.
Conchal cartilage is widely used in the field of plastic surgery, but donor-site morbidity is inevitable when all of the conchal cartilage is harvested. To maintain ear shape, the authors introduce a new method using an absorbable plate to reconstruct the conchal central strut after total harvesting of the conchal cartilage.
In total, 18 subjects underwent surgery, and 14 subjects who were followed up for more than 12 months were included in this article. Before the total harvesting of the conchae, an absorbable plate was adjusted to the proper curvature and length. After harvesting, the central strut was reconstructed by the precrafted absorbable plate. When the harvested cartilage was too large or one implant was not sufficient to reconstruct the central strut, an additional implant was added to the cymba conchae.Outcomes were evaluated by photogrammetry and questionnaires. Seven items were selected to evaluate the shape of the ear and conchal cavity. The authors compared preoperative and postoperative photographs, looking at proportion indices of 7 items using Photoshop. Ten assessors who did not participate in the operation were also shown preoperative and postoperative photographs and answered questionnaires about the shapes of the ear, conchal cavity, and conchal central strut.
Except for the effective conchal cavity height index, no statistically significant differences were observed between preoperative and postoperative ear shapes. Additionally, the questionnaire showed excellent assessments for all items.
Reconstruction of the central strut using an absorbable plate after total harvest of the conchal cartilage was a simple and effective method to prevent ear collapse.
耳甲软骨在整形外科领域应用广泛，但全耳甲软骨取材后供区并发症难以避免。为维持耳郭形态，作者介绍一种在全耳甲软骨取材后使用可吸收板重建耳甲中央支柱的新方法。
共18例患者接受手术，本文纳入14例随访时间超过12个月的患者。在全耳甲取材前，将可吸收板调整至合适的曲率和长度。取材后，用预制的可吸收板重建中央支柱。当取材的软骨过大或一块植入物不足以重建中央支柱时，在耳甲艇处增加一块植入物。通过摄影测量和问卷调查评估结果。选择7项指标评估耳郭及耳甲腔形态。作者使用Photoshop比较术前和术后照片，观察7项指标的比例指数。还向10名未参与手术的评估者展示术前和术后照片，并让他们回答有关耳郭、耳甲腔和耳甲中央支柱形态的问卷。
除有效耳甲腔高度指数外，术前和术后耳郭形态差异无统计学意义。此外，问卷调查对所有项目的评价均为优。
全耳甲软骨取材后使用可吸收板重建中央支柱是预防耳郭塌陷的一种简单有效的方法。
