Márquez-Gutiérrez Erik Agustín, Gutiérrez-Gómez Del Hierro Claudia, Rodríguez-Quintero Jorge Humberto, Pereyra-Arzate Jorge Enrique, Rivera-Martínez Rodolfo
Plastic Surgery Department, Instituto Nacional de Rehabilitación INR, Mexico City, Mexico; †Plastic Surgery Department, Hospital General Manuel Gea González, Mexico City, Mexico; and ‡Radiology Department, Hospital General Manuel Gea Gonzalez, Mexico City, Mexico.
Plast Reconstr Surg Glob Open. 2017 Dec 28;5(12):e1594. doi: 10.1097/GOX.0000000000001594. eCollection 2017 Dec.
Microtia is a congenital auricular deformity that occurs in 1:5,000-10,000 births. It can cause severe impairment to the patient's self-esteem and problems regarding social integration. Multiple measures have been described in attempt to better operative outcomes of these patients. We used computed tomography (CT) angiography to analyze the vascular pattern of the auricular region before surgery.
Fourteen patients with unilateral microtia were included. All underwent CT angiogram plus tridimensional reconstruction. Both healthy and microtic auricles were analyzed descriptively in terms of main arterial supply, pattern, diameter of subbranches, and angulation. The sample was divided in 2 age groups for better understanding of the data.
Blood supply to the auricle was found to depend on 2 main vessels: temporal superficial artery (TSA) and its subbranches (superior, middle, and lower branch) and posterior auricular (PA) artery. In the microtic group, TSA was the dominant artery in 13 of 14 cases (92%). Superior, middle, and inferior branches were present in 4, 3, and 0 cases, respectively. Three of the microtic auricles presented supply from PA artery, from which in 1 case, it represented the only supply to the region.
There is wide variability in the blood supply of both healthy and microtic auricles; however, we were able to identify some tendencies in our sample. Further research is needed to prove the benefit of a preoperative imaging study in these patients. Still, in our experience, we found it useful as a complement for surgical planning.
小耳畸形是一种先天性耳廓畸形,发病率为1/5000至1/10000。它会严重损害患者的自尊心,并导致社交融合方面的问题。为改善这些患者的手术效果,人们已描述了多种措施。我们使用计算机断层扫描(CT)血管造影术来分析术前耳廓区域的血管模式。
纳入14例单侧小耳畸形患者。所有患者均接受CT血管造影及三维重建。对健康耳廓和小耳畸形耳廓的主要动脉供应、模式、分支直径和角度进行了描述性分析。为更好地理解数据,将样本分为2个年龄组。
发现耳廓的血液供应依赖于2条主要血管:颞浅动脉(TSA)及其分支(上、中、下分支)和耳后动脉(PA)。在小耳畸形组中,14例中有13例(92%)TSA是主要动脉。上支、中支和下支分别出现在4例、3例和0例中。3例小耳畸形耳廓有PA动脉供血,其中1例PA动脉是该区域的唯一供血来源。
健康耳廓和小耳畸形耳廓的血液供应存在很大差异;然而,我们能够在样本中识别出一些趋势。需要进一步研究以证明术前影像学检查对这些患者的益处。尽管如此,根据我们的经验,我们发现它对手术规划很有用。