From the Plastic Reconstructive and Aesthetic Surgery Department, Jimer Hospital, Bursa, Turkey.
Ann Plast Surg. 2020 Jan;84(1):20-23. doi: 10.1097/SAP.0000000000001939.
Complications after otoplasty procedure can be divided into early- and late-period complications, with the former occurring up to 14 days postoperatively and the latter occurring after the initial 14-day period. Indications for revision surgery of ear deformations after primary otoplasty are generally related to late complications. The majority of patients demand secondary treatment because of unsatisfactory cosmetic results.
A total of 32 patients (18 male and 14 female patients) underwent revision otoplasty with the same surgeon between May 2015 and May 2018. Patient ages ranged from 24 to 70 years. In total, 21 patients underwent bilateral revision otoplasty, whereas 11 patients underwent unilateral revision otoplasty. Patients were also evaluated for complaint and deformity type such as suture extrusion, recurrence, asymmetry, and postauricular area sensitivity or pain. Patients were also evaluated for previously performed primary otoplasty technique.
There were mainly 4 long-term complications for revision otoplasty: suture extrusion, asymmetry, recurrence, and long-term pain and sensitivity in the posterior auricular area. In 12 cases, the complaint was suture extrusion; in 8 cases, patients complained about both suture extrusion and asymmetry. Bilateral recurrence was present in 10 cases, and in 2 cases, revision otoplasty was performed because of long-term pain and sensitivity.
In this study, it was aimed to demonstrate that posterior perichondrioadipodermal flap is a safe and simple method for revision otoplasty. The technique is highly advantageous if the primary otoplasty technique is a cartilage-sparing method. However, if the primary otoplasty technique is a cartilage-sculpting method, the efficiency of this technique remains unknown because no patient in this study had cartilage-sculpting otoplasty as primary otoplasty, which is possibly the main drawback of this study.
耳成形术后的并发症可分为早期和晚期并发症,前者发生在术后 14 天内,后者发生在最初 14 天之后。初次耳成形术后耳畸形修复手术的适应证一般与晚期并发症有关。大多数患者因美容效果不满意而要求二次治疗。
共有 32 例患者(18 名男性和 14 名女性)由同一位外科医生于 2015 年 5 月至 2018 年 5 月期间行耳畸形修复术。患者年龄为 24 岁至 70 岁,其中 21 例为双侧耳畸形修复术,11 例为单侧耳畸形修复术。还评估了患者的抱怨和畸形类型,如缝线外露、复发、不对称、耳后区敏感或疼痛。还评估了患者先前进行的初次耳成形术技术。
耳畸形修复术的主要长期并发症有 4 种:缝线外露、不对称、复发和耳后区长期疼痛和敏感。在 12 例中,主诉为缝线外露;在 8 例中,患者同时抱怨缝线外露和不对称。双侧复发 10 例,2 例因长期疼痛和敏感而进行了耳畸形修复术。
本研究旨在表明,后软骨膜脂肪瓣是耳畸形修复术的一种安全、简单的方法。如果初次耳成形术采用的是软骨保留技术,该技术具有很高的优势。然而,如果初次耳成形术采用的是软骨雕刻技术,那么这种技术的效果仍然未知,因为本研究中没有患者采用软骨雕刻技术作为初次耳成形术,这可能是本研究的主要缺点。