Ersen Burak
From the Odunluk Mahallesi, Mihrapli Cad; and Plastic Reconstructive and Aesthetic Surgery Department, Jimer Hospital, Nilüfer/Bursa, Turkey.
Ann Plast Surg. 2019 Nov;83(5):500-506. doi: 10.1097/SAP.0000000000002025.
Prominent ear deformity is a common congenital deformity of the external ear affecting 5% of the general population. Because of the deformity's displeasing nature, corrective prominent ear surgery is widely common and performed as a prophylactic surgery. More than 200 surgical techniques for the correction of prominent ear deformity have been described to improve the cosmetic outcome and decrease complication rates. The aim of the study was to present a modified post auricular flap technique that increases the control of reshaping the ear cartilages, decreases the operation time, and provides a symmetrical long-lasting cosmetic outcome.One hundred sixty-two patients (141 male and 21 female) had ear correction surgeries performed by the same surgeon using the described technique between January 2015 and January 2018. One hundred sixty patients were gone through bilateral ear correction, whereas only 2 patients had unilateral ear correction procedures. A modified posterior perichondrio-adipo-dermal flap technique for protruding ear correction was applied to all patients.The patients' ages ranged from 18 to 40 years, with a median of 28.3 years. The mean follow-up time was 22.5 months (6-36 months). Total operation time was 35 minutes on average (25-45 minutes). As more experience was gained in flap harvesting, operation time became shorter. The mean preoperative upper third ear proportion-scalp distance was 33.1 mm and the middle third ear proportion-scalp distance was 29.8 mm. At the sixth month of the surgery, the measurements were 9.8 and 11.6 mm.Measuring and adjusting flap's width provided to achieve symmetry in initial technique. Locating the postoperative scar along the posterior surface of the helical groove also provides a natural view. Different from traditional posterior fascial flap, the width of the flap was narrowed to 8 to 10 mm. In the traditional technique, the flap was dissected along the incision margins. Narrowing the width of the flap decreased the operation time. The preserved skin between the helix and the mastoid bone has the same width with perichondrio-adipo-dermal flap. That increases the control over the helix-mastoid distance and posterior auricular fold not to mention provides permanent results. The previously mentioned method can be a simple, useful, and practical technique for protruding ear deformity.
招风耳畸形是一种常见的先天性外耳畸形，影响着5%的普通人群。由于这种畸形令人不悦，矫正招风耳手术广泛常见，且作为预防性手术进行。已经描述了200多种用于矫正招风耳畸形的手术技术，以改善美容效果并降低并发症发生率。本研究的目的是介绍一种改良的耳后皮瓣技术，该技术可增强对耳廓软骨重塑的控制，缩短手术时间，并提供对称且持久的美容效果。
2015年1月至2018年1月期间，同一位外科医生使用所描述的技术为162例患者（141例男性和21例女性）进行了耳部矫正手术。160例患者接受了双侧耳部矫正，而只有2例患者进行了单侧耳部矫正手术。所有患者均采用改良的后软骨膜 - 脂肪 - 真皮皮瓣技术进行招风耳矫正。
患者年龄在18至40岁之间，中位数为28.3岁。平均随访时间为22.5个月（6 - 36个月）。平均总手术时间为35分钟（25 - 45分钟）。随着皮瓣切取经验的增加，手术时间变得更短。术前上三分之一耳廓与头皮的平均距离为33.1毫米，中三分之一耳廓与头皮的平均距离为29.8毫米。在手术后第六个月，测量值分别为9.8毫米和11.6毫米。
在初始技术中，测量并调整皮瓣宽度以实现对称。将术后瘢痕定位在耳轮沟后表面也能呈现自然外观。与传统的后筋膜皮瓣不同，皮瓣宽度缩小至8至10毫米。在传统技术中，皮瓣沿切口边缘进行解剖。缩小皮瓣宽度缩短了手术时间。耳轮与乳突骨之间保留的皮肤与软骨膜 - 脂肪 - 真皮皮瓣宽度相同。这增加了对耳轮 - 乳突距离和耳后皱襞的控制，更不用说能提供永久性效果了。上述方法对于招风耳畸形可能是一种简单、有用且实用的技术。
