Yotsuyanagi Takatoshi, Yamashita Ken, Yamauchi Makoto, Nakagawa Tsugufumi, Sugai Asuka, Kato Shinji, Gonda Ayako, Suzuki Akiyo, Onuma Masahiro
Department of Plastic and Reconstructive Surgery, Sapporo Medical University school of Medicine; Sapporo, Hokkaido, Japan.
Plast Reconstr Surg Glob Open. 2019 Jul 26;7(7):e2337. doi: 10.1097/GOX.0000000000002337. eCollection 2019 Jul.
We have already reported surgical procedures for lobule-type microtia that provide an excellent contour and shape of the ear with minimum sacrifice of the donor. We have succeeded in establishing a standard surgical technique for almost all types of concha-type microtia that effectively uses the remnant ear and can use a unified costal cartilage frame.
The concept of our technique is that remnant cartilage should be used maximally but that the deformed area should be completely replaced by the costal cartilage frame. The differences between the cartilage frame for lobule-type microtia and that for concha-type microtia are that the lower half beneath the antihelical area and the concha cymba in the base frame are omitted in concha-type microtia. The area from the tragus to the incisura of the tragus in the antihelical-tragal frame is also omitted. The area of the helical crus in the helical frame and the lower half in the antihelix are not immobilized in the base frame and are free edges. On the other hand, the remnant cartilage outside the concha is removed, but the antitragus is preserved. When the cartilage frame and the remnant are incorporated, all of the components of the ear can be provided.
The ears created by our technique have a natural appearance and clear contour.
我们已经报道了针对小叶型小耳畸形的手术方法,该方法能以最小的供体牺牲提供极佳的耳部轮廓和形状。我们成功地为几乎所有类型的耳甲腔型小耳畸形建立了一种标准手术技术,该技术能有效利用残留耳部,并可使用统一的肋软骨框架。
我们技术的理念是最大程度地利用残留软骨,但变形区域应由肋软骨框架完全替代。小叶型小耳畸形的软骨框架与耳甲腔型小耳畸形的软骨框架的区别在于,耳甲腔型小耳畸形的框架中省略了对耳轮区域下方的下半部分以及基部框架中的耳甲艇。在对耳轮 - 耳屏框架中,从耳屏到耳屏切迹的区域也被省略。螺旋框架中的螺旋脚区域和对耳轮的下半部分在基部框架中不固定,是自由边缘。另一方面,耳甲腔外部的残留软骨被去除,但对耳屏保留。当软骨框架和残留部分合并时,耳部的所有结构都能得以构建。
我们的技术所塑造的耳朵外观自然,轮廓清晰。