Servicio de Dermatología, Hospital General Universitario de Ciudad Real, Ciudad Real, España.
Servicio de Dermatología, Hospital General Universitario de Ciudad Real, Ciudad Real, España.
Actas Dermosifiliogr (Engl Ed). 2020 Sep;111(7):590-599. doi: 10.1016/j.ad.2020.03.002. Epub 2020 Jun 21.
Defects of the anterior region of the pinna pose a reconstruction challenge owing to the complex topography and difficult access. We report our experience using the revolving door island flap (RDIF) to reconstruct pinna defects and present the surgical results.
Retrospective descriptive study of patients undergoing ear reconstruction using RDIF at different sites of the anterior region after resection of malignant tumors.
Seventeen patients underwent surgery between 2011 and 2019 for squamous cell carcinoma (n=7) and basal cell carcinoma (n=10). Conventional histology showed disease-free surgical margins in all the resected tissue specimens. The mean follow-up period was 40 months. One local recurrence of squamous cell carcinoma was observed, which responded well to radiation therapy; all patients were free of disease at the end of follow-up. Only 3 patients presented minor complications (depression of the flap surface in 1 case and retraction of the ear toward the mastoid process in 2 cases). Subjective rating scales were used to evaluate cosmetic and functional outcomes as assessed by both the dermatologist and the patient. The normal contour of the pinna was conserved in all patients and no patients required additional corrective surgery.
Reconstruction of the pinna using RDIF allowed for satisfactory repair following complete resection of the tumors, while conserving structure and functionality. RDIF has been reported to be a very good option for reconstruction of the pinna. It is a simple technique that makes it possible to repair large defects with minimal risk of necrosis. In our series, the cosmetic results were excellent and recurrence rates were very low. RDIF provided optimal results in repairing lesions in the concha and in other regions, such as the antihelix, triangular fossa, and scapha.
由于耳前区的复杂解剖结构和难以到达的位置，该区域的缺损重建极具挑战性。我们报告了使用旋转门岛皮瓣（RDIF）修复耳前区缺损的经验，并介绍了手术结果。
回顾性分析了 2011 年至 2019 年间在切除恶性肿瘤后，不同部位的 RDIF 在前耳区重建的患者资料。
17 例患者因鳞状细胞癌（n=7）和基底细胞癌（n=10）接受了手术。所有切除组织标本的常规组织学检查均显示手术切缘无肿瘤残留。平均随访时间为 40 个月。1 例鳞状细胞癌局部复发，经放射治疗后反应良好；所有患者在随访结束时均无疾病。仅 3 例患者出现轻微并发症（1 例皮瓣表面凹陷，2 例耳向乳突回缩）。皮肤科医生和患者均使用主观评分量表评估美容和功能结果。所有患者均保留了耳廓的正常轮廓，无需进行额外的矫正手术。
在完全切除肿瘤后，使用 RDIF 重建耳前区可获得令人满意的修复效果，同时保留了结构和功能。RDIF 已被报道为重建耳廓的一种非常好的选择。它是一种简单的技术，可以用最小的坏死风险修复大的缺损。在我们的系列中，美容效果非常出色，复发率非常低。RDIF 在修复对耳轮、对耳轮脚、三角窝和舟状窝等部位的病变方面提供了最佳的效果。
