Rendón-Medina Marco Aurelio, Hanson-Viana Erik, Arias-Salazar Leidy, Rojas-Ortiz Jorge Arturo, Mendoza-Velez Maria de Los Angeles, Hernandez-Ordoñez Rubén, Vázquez-Morales Hecly Lya, Pacheco-López Ricardo C
Department of Plastic and Reconstructive Surgery, The General Hospital "Ruben Leñero," México City, México.
Plast Reconstr Surg Glob Open. 2022 Oct 13;10(10):e4580. doi: 10.1097/GOX.0000000000004580. eCollection 2022 Oct.
The anatomic position of the auricle leaves it vulnerable to traumatic lesions. In most cases, the best reconstructive outcome is accomplished using a temporoparietal flap with a costal cartilage frame and a partial thickness skin graft. Exceptional cases may require different approaches because the reconstructive goals could be more structural than aesthetic. An important factor in this regard is the mechanical properties of the skin that will provide coverage. This study aimed to share a particular case of total auricular reconstruction assisted by 3D surface imaging and 3D printing in a radial forearm free flap. We present a 58-year-old man with a history of having tympanic barotrauma causing hearing loss, burdening him with the use of auricular devices for hearing assistance. Seven days before presenting for the initial treatment, he sustained ear trauma while performing mechanical reparations in a car. The wheel was activated, causing a total amputation of the right ear. He first went to another hospital' where they performed primary closure and then referred him to our unit. The team performed a prelaminated radial forearm free flap assisted by 3D scanning and planning. A detailed comparison between the left ear and the result of the reconstruction was measured and described. The radial forearm prelaminated free flap is a viable structural alternative with the disadvantage of poor auricular definition in some cases.
耳廓的解剖位置使其易受创伤性损伤。在大多数情况下，使用带有肋软骨框架和部分厚度皮肤移植的颞顶皮瓣可实现最佳的重建效果。特殊情况可能需要不同的方法，因为重建目标可能更多是结构性的而非美观性的。在这方面，一个重要因素是提供覆盖的皮肤的机械性能。本研究旨在分享一例在桡侧前臂游离皮瓣中借助三维表面成像和三维打印辅助进行全耳廓重建的特殊病例。我们报告一名58岁男性，有鼓膜气压伤导致听力损失病史，使用耳廓助听装置给他带来负担。在初次就诊前7天，他在汽车上进行机械维修时耳部受伤。车轮转动，导致右耳完全离断。他先去了另一家医院，在那里进行了一期缝合，然后转诊至我们科室。该团队在三维扫描和规划辅助下进行了预构的桡侧前臂游离皮瓣手术。对左耳与重建结果进行了详细比较并予以描述。桡侧前臂预构游离皮瓣是一种可行的结构性替代方案，但在某些情况下存在耳廓外形不佳的缺点。
