Maglic Dino, Sudduth Jack D, Marquez Jessica L, Tieman Joshua, Overschmidt Bo, Siddiqi Faizi, Gociman Barbu
Division of Plastic and Reconstructive Surgery, The University of Utah Hospital, Salt Lake City, Utah.
Plast Reconstr Surg Glob Open. 2023 Feb 13;11(2):e4797. doi: 10.1097/GOX.0000000000004797. eCollection 2023 Feb.
The Antia-Buch flap is a popular reconstructive method for full-thickness ear defects involving the helical rim. However, scaphal or conchal resection is often required to prevent ear distortion. Noel et al described a modified technique to the Antia-Buch flap, which includes an incision in the temporal scalp and complete detachment of the preauricular helical root to increase mobility of the flap. Since then, no studies have reported on the use of this modification. We report our experience in implementing Noel et al's modification of the Antia-Buch flap for helical rim defects.
The modified technique differs from the original Antia-Buch flap by completely detaching the root of the helix and adding a vertical incision to the temporal scalp to increase mobility of the flap. No scaphal resection is necessary. After complete elevation of the flaps, the flaps are advanced and inset toward each other followed by closure.
In our practice, 10 patients have been treated with Noel et al's modification to the Antia-Buch flap. In each of these patients, acceptable reconstruction of the helical rim was able to be achieved. All the patients were pleased with their reconstructive outcome and ear anatomy was able to be successfully maintained.
The modified Antia-Buch flap has shown to be an excellent method for large, helical rim defects, creating versatility by adding the temporal scalp incision. Our outcomes with Noel et al's modification to the original Antia-Buch flap support this method as a versatile technique for wide full-thickness helical rim defects.
安蒂亚-布赫皮瓣是一种用于修复累及耳轮缘的全层耳缺损的常用重建方法。然而，通常需要切除舟状窝或耳甲以防止耳朵变形。诺埃尔等人描述了一种对安蒂亚-布赫皮瓣的改良技术，其中包括在颞部头皮做切口并完全游离耳前螺旋根部以增加皮瓣的活动度。自那时以来，尚无研究报道过这种改良技术的应用情况。我们报告了我们应用诺埃尔等人改良的安蒂亚-布赫皮瓣修复耳轮缘缺损的经验。
改良技术与原始的安蒂亚-布赫皮瓣不同之处在于完全游离螺旋根部，并在颞部头皮增加一条垂直切口以增加皮瓣的活动度。无需切除舟状窝。皮瓣完全掀起后，将皮瓣向彼此推进并对位，然后缝合。
在我们的实践中，10例患者接受了诺埃尔等人改良的安蒂亚-布赫皮瓣治疗。在这些患者中，每例均实现了耳轮缘的可接受重建。所有患者对重建效果满意，耳部解剖结构得以成功维持。
改良的安蒂亚-布赫皮瓣已被证明是修复大型耳轮缘缺损的一种极佳方法，通过增加颞部头皮切口增加了灵活性。我们应用诺埃尔等人对原始安蒂亚-布赫皮瓣的改良技术所取得的结果支持该方法作为一种用于广泛全层耳轮缘缺损的灵活技术。
