Moreno-Vazquez Sofia, Antoñanzas Javier, Oteiza-Rius Inés, Redondo Pedro, Salido-Vallejo Rafael
School of Medicine, University of Navarra, 31008 Pamplona, Spain.
Department of Dermatology, University Clinic of Navarra, School of Medicine, University of Navarra, 31008 Pamplona, Spain.
J Clin Med. 2023 Oct 14;12(20):6521. doi: 10.3390/jcm12206521.
Reconstruction of the auricular concha poses a challenge due to its difficult access and limited tissue flexibility; however, there are no recommendations in the literature on which reconstructive technique should be favored for this anatomical site. This systematic review intends to describe and compare the reconstructive techniques used in conchal bowl reconstruction following cutaneous oncologic surgery of this region, with regard to their complications and aesthetic results. In doing so, we aim to identify the best suited reconstructive procedure(s) for the conchal bowl. The six databases searched (PubMed, Scopus, Web of Science, Ovid, SciELO, and CENTRAL) yielded twelve eligible studies that explored the revolving door flap, split-thickness skin grafts (STSG), full-thickness skin grafts (FTSG), second intention healing, the preauricular translocation flap, subcutaneous pedicle grafts, and other local flaps. Qualitative synthesis of the results concluded that the revolving door flap could be the reconstructive procedure of choice for the auricular concha, following skin cancer excision. It has a low risk of necrosis, infection, and postoperative hemorrhage, as well as excellent aesthetic outcomes. STSG may be used as an alternative. Nonetheless, due to the low sample size and the high risk of bias in some studies, further investigations must be conducted on this subject.
耳甲腔的重建颇具挑战，因其手术入路困难且组织柔韧性有限；然而，文献中并未就该解剖部位应首选何种重建技术给出建议。本系统综述旨在描述和比较该区域皮肤肿瘤切除术后耳甲腔重建所采用的重建技术，包括其并发症和美学效果。在此过程中，我们旨在确定最适合耳甲腔的重建手术方法。检索的六个数据库（PubMed、Scopus、科学网、Ovid、SciELO和CENTRAL）共产生了12项符合条件的研究，这些研究探讨了旋转门皮瓣、断层皮片移植（STSG）、全厚皮片移植（FTSG）、二期愈合、耳前移位皮瓣、皮下蒂移植以及其他局部皮瓣。结果的定性综合分析得出结论，旋转门皮瓣可能是皮肤癌切除术后耳甲腔重建的首选手术方法。它发生坏死、感染和术后出血的风险较低，美学效果也极佳。断层皮片移植可作为一种替代方法。尽管如此，由于一些研究样本量较小且存在较高的偏倚风险，因此必须对该主题进行进一步研究。
