Lashin Riham, Elshahat Ahmed
Department of Plastic, Burn, and Maxillofacial Surgery, Faculty of Medicine, Ain Shams University, Cairo, Egypt.
J Craniofac Surg. 2024 Feb 1. doi: 10.1097/SCS.0000000000009983.
In adults, the volume of costal cartilage is enough for reconstruction, but floating cartilage is hard, brittle, and easily broken due to calcification, in addition to being short, making it unsuitable for helical rim reconstruction in such age groups.
This study describes a novel technique in which adult patients underwent 2-stage helical rim reconstruction using the syncytium of sixth and seventh costal cartilage.
A single-arm clinical trial involves 35 adults with total and subtotal helical rim defects, either congenital, post-traumatic, postburn, or postvascular malformation excision. Twenty-nine unilateral and 6 bilateral cases. The age of patients ranged between 19 and 40 years. In the period between April 2021 and April 2023. Follow-up was 6 months.
There were no technique-related complications, such as broken helix. In most cases, scars were invisible, with the normal contour of helical rim. Among the 35 patients, 19 were graded as excellent, 13 as good, and 3 as fair. In objective photographic evaluation, all patients were evaluated with high (3 or 4) ratings; the score was 3 in 19 patients and 4 in 16 patients. All patients were satisfied with the size, contour, position and details of the new helix.
Using the syncytium of the sixth and seventh costal cartilage to fabricate the helical rim in adult patients gives a suitable volume of cartilage graft as regards the length and width, which suits the reconstruction of the helical rim, and shows a good configuration with satisfactory surgical results.
在成年人中,肋软骨的体积足以用于重建,但由于钙化,浮动软骨坚硬、易碎且容易折断,此外其长度较短,因此不适合在该年龄组中用于耳轮缘重建。
本研究描述了一种新技术,即成年患者使用第六和第七肋软骨的融合体进行两阶段耳轮缘重建。
一项单臂临床试验纳入了35例患有完全性和部分性耳轮缘缺损的成年人,缺损原因包括先天性、创伤后、烧伤后或血管畸形切除术后。其中29例为单侧病例,6例为双侧病例。患者年龄在19至40岁之间。研究时间为2021年4月至2023年4月。随访时间为6个月。
未出现与技术相关的并发症,如耳轮折断。在大多数情况下,瘢痕不可见,耳轮缘轮廓正常。35例患者中,19例评定为优秀,13例为良好,3例为中等。在客观摄影评估中,所有患者的评分均较高(3分或4分);19例患者评分为3分,16例患者评分为4分。所有患者对新耳轮的大小、轮廓、位置和细节均感到满意。
在成年患者中使用第六和第七肋软骨的融合体制作耳轮缘,在长度和宽度方面能提供合适体积的软骨移植物,适合耳轮缘重建,且形态良好,手术效果令人满意。