ABSTRACT
Congenital or acquired loss of body parts is of common occurrence and replacement of such parts for restoring their lost function and esthetics is done by using various bio‑compatible materials. Proper assessment of the disfigured body parts and a feasible approach to rehabilitating them has for long, been the target of clinical maxillofacial prosthodontics. The aim of this article is to present a case report of such a silicone prosthesis for a patient with a congenital unilateral auricular defect.
ABSTRACT
Objective@#To explore the method and result of repairing segmental ear defect with postauricular skin flap according to different region.@*Methods@#25 partial ear defects were divided into 5 regions.The cases with defect in 1 and 2nd regions were treated by postauricular flap combined with ipsilateral conchal cartilage graft in one stage; Cases in the 3rd regions were repaired with the posterior pedicled flap combined with conchal or rib cartilage graft in two stages; According to the defect in 4th region, post-auricular skin flap was transplanted anteriorly to repair; The temporal fascial flap and skin graft were used for the 3 cases with post-operative cartilage exposure.@*Results@#All flaps survived with good shape except one case with partial epidermal necrosis and 3 cases deep color after the temporal fascial flap and skin graft. 9 cases that needed second operation.@*Conclusions@#The postauricular flap is a preferred alternative method in case periauricular skin is in fact, which yields closer tissue match, color, and texture. It is safe and effective for the correction of segmental ear defect with satisfied shape. The temporal fascial flap can be regarded as the last alternatives.
ABSTRACT
La posición expuesta de la oreja la hace vulnerable a muchos tipos de lesiones, entre las que se encuentran los traumas. Nuestro propósito es presentar un caso clínico en el que se realizó la reconstrucción de una pérdida parcial del pabellón auricular por trauma. Acude al cuerpo de guardia del Hospital Universitario General Calixto García; un paciente masculino de 42 años refiriendo haber perdido un fragmento de oreja en una riña. Se decide realizar hemostasia y fijación mediante puntos de sutura del pabellón auricular remanente a la región temporal, previa incisión en la zona. A los 3 meses del evento traumático se reevalúa con fines de realizar la planificación preoperatoria reconstructiva. Se decide la realizarla mediante injerto de cartílago costal colocado en forma de bolsillo; en la región temporal. Al mes de esta última intervención quirúrgica se realiza, bajo anestesia local, la liberación de la región auricular, el avance de un colgajo temporal y la colocación de un injerto libre de piel en la cara posterior del área reconstruida. Se observa una excelente evolución posoperatoria. El paciente refirió una gran satisfacción por los resultados estéticos obtenidos. En este caso se empleó una secuencia diagnóstica y terapéutica, según elección de los cirujanos involucrados, ante un defecto traumático parcial del pabellón auricular en sus tercios superior y medio. Este tipo de secuela traumática requirió el empleo de procederes quirúrgicos en varios tiempos operatorios que garantizaran un buen aporte sanguíneo de los tejidos y adecuados resultados estéticos finales(AU)
The exposed position of the ear makes it vulnerable to many types of injuries, including traumas. It is our purpose to present a clinical case in which reconstruction was performed of a partial traumatic auricular loss. A 42-year-old male patient presents at the emergency service of General Calixto García; University Hospital and reports having lost a piece of his ear in a fight. It was decided to perform hemostasis and fixation by stitching the remaining section of the auricle to the temporal region, after making an incision in the area. Three months after the traumatic event re-evaluation was conducted with a view to planning reconstructive surgery. It was decided to carry out the reconstruction placing a pocket-shaped rib cartilage graft in the temporal region. One month after the operation, auricular release, advancement of a temporary flap and placement of a free skin graft on the back of the reconstructed area were performed under local anesthesia. Excellent postoperative evolution was observed. The patient reported great satisfaction with the esthetic results obtained. The case herein presented was based on a diagnostic and therapeutic sequence of actions determined by the surgeons involved with a view to correcting a partial traumatic defect of the upper and middle thirds of the auricle. This type of traumatic sequel required the use of surgical procedures at several operative moments ensuring good blood supply to tissues and appropriate final esthetic results(AU)
Subject(s)
Humans , Male , Adult , Ear Auricle/injuries , Ear Auricle/surgery , Ear Cartilage/transplantation , Surgical Flaps/surgery , Wounds and Injuries/diagnosisABSTRACT
PURPOSE: Patients with serious burns are prone to chondritis due to lack of soft tissue in the auricle, which can cause severe defects in the auricular morphology. In addition, skin damage occurs frequently in the vicinity of post-burn wounds, presenting difficulties in reconstruction surgery. An auricular reconstruction has functional and cosmetic significance. The aim of this study is to develop appropriate reconstruction methods for auricular defects. METHODS: Thirty seven patients, who were treated for auricular defects from 2005 to 2009, were enrolled in this study. A local flap, multiple regional flaps and cartilage framework with or without a temporal fascial flap were applied in reconstruction surgery according to the location of the auricular defect. RESULTS: The age of the subjects ranged from 11 to 56. Some subjects had defects that cover more than half of the helical rim with most exhibiting post-burn scars in the vicinity, for whom a multiple regional flap was used. A single use of a tubed flap was sufficient for subjects with defects that covered less than half of the helical rim. A regional flap was also used for reconstruction in subjects with defects covering both the helical rim and antehelix. CONCLUSION: Achieving satisfactory results from the skin flaps and skin grafts for post-burn auricular defects in both functional and cosmetic aspects is a difficult task. Therefore, selecting an appropriate surgical method through proper diagnosis of the auricular defect and the state of the available skin in the vicinity is essential.