Application analysis of a modified retroauricular hairline incision in the resection of a benign parotid gland tumor / 华西口腔医学杂志

OBJECTIVES@#This study aimed to evaluate the application value of a modified retroauricular hairline incision and a sternocleidomastoid flap with an inferior pedicle in the resection of benign parotid gland tumors.@*METHODS@#Forty-eight patients with benign parotid gland tumors were retrospectively analyzed: 19 cases were included in the experimental group with an improved retroauricular hairline incision and a sternocleidomastoid flap with an inferior pedicle, and 29 cases were assigned in the control group with a modified facelift incision. Operation time, postoperative drainage, postoperative esthetic degree, and incidence of facial nerve paralysis, salivary fistula, and Frey's syndrome were compared.@*RESULTS@#After the esthetic procedure, the average score of the experimental group was higher than that of the control group, and the esthetic effect of the former was better than that of the latter (@*CONCLUSIONS@#The modified retroauricular hairline incision and sternocleidomastoid flap with an inferior pedicle can be applied to resect benign parotid gland tumors safely. It shows a better cosmetic effect and does not cause obvious postoperative complications. Therefore, it should be promoted for tumor treatments.

The management of auricular defect using retroauricular flap

Management of auricular defect is still a challenge for reconstructive plastic surgeons. The complexity of anatomy and shape will make the reconstruction complicated. It is also inevitable that choosing the right donor to close the defect that resembles the original contour is one of the success indicators of any ear reconstruction. There are wide selections of techniques for the management of auricular defect. Retroauricular flap is one of the best choices in auricular reconstruction due to its vascular richness, low of failure rate, similarity of tissue contour and the ease of closing the donor-site defect primarily. This article reported three cases of auricular defect with various causes: crushed injury, human bite, and tumor excision. Two stages of surgeries were performed on all three patients. After sufficient debridement, the ear defect is planted beneath retroauriculomastoid dermis. The second stage, three weeks from the first surgery, the donor flap is separated from it host. One week follow up after the second stage surgery, all of the post-operative wounds showed no signs of infection, minimal scar formation and has satisfied aesthetic outcomes. The retroauricular flap has the advantages of simple dissection, low failure rate and has a good shape, texture, color for a very good aesthetic results. This flap may be considered as a good solution in the management of auricular defect and a flap bank for ear reconstruction.

Removal of benign tumor in the lower pole of the parotid gland through concealed incision in the retroauricular sulcus / 口腔疾病防治

Objective @#To assess the safety and feasibility of incision in the retroauricular sulcus for removal of benign tumors in the lower pole of the parotid gland and to provide some ideas for aesthetic consideration of parotidectomy.@*Methods@# In total, 18 cases with benign tumors of the lower pole regions of the parotid gland were included in this study, including 9 pleomorphic adenomas, 2 myoepitheliomas, 5 Warthin tumors, 1 basal cell adenoma and 1 oncocytoma. Three months after the operation, facial paralysis and salivary fistula were assessed. A visual analog scale was used to score the cosmetic satisfaction of the surgical incision. Tumor recurrence was followed up 6 ~ 12 months after operation.@*Results@# In 18 patients with benign tumors the lower pole regions of the parotid gland, the tumor diameter ranges from 1.0 to 3.1 cm, with an average value of 2.5 cm. All patients experienced successful complete removal of the parotid mass with the minimally invasive retroauricular approach, and all wounds healed in one stage after operation. No serious complications, such as permanent facial paralysis and tumor recurrence, occurred 3 months after the operation. The patients were satisfied with the appearance of the surgical incision (aesthetic score 9.3 ± 0.4), achieving the expected aesthetic effect. @*Conclusion@#This approach is feasible and safe for most small benign parotid tumors located in the lower pole region of the parotid gland and in the posterior region of the jaw. The scar is located in the retroauricular sulcus, which significantly meets the aesthetic needs of the concealed incision for patients.

Natural sideburn reconstruction with retroauricular expanded flap with original hairline / 中华整形外科杂志

Objective@#To introduce a reconstruction procedure of natural sideburn, with combined expanded retroauricular flap and scalp flap.@*Methods@#A retrospective study was produced in Plastic Surgery Hospital, PUMC, from January 2014 to December 2017. Twenty patients (21 sides) underwent sideburn reconstruction with combined expanded retroauricular flap and scalp flap (double pedicled flap, n=3; single pedicled flap, n=17) were included in this study. There were 12 male (12 sides) and 8 female (9 sides), with the mean age of (23.8±3.2) years. The sideburn defect was caused by burn in 19 patients, and it was resulted from hemangioma in 1 patient.@*Results@#The size of flaps ranges from 8 cm×12 cm to 10 cm×16 cm. Venous congestion at the distal end of the flap occurred in 1 patient, which was cured after dressing change, and the sideburn was not affected. The reconstructed sideburns are natural, symmetric, and without obvious scar. The follow-up time was 3-40 months. Fourteen patients were very satisfied with the reconstructed sideburn, and 6 patients were satisfied. No severe complication was observed during follow-up time.@*Conclusions@#The combined retroauricular flap and scalp flap is an alternative method for sideburn reconstruction, which provide natural hair distribution, inconspicuous scars and less complications.

Reconstrucción auricular traumática con colgajo retroauricular. Una alternativa vigente y reproducible para los médicos residentes en formación / Traumatic auricular reconstruction with a retroauricular flap. A current and reproducible alternative for resident doctors in training

Resumen Introducción La reconstrucción auricular traumática es un reto para el cirujano plástico. Su objetivo es reproducir y recrear la forma y topografía de la región auricular, haciendo que los estigmas propios de la reconstrucción sean mínimos. Caso clínico Se presenta el caso de un paciente varón de 5 años de edad, con lesión por mordedura de perro en la oreja derecha, y lesión corto-contusa en pabellón auricular con pérdida de cobertura cutánea, pérdida parcial de cartílago auricular y exposición cartilaginosa a nivel de hélix y porción retroauricular. Se realizó reconstrucción auricular mediante reparación auricular y colgajo retroauricular. En un segundo tiempo quirúrgico, se realizó sección de la base del colgajo, y se logró un adecuado contorno auricular, así como cobertura cutánea definitiva Conclusiones Las lesiones auriculares, por su situación anatómica, son frecuentes en la práctica profesional de un cirujano plástico y reconstructivo. Existen múltiples técnicas quirúrgicas para la reconstrucción de defectos auriculares, sin embargo, el colgajo retroauricular ofrece una técnica sencilla y versátil.

Abstract Introduction Traumatic auricular reconstruction is a challenge for the plastic surgeon. The purpose of this reconstruction is to reproduce and recreate the shape and topography of the auricular region, diminishing the typical stigmas of a reconstruction. Clinical case The case of a 5-year-old male patient with right bite of a dog in a right ear presenting a short-contusional lesion in the auricular hall with loss of cutaneous cover, partial loss of atrial cartilage and cartilage exposure At the level of helix and retroauricular portion. Auricular reconstruction is performed by atrial repair and retroauricular flap. In a second surgical time, a section of the base of the flap is performed, achieving a suitable atrial contour and definitive skin coverage. Conclusions Auricular injuries, due to their anatomical situation, are frequent in the professional practice of a plastic and reconstructive surgeon. There are multiple surgical techniques for the reconstruction of atrial defects, however, the retroauricular flap offers a simple and versatile technique.

Retroauricular pain caused by Eagle syndrome: A rare presentation due to compression by styloid process elongation / Dor retroauricular causada pela síndrome de Eagle: uma apresentação rara por compressão pelo alongamento do processo estiloide

Summary Eagle syndrome is a rare condition presenting with retroauricular pain (usually as main symptom) associated with dysphagia, headache, neck pain on rotation and, much rarelier, stroke. This occurs due to styloid process elongation. Sometimes, there is also styloid ligament calcification, which can cause compression of nerves and arteries and the symptoms above. Treatment can be conservative with pain modulators (e.g. pregabalin) or infiltrations (steroids or anesthetics drugs). In refractory cases, surgical approach aiming to reduce the size of the styloid process can be performed. We present a rare case of Eagle syndrome (documented by computed tomography) with good response to clinical treatment.

Resumo A síndrome de Eagle é uma condição rara na qual ocorre dor retroauricular (usualmente é o principal sintoma) associada a disfagia, cefaleia, cervicalgia durante a rotação da cabeça e, mais raramente, a AVC. Isso ocorre por conta do alongamento do processo estiloide e, às vezes, há também calcificação do ligamento estiloide. Essas estruturas podem comprimir nervos e artérias causando os sintomas citados. O tratamento pode ser conservador com moduladores da dor, como pregabalina, ou com infiltrações (corticoides ou drogas anestésicas). Em casos refratários, cirurgia para reduzir o tamanho do processo estiloide pode ser realizada. É apresentado um caso raro de síndrome de Eagle (documentado com tomografia computadorizada) com boa resposta ao tratamento clínico.

Retroauricular Thyroidectomy Using a New Flexible, Single-Port Robotic Surgical System / 대한이비인후과학회지

This study aimed to assess a new flexible, single-arm robotic surgical system to retroauricular thyroidectomy. Three fresh cadavers were used. Technical elements of the system and the whole surgical procedures were described in detail. This single-port flexible system could be used to successfully perform retroauricular thyroidectomy. The ideal angle to dock the patient-side cart was at a 90-degree angle to the operating table. When the cannula tip was placed 10–15 cm away from the skin incision, positioning and full movement of all four instruments without collisions were possible. Flexible three instruments and a stereoscope made the robotic dissection more efficient, safe and time-saving. We report the first preclinical evaluation of an innovative, flexible, single-arm robotic surgical system for retroauricular thyroidectomy.

Application of functional parotidectomy via retroauricular hairline incision in the excising superficial parotid tumor / 中华耳鼻咽喉头颈外科杂志

Objective@#To evaluate the usefulness of retroauricular hairline incision (RAHI) in partial superficial parotidectomy (PSP) by comparison with modified Blair incision (MBI).@*Methods@#A retrospective analysis of 64 medical records for patients with benign parotid tumors who underwent partial superficial parotidectomy was undertaken (28 were in MBI group, 36 in RAHI group). Size and location of tumors, operative time, occurrence of facial nerve paralysis and Frey′s syndrome, and cosmetic outcomes were compared between RAHI and MBI groups.@*Results@#Compared with MBI group, RAHI group showed better cosmetic results for benign parotid tumors in mean satisfaction score(P<0.001). There were no significant differences in size and location of tumors, operative time, incidence of transient or permanent facial nerve paralysis and Frey′s syndrome between two groups (P>0.05).@*Conclusions@#Partial superficial parotidectomy can be performed safely via RAHI in most cases of benign parotid tumors. Compared with MBI, RAHI for benign parotid tumorscan improve the cosmetic outcome, without increasing the operative time or operative morbidity.

Partial Superficial Parotidectomy via Retroauricular Hairline Incision

OBJECTIVES: The purpose of this study was to evaluate the usefulness of retroauricular hair line incision (RAHI) in partial superficial parotidectomy by comparison with modified Blair incision or facelift incision. METHODS: Medical records of 73 patients with benign parotid tumor who underwent partial superficial parotidectomy were retrospectively reviewed. Size and location of tumors, operative time, occurrence of facial nerve paralysis and Frey's syndrome, and cosmetic outcomes were compared among RAHI, facelift incision (FLI), modified Blair incision (MBI) groups. RESULTS: RAHI group showed better cosmetic results than FLI group or MBI group compared with other type of incisions (P0.999), occurrence of temporary or permanent facial nerve paralysis (P=0.745) and Frey's syndrome (P=0.940). CONCLUSION: Partial superficial parotidectomy can be done safely by RAHI in most cases of benign parotid tumor. Compared with MBI or FLI, RAHI has better cosmetic outcome with no increase of operative time or postoperative complications.

Reconstrucción parcial del pabellon auricular con colgajo retroauricular / Partial reconstruction with flap pinna retroauricular

El pabellon auricular por su situación anatómica se encuentra susceptible a una serie de lesiones traumáticas y/o patológicas, por lo que su reconstrucción es un verdadero desafío para el área quirúrgica encargada de mantener la simetría con el pabellon contralateral como su compleja estructura. Presentamos el caso clínico de un paciente con pérdida del borde helical, posterior a mordedura humana, reconstrucción del daño mediante colgajo retroauricular, una técnica versátil, sencilla que requiere siempre cumplir con todos los requisitos de orden técnico-quirúrgicos de tratamiento de movilización de colgajos.

The earlobe, due to its exposed situation, is susceptible to a variety of traumatic and/or pathologic lesions, therefore its reconstruction is a real challenge for surgery in order to maintain symmetry with the earlobe on the opposite side as its complex structure. Therefore we present the case of a patient with loss of the posterior helical border after a human bite. The damage was cured by retroauricular skin graft, a versatile, simple technique which requires always the fulfilment of all surgical technical requirements of treatment by movilization of skin grafts.

Paroxysmal Stabbing Headache in the Retroauricular Regions

BACKGROUND: Paroxysmal stabbing or ice pick-like headaches located in the extratrigeminal areas are not uncommon in clinical practice. However, clinical characteristics of acute stabbing headaches initially presented in the retroauricular regions have rarely been described in detail. METHODS: Among the subjects referred to Hallym University Medical Center, due to the acute-onset stabbing headache during the last five years, sixty-six consecutive patients in which stabbing symptoms were confined to the retroauricular regions at initial presentation were prospectively included. RESULTS: All patients were neurologically and otologically considered to be normal at the initial presentation. The nature of pain lasted for short intervals of time, and were moderate to severe in intensity for most patients. All but five ran a self-limited benign course, recovering completely in 3 days to 30 days, mostly within 2 weeks. During the clinical course, subsequent Bell's palsy developed in 2 patients, and otic or cervical zoster lesions followed in three cases. Those among the 61 subjects with unknown etiology, the headaches were preceded by flu-like symptoms or upper respiratory tract infections in 21 subjects (34%) and physical, mental or both kinds of stresses were reported in 15 subjects. CONCLUSIONS: Most of paroxysmal stabbing headaches confined to the retroauricular regions are very short-lasting in nature, and show self-limiting and benign course, suggesting lesser occipital neuralgia or a variant of primary stabbing headache involving cervical nerves. However, the possibility of subsequent zoster infection or peripheral type of facial palsy should be considered, even though neurologically not remarkable at initial presentation.

Application of retroauricular fascial flap to postburn auricular reconstruction / 第三军医大学学报

Objective To introduce a new technique of one-stage auricular reconstruction by using the retroauricular fascial flap. Methods The retroauricular fascial flap was designed to cover a cartilage framework for auricular reconstruction. Results Seventeen cases who had injured over two years and received no surgical treatment, underwent auricular construction. In 3-month to 2-year follow-up, all patients obtained satisfactory appearance of the reconstructed ears that possess delicate structure and close color to adjacent skin. Conclusion For retroauricular fascial flap has adequate blood supply, it makes operating procedure simple and the occurrence rate of complication reduced. It is proven that this is a good method of auricular reconstruction.

A Case Report of Correction of Cryptotia / 대한이비인후과학회지

Cryptotia is a congenital auricular anomaly found more commonly in orientals than whites. It is characterizaed by the invagination of the upper part of the auricle under the temporal skin and deformity of the auricular cartilage. Surgeries to correct cryptotia principally involves addition of skin to the deficient retroauricular sulcus and cartilage plasty. We have developed a surgical method using modified retroauricular flap and have obtained good result without complication. We hereby report a surgical case with discussion and review of literatures.

A Case of Recurrent Preauricular Cyst Treated with Retroauricular Transposition Flap Using Superior Auricular Artery / 대한이비인후과학회지

The retroauricular flap has been known as a useful material for reconstruction of nose, auricle, and other facial area. A key point of success using a retroauricular flap in the reconstruction surgery is the preservation of feeding artery. This method also has advantages of co-transplantation of hair, a good color match for the face, and of not having to leave a conspicuous donor site. Two main blood vessels of retroauricular flap are posterior auricular and superior auricular artery. Although the former has been widely used, the retroauricular transposition flap using the latter is easier and time-saving than other techniques in the reconstruction of anterosuperior defect of auricle. Recently, we experienced a case of recurrent preauricular cyst, reconstructed with retroauricular transposition flap using superior auricular artery and report this case with literature review.

A Case of Dermoid Cyst / 대한피부과학회지

A 13-year-old male presented a single, elevated, oval, walnut sized, soft mass on the left retroauricular ares which has increased in size since birth, Histopathologic examination revealed a cyst in the subcutaneus area. Cyst wall is lined by normal epiderrnis and cyst cavity contains hairs and keratinous materials.