Reconstruction of anterior auricular defect with postauricular island / 中华医学美学美容杂志

Objective:To investigate the clinical effect of postauricular island flap in reconstruction of anterior auricular defect.Methods:Twelve patients with auricular tumors were retrospectively analyzed in the Department of Aesthetic Plastic and Craniofacial Surgery, the First Affiliated Hospital of Xi'an Jiaotong University. After the tumors were completely removed, the skin defects were repaired with retroauricular island flaps, and the clinical results of the flaps were observed.Results:All the twelve postauricular island flaps were survived postoperatively. One of the flaps had the disorder of blood supply. After puncture with the needle, the congestion was drained out and the flap survived finally. During 1 to 2 years' follow-up, all patients were well satisfied with the surgical results.Conclusions:The posterior auricular island flap in reconstruction of anterior auricular defect has the advantages of simple and easy operation, high survival rate, small scar in the donor area and good aesthetic effect, which is worthy of clinical promotion.

Clinical comparison of modified postauricular transverse incision and traditional vertical incision for microvascular decompression in the treatment of hemifacial spasm / 中国医师进修杂志

Objective:To compare the effect of modified postauricular transverse incision and traditional vertical incision for microvascular decompression in the treatment of hemifacial spasm.Methods:Prospective study method was used. A total of 116 patients with hemifacial spasm in Handan Central Hospital from January 1, 2019 to January 1, 2020 were selected, and divided into two groups according to the admission order. Both groups underwent microvascular decompression; control group (57 cases) received traditional vertical incision, while treatment group (59 cases) received modified postauricular transverse incision. The brainstem auditory evoked potential (BAEP), pain degree, surgical indicators, facial aesthetic satisfaction and complications were compared between two groups.Results:After treatment, the BAEP of latency, wave interval and wave amplitude in the two groups increased compared with that before treatment, and the BAEP of latency, wave interval and wave amplitude in the treatment group were higher than those in the control group: (1.89 ± 0.15) ms vs. (1.62 ± 0.21) ms, (7.89 ± 0.15) ms vs. (6.25 ± 0.41) ms, (1.79 ± 0.19) ms vs. (1.54 ± 0.11) ms ( P<0.05). After treatment, the visual analogue score (VAS) of patients in the two groups decreased compared with that before treatment, and the VAS of patients in the treatment group was lower than that in the control group: (1.15 ± 0.27) points vs. (2.18 ± 0.24) points ( P<0.05). The operation time, intraoperative bleeding volume and postoperative scar length of patients in the treatment group were less than those in the control group: (60.41 ± 3.81) h vs. (76.87 ± 3.87) h, (30.18 ± 4.19) ml vs. (56.87 ± 4.15) ml and (4.18 ± 1.07) cm vs. (6.87 ± 1.05) cm ( P<0.05). The satisfaction rate of patients in the treatment group was higher than that in the control group: 91.53% (54/59) vs. 71.93% (41/57) ( P<0.05). The complication rate of patients in the treatment group was lower than that in the control group: 5.08% (3/59) vs. 21.05% (12/57) ( P<0.05). Conclusions:Compared with traditional vertical incision, the modified transverse incision for microvascular decompression in the treatment of hemifacial spasm can reduce intraoperative blood loss and postoperative scar area, enhance brainstem auditory evoked potential, and improve facial aesthetics, which is worthy of recommendation.

Comparative Study of Outcome of Tympanoplasty by Postauricular and Permeatal Approach

Background: As from time of residency, tympanoplasty is the most common operation performed by an otolaryngologist. Because of the continuing efforts of otologists all around the world to produce the maximum surgical outcome, significant improvements in this surgical method have developed during the middle ages. Objective: The aim of the study was to compare the outcome of Tympanoplasty in Postauricular and Permeatal Approach.Methods:A total of 74 patients between the age group 15 to 44 years who were attending the ENT OPD, suffering from Chronic Suppurative Otitis Media (CSOM) were selected on the basis of type of perforation and their workup was done to assess the candidature for tympanoplasty. Comparative analysis between the two groups were done based on analysis using SPSS 24 software version. The level of significance was set to 5% (p < 0.05).Results:A total of 74 patients were included in the study and the overall graft take was 76.92% in cases of Permeatal technique as compared to 91.66% in the case of postaural underlay technique. The complication of postaural approach higher than Permeatal approach. There was a difference in hearing improvement with majority of the cases improving to the range of 10-22 dB in Permeatal technique compared to 08-18 dB in Postaural Underlay technique.Conclusion:In terms of complications and hearing improvement, the Permeatal method outperforms the Postauricular Approach, however the graft takes a higher percentage in the Postauricular Approach than the Permeatal Approach.

Kimura Disease as a Rare Cause of Proptosis: A Case Report

ABSTRACT@#Kimura disease (KD) is a rare chronic inflammatory disorder of unknown aetiology that primarily affects the head and neck region with lymph node involvement. Young to middle-aged adult Asian males are predominantly affected. The most common presentation is painless subcutaneous swelling in the head and neck region, while proptosis or orbital involvement is very rarely reported. KD shares some features with other inflammatory and neoplastic disorders, including lymphoma; thus, investigations to confirm the diagnosis should not be delayed. Systemic corticosteroids are commonly used to treat KD and show an excellent response; however, the optimal treatment is still uncertain, and KD has a high recurrence rate. We describe the case of a patient with KD who presented with proptosis and post-auricular swelling, which responded well to oral prednisolone treatment.

A novel surgical technique for neck neoplasms: endoscope-assisted resection of benign tumors via a small concealed incision / 中华口腔医学杂志

Objective@#To introduce a new surgical procedure for the treatment of neck benign tumors by endoscopic techniques.@*Methods@#Seventeen patients with neck benign tumor underwent surgery by endoscope through a concealed incision in Department of Oral and Maxillofacial Surgery, Qilu Hospital of Shandong University from January 2018 to August 2019 were analyzed, which included 3 cases of tumor in the submental area, 2 cases in submandibular region, 9 cases in lower pole region of parotid gland, 1 case in superior region of sternocleidomastoid muscle, 1 case in central region of sternocleidomastoid muscle, 1 case in inferior region of sternocleidomastoid muscle. All patients underwent routine preoperative examination and CT examination to evaluate tumor size, boundary, morphology and nature. According to the area where the tumor located, concealed incisions in different sites were designed. Lumps in the submental area and submandibular area were treated with oral vestibular sulcus incision. Benign tumors located in the lower pole region of parotid gland and the sternocleidomastoid muscle region were treated with approach of the short hidden postauricular incision. During the operation, the self-developed "maxillofacial suspension device" was used to provide the operating space. The tumors were completely removed with endoscope and all patients were followed up every 3 months.@*Results@#All surgical procedures were performed as expected. Visual analogue scale (VAS) was 9.3 on average at 3 months after operation, all the patients were satisfied with the incision design and the cosmetic effect. No recurrences were found in patients with a follow-up period ranged from 1-15 months.@*Conclusions@#These studies have shown that endoscope-assisted neck benign tumor resection is a surgical procedure with covert incision and good cosmetic results.

Postoperative Complications of Different Incisions of Parotidectomy in Benign Parotid Tumor and the Impact on Life Quality / 现代生物医学进展

Objective:To explore the postoperative complications of different incisions of parotidectomy in benign parotid tumor and the impact on life quality.Methods:62 patients with benign parotid ttmor underwent improved parotidectomy in our hospital from January 2010 to January 2015 were selected and randomly divided into group A and group B.The patients in group A were using improved S incision,and the patients in group B were using postauricular concealing incision.Then the perioperative indexes,complications after surgery and the influences to life quality of 2 groups were observed and compared.Results:The surgery time,blood loss,postoperative suction drainage and hospital stays of 2 groups had no great differences (P＞0.05).The early and forward complication rate of group A was 29.03 ％ and 25.81％ respectively,of group B was 19.35 ％ and 12.90 ％ respectively.There were no differences between them (P＞0.05).The scores of pain and emotion after surgery of group A were getting better,and appearance,smell and chewing function was getting worse than before surgery with statistically significance (P＜0.05).The scores of pain and emotion after surgery of group B were getting better than before (P＜0.05).The scores of appearance and emotion of group A were worse than those of group B with statistically significance (P＜0.05).Conclusions:Using postauricular concealing incision can obtain good life quality and safety for the patients with benign parotid tumor,which is superior to improved S incision,worthy of clinical applications.

A Case of Dermoid Cyst on the Posterior Auriculocephalic Sulcus / 대한피부과학회지

No abstract available.

Efifcacy of combined postauricular methylprednisolone injection and systemic therapy for profound Idiopathic sudden hearing loss / 中国耳鼻咽喉头颈外科

[ABSTRACT]OBJECTIVETo investigate the efficacy and the related complications of combinedpostauricular methylprednisolone injection and systemic therapy for profound idiopathic sudden hearing loss (ISSNHL). METHODSTotal of 60 patients with ISSNHLwho had received therapy from June 2014 to May 2015 in Beijing Anzhen Hospital affiliated to Capital University of Medical Science,were randomly divided into 2 groups,the systemic application group (30 patients): dexamethasone (DEX) was applied intravenously in dose of 10 mg×5 d, and the postauricular injection group (30 patients): methylprednisolone sodium suecinate was injected subperiosteally near the upper one-thirds of postauricular sulcus every day, 40 mg×5 d.All 60 patients received the same medications for 2 weeks to improve the hearing. Hearing and tympanic membrane were monitered before the injections and two weeks after the termination of injections. SPSS 16.0 software was used to analyze the data.RESULTSThe postauricular injection group: 23 of 30 ears had improvement of hearing. No related complications were reported. The systemic application group: 23 of 31 ears had improvement of hearing (P>0.05) No related complications were reported.CONCLUSIONCombined postauricular methylprednisolone injection and systemic medications therapy can be considered as is an effective therapy for profound idiopathic sudden hearing loss. It can avoid the side-effects of high dose systemic corticostemid treatment. For ISSNHL patients, postauricular methylprednisolone injection may be an appropriate treatment.

PRE-AURICULAR SINUS: AN UNCOMMON PRESENTATION

An infected pre-auricular sinus presenting as a post-auricular swelling is commonly misdiagnosed as an infected dermoid or sebaceous cyst. It may even mimic a mastoid abscess leading to further unwarranted investigations and interventions. We present a case of a 25-year-old Malay man who was initially diagnosed with recurrent infected dermoid cyst. At presentation, a right post-auricular inflamed swelling was noted with an overlying old incision and drainage scar. An auricular pit was found at the crus of helix. Using a blunt probe inserted along the sinus tract pus was drained without the need for further surgical incision. Six weeks after the acute episode, patient underwent excision of the pre-auricular sinus with no evidence of recurrence at three months follow up. Awareness by the attending physician of this ‘variant type’ of pre-auricular sinus at patient’s first presentation may negate the need for unnecessary incision and drainage which may subsequently impact the outcome of surgical excision and reduce the risk of recurrence.

Postauricular Island Pedicle Flap ("Flip-Flop" Flap) for Reconstruction of the External Ear Defect / 대한피부과학회지

About six percent of head and neck cancers occur on the external ears. Excision of the cancer can cause changes of morphology and poor cosmesis. Reconstruction of ear defects presents a unique and notable challenge to the dermatologic surgeons. This is due to the complex architecture of the external ear which is difficult to duplicate surgically. Several methods are available for reconstruction of defects to the external ear. However, the diversity of external ear shapes shows how difficult it is to achieve a certain solution to this problem. Postauricular island pedicle flap was initially reported as a technique for reconstruction of small defects of the concha after excision, and has since been used successfully in the repair of more extensive defects involving not only the concha, but also the antihelix and external auditory meatus. We report two cases of auricular squamous cell carcinoma in which the skin defect is reconstructed by a postauricular island pedicle flap ("flip-flop" flap).

Harvesting Various Kinds of Grafts from Postauricular Region

Harvesting grafts at another area in facial surgery would be complicating and troublesome. Moreover the additional scar would be remarkable. So authors have harvested grafts from the postauricular area. Between March of 2004 and January of 2008, we had harvested grafts from the postauricular area in 132 patients. We incised along the postauricular hair line. We made deep incision until we found adequate tissues. Then we dissected to the side as much as the right size. After harvesting, we closed the wound and made an aseptic compressive dressing. We compared pre-operative states to post-operative results with medical photos and made a survey of the patient's degree of satisfaction. We obtained various grafts such as the skin, hair, dermis, dermofat, fascia, fasciofat and bone from the postauricular area. We could use these in the eyelid, nose, chin, scar and anywhere. The fat graft was useful in the thin area such as eyelid. We got good results by using dermofat graft in nasal dorsum and fasciofat graft in nasal tip area. The scar was not seen in the frontal view and camouflaged by the hair easily. By harvesting grafts from the postauricular area, we can get various grafts in the same operative field and this procedure is very simple. Moreover the scar is not seen easily. Therefore this method is not only the good choice but also the best choice of the graft donor site.

Schwannoma in the Postauricular Sulcus being Misdiagnosed as Lipoma: A Case Report

Schwannomas or neurilemmomas are the most often found as solitary, slow-growing, asymptomatic, well-encapsulated, firm yet transversely mobile benign mass in head and neck region. Most of Schwannomas appear in the cranial nerve, especially vestibular nerve, but must always be considered to be able to appear in any parts where the nerve tissues are distributed. Sometimes, inaccurate preoperative clinical diagnosis leads to accidentally resecting the affected nerve and produces permanent neurological deficits. We experienced a extremely rare schwannoma being confused with lipoma in upper left postauricular sulcus. After simple mass excision without considering possibility of schwannoma, the patient complained of dull sensation and pinprick pain in the superior part of the ipsilateral postauricular area. When clinical symptom and physical examinations are insufficient to distinguish schwannoma from other benign soft masses, and the mass along the critical nerve pathway can possibly be originated from the designated nerves, we would like to recommend radiologic examinations such as ultrasonography and/or MRI for correct diagnosis prior to operation. Moreover, when it is adjacent the neurovascular structures, meticulous microscopic surgery must always be performed so as not to impair the important structures.

A electroneurographic technique of the facial nerve / 实用口腔医学杂志

砄bjective: To explore an effective method for Electroneurography(ENoG) of facial nerve. Methods: ENoG of 114 normal subjets and 69 patients with traumatic facial nerve injuries were investigated. Latency time(LT), duration time(DT), amplitude(A) and square under the curve(S) were measured in facial muscles when facial nerve was stimulated postauricularly or anteroauricularly. Results: In most facial musles except square muscle of lower lip postauricular stimulation gave longer LT, shorter DT, lower A and smaller S. Conclusion: The postauricular stimulation is effective prior to anteroauricular stimulation for electroneurography of the facial nerve.

Primary Ectopic Malignant Meningioma

We report a very rare case of ectopic malignant meningioma in the postauricular area. The patient had suffered postauricular headache for four months, and brain magnetic resonance imaging revealed a large mass extending from the base of the skull to the cervical vertebra; there was, however, no intracranial lesion nor connection with the dura mater. Subtotal removal involved the postauricular approach and malignant meningioma was histologically diagnosed. Metastasis to the right side of the neck and the lung developed nine and sixteen months later, respectively.

Postauricular Subperiosteal and Bezold's Abscesses Complicating Chronic Suppurative Otitis Media with Cholesteatoma / 대한이비인후과학회지

Subperiosteal abscess of the mastoid region and Bezold's abscesses have become very rare since introduction of antibiotics. Subpriosteal abscess is usually seen in children who have acute mastoiditis. Its occurrence in adults or in associated with chronic otitis media is even more unusual. Bezold's abscess, a complication of acute otitis media in adult who has well pneumatized air cells in the tip of the mastoid, is also rarely seen in the current era of antibiotics. This paper reports a case of postauricular subperiosteal and Bezold's abscess complicating chronic suppurative otitis media with cholesteatoma in a 37-year old woman with review of literatures.