Application of ultra-thin oblique posterosuperior auricular fascial flap in the second stage of Nagata microtia reconstruction / 中华整形外科杂志

Objective@#To investigate the effect and safety of ultra-thin oblique posterosuperior auricular fascial flap in the second stage of ear reconstruction.@*Methods@#Fifty-six cases with congenital microtia treated in The Second Affiliated Hospital of Zhengzhou University Medical Cosmetology Department from November 2015 to November 2018 were selected as the research objects. In the first stage, the costal cartilage ear stent was implanted, and in the second stage. The ultra-thin posterior oblique fascia flap was used to cover the stent. And the cranioauricular angle was reconstructed by free skin grafting.@*Results@#48 cases of the 54 cases completely survived, and 8 cases had hemorrhage after operation. The wounds were healed after dressing change. The postoperative cranioauricular angle was close to the healthy side.@*Conclusions@#In the second stage of ear reconstruction, the retroauricular ultra-thin fascial flap method has reliable blood supply, small wound, unswollen reconstructed ears, and good outcome. It is a good choice for covering the ear framework.

Aesthetic study of helix reconstruction using autologous costal cartilage / 中华整形外科杂志

Objective@#To observe the conditions of the eighth costal cartilage in ear reconstructed patients, and accomplish individualized aesthetic helix fabrication according to the texture and features of the cartilage.@*Methods@#From May 2013 to May 2016, the conditions of the eighth costal cartilages in 415 patients who received ear reconstruction with autogenous costal cartilage in our hospital were analyzed, during which, the length, width, flexibility, and plasticity that were closely related with the reconstruction of the helix attracted predominant attentions. During the surgery, based on the features of the above-mentioned aspects, 4 different methods were used to achieve reasonable length and strength of the helix as well as natural jointing between the helix and ear lobe.@*Results@#Four possible methods of using the eighth costal cartilage to reconstruct the helix were summarized and an autogenous costal cartilage framework that was individualized and with natural appearance was obtained.@*Conclutions@#According to the conditions of the eighth costal cartilage, a more satisfactory appearance of the reconstructed ear than ever before is obtained by choosing relevant helix fabrication programs.

[Ear reconstruction: from reconstructive to cosmetic].

OBJECTIVE: Previous literatures have reported favorable results in ear reconstruction. Many details in fabricating cartilage framework have been paid much attention. Whereas, many patients still complain about unnatural contours. This article is to provide a new technique to solve some of the problems. METHODS: A total of 253 patients underwent reconstruction using the modified technique from 2011 to 2014. In fabricating the complex of antihelix, the authors modified the prior method. Instead of sculpting a sharp Y-shaped cartilage graft for projecting the prominent structures, the authors increased the width of the superior crura, sculpted a gentle slope in the both sides of superior crura, simultaneously carved a groove in the base frame to join with the carved attachment smoothly. The width of inferior crura was about one third of the superior crura width, and the inferior crura was narrow and prominent. A gentle slope was carved on the antihelix and a groove was carved on the base frame for the antihelix to sit on. RESULTS: Four cases have been selected to illustrate the favorable results of this technique. Due to the modified details, the superior crura, inferior crura, antihelix and the structures around them, in these cases, show natural contours, and provide a coordinated figure to the integrity of reconstructed ear. CONCLUSIONS: Antihelix complex is one of the most important structures for creating a natural auricle. The natural superior and inferior crura and antihelix can enhance the impression of a harmonious shape, and acquire an increased satisfaction for both patients and surgeons.

Reconstruction of the anophthalmic orbit by orbital osteotomy and free flap transfer.

It is a challenging problem for the plastic surgeon to perform adequate reconstruction of the postenucleation and radiated orbit of patient with retinoblastoma. Rebuilding of the orbital structure, reconstruction of the eye socket, and restoration of periorbital volume are required in this kind of orbital reconstruction. In this study, we reviewed 12 patients with hypoplastic orbital deformities who underwent orbital osteotomy and free flap transfer. Reconstruction of the orbital cavity was achieved using "C" osteotomy of the lateral portion of the orbit in mild and moderate cases or transverse "U" osteotomy of the lateral wall, roof, and floor by an intracranial approach in a portion of severe cases. Socket reconstruction and periorbital volume restoration was achieved using dorsalis pedis free flap transfer by microsurgery. What we concluded from our experience was that the combination of orbital osteotomy and free flap transfer could meet the multirequirements for anophthalmic orbital reconstruction, including both orbital bony enlargement and soft tissue restoration.

Curved-osteotomy for prominent mandibular angle through intra-and extra-oral approach with a small incision / 中华医学美学美容杂志

Objective To study a simple, safe and effective way in correction of prominent mandibular angle. Methods Curved osteotomy was employed for prominent mandibular angle through intra and extra oral approach with a small incision in 20 cases.Partial masseter resection was performed simutaneously in 5 cases with masseter hypertrophy, buccal fat pads were resected in 3 cases with broad faces, and genioplasty were performed in 3 cases with micrognathia. Nine cases only suffering from prominent mandibular angle were underwent curved osteotomy reconstruction. Results A series of 20 cases was followed up from six months to six years, in which 95 % was satisfactory.Conclusion The advantages of this method are simple, safe and symmetric with better result. It is easy to dissect under periosteum and perform curved osteotomy with less complication, quick recovery, and better contouring.