HEVAL SELMAN ÖZKAN, Saime İRKÖREN, Hüray KARACA, DENİZ YILDIRIM

Fascioperichondrial Flap with a Proximal Base Combined with Prominent Ear Surgery

Amaç: Bu makalede geleneksel otoplasti yöntemleri sık karşılaşılan bir sorun olan keskin sınırları saklamak ve sonuçları iyileştirmek için kullandığımız bir yöntem olarak proksimal bazlı fasyoperkondriyal flep kullanımını sunduk. Gereç ve Yöntemler: Cerrahi yöntemde; dorsal taraftan hazırlanan proksimal bazlı fasyoperikondriyal flep anterior heliks ve konkal eksizyon bölgesine transpose edilir ve görünür sınırları gizlemek, Furnas dikişlerine destek olmak için sütürler ile tespit edilir. Bu cerrahi teknik kullanılarak opera edilen dokuz hasta çalışmaya dahil edildi, en kısa takip süresi altı aydı. Metodun başarısını değerlendirmek için kulağın superior ve orta 1/3 bölgelerinden konkal mastoid mesafeler preoperatif, postoperatif ve altıncı ay kontrollerinde ölçüldü. Bulgular: Hiçbir hastada deri nekrozu, enfeksiyon veya sütür açığa çıkması görülmedi. Kulak orta ve superior 1/3 ölçümleri altıncı ay kontrollerinde istatistiksel olarak anlamlı olarak azalmış bulundu (p

Belirgin Kulak Deformitesi Onarımında Proksimal Bazlı Fasyoperikondriyal Flep Kullanımı

Objective: In this article, we present a personalized surgical technique to relocate a fascioperichondrial flap with a proximal base as an additional measure to improve results and hide sharp edges which frequently occur following traditional otoplasty. Materials and Methods: Fascioperichondrial flap with a proximal base prepared from the dorsal side was transposed to the anterior helix and conchal excision side and secured with stitches to hide visible edges and reinforce Furnas sutures. Nine patients operated for prominent ear deformity using this modification were included in the study and follow-up period was at least 6 months. Conchal mastoid distances were calculated from the superior and middle third of the ears before and after the operation, also in follow-up controls to determine the efficiency of the method. Results: There were no suture extrusions, skin necrosis or infection. The mean difference for both the upper and middle third of the ears were considerably lower (p<=0.05) at the end of six month after the operation. There were no visible skin edges and discomfort described by the patients. Conclusion: Fascioperichondrial flap with a proximal base repositioning to conchal side is an easy procedure that can be applied simply as an adjunct to traditional techniques. Addition of this flap provides an additional tissue to reinforce suture repair and, the results seem to be more durable and strong. Another main advantage of this flap is eliminating the unnatural visible breakpoints in the conchal bowl.

PDF

___

1. Luckett WH. A new operation for prominent ears based on the anatomy of the deformity. Surg Gynecol Obstet 1910; 10: 635.
2. Rogers BO. Ely's 1881 operation for correction of pro-truding ears. A medical ''first''. Plast Reconstr Surg 1986; 77: 222-6.
3. Mustarde JC. The correction of prominent ears using simple mattress sutures. Br J Plast Surg 1963; 16: 170-8.
4. Mustarde JC. Correction of prominent ears using buried mattress sutures. Clin Plast Surg 1978; 5: 459-64.
5. Stenstrom SJ. A natural technique for correction of congenitally prominent ears. Plast Reconstr Surg 1963; 32: 509-18.
6. Stenstrom SJ. A simple operation for prominent ears. Acta Otolaryngol 1966; 224: 393.
7. Chongchet V. A method of antihelix reconstruction. Br J Plas Surg 1963; 16: 268-72.
8. Peker F, Celikoz B. Otoplasty: anterior scoring and posterior rolling techniques in adults. Aesthetic Plast Surg 2002; 26: 267- 73.
9. Bauer BS, Margulis A, Song DH. The importance of conchal resection in correcting the prominent ear. Aesthet Surg J 2005; 25: 72-9.
10. Hinderer UT, Del Rio JL, Fregenal FJ. Otoplasty for prominent ears. Aesth Plast Surg 1987; 11: 63-9.
11. McDowell AJ. Goals in otoplasty for protruding ears. Plast Reconstr Surg 1968; 41: 17-27.
12. Furnas DW. Correction of prominent ears by conchamastoid sutures. Plast Reconstr Surg 1968; 42: 189-93.
13. Tolleth H. Artistic anatomy, dimensions and proportions of the external ear. Clin Past Surg 1978; 5: 337-45.
14. Johnson PE. Otoplasty: shaping the antihelix. Aesth Plast Surg 1994; 18: 71-4.
15. Spira M. Reduction otoplasty. In: Goldwyn RM (ed) The unfavorable result in plastic surgery. Little Brown, Boston, 1984, pp. 307-3.
16. Jeffery S. Complications following correction of prominent ears: an audit review of 122 cases. Br J Plast Surg 1999; 52: 588-90.
17. Caouette-Laberge L, Guay N, Bortoluzzi P, Belleville C. Otoplasty: anterior scoring techniques and results in 500 cases. Plast Reconst Surg 2000; 105: 504-15.
18. Messner AH, Crysdale WS. Otoplasty: clinical protocol and longterm results. Arch Otolaryngol Head Neck Surg 1996; 122: 773-7.
19. Yugueros P, Friedland JA, Furnas DW. Otoplasty: the experience of 100 consecutive patients. Plast Reconst Surg 2001; 108: 1045- 53.
20. Minderjahn A, Huttl W, Hildmann H. Mustarde's otoplasty: evaluation of correlation between clinical and statistical findings. J Maxillofac Surg 1980; 8: 241-50.
21. Adamson PA. Complications of otoplasty. Ear Nose Throat J 1985; 64: 568-74.
22. Shokrollahi K, Cooper MA, Hiew LY. A new strategy for otoplasty. J Plast Reconstr Aesthet Surg 2009; 62: 774-81.
23. Frascino LF. The use of a retroauricular fascioperichond-rial flap in the recreation of the antihelical fold in prominent ear surgery. Ann Plast Surg 2009; 63: 536-40.
24. Horlock N, Misra A, Gault DT. The postauricular fascial flap as an adjunct to Mustardé and Furnas type otoplasty. Plast Reconstr Surg 2001; 108: 1487-90.
25. Schaverien MV, Al-Busaidi S, Stewart KJ. Long-term results of posterior suturing with postauricular fascial flap otoplasty. J Plast Reconstr Aesthet Surg 2010; 63: 1447-51.