A clinical study on reconstruction of traumatic auricular defects

The auricle or external ear is an important aesthetic subunit of the face. The intricate anatomy due to multiple convolutions along with the thin integument poses a challenge to the reconstructive surgeon. The prominent position of the ear on either side of the face and over a bony prominence makes it more prone for injury. The objective of the study is to describe various traumatic auricular defects and their subsequent reconstructive methods. A retrospective analysis of 15 patients with traumatic auricular defects was carried out over a period of 2 years between the time period of January 2022 and December 2023. Various reconstructive methods such as Primary closure, use of chondral grafts and chondrocutaneous flaps, local flaps were employed depending on the size of the defect and according to the reconstructive ladder. Out of 15 patients, 12 were male and 3 were female, with traumatic ear defects secondary to road traffic accidents (12) and human bite (3). The site of the defect was upper 1/3d (8), upper+middle 1/3rd (3), lower+middle third (2), middle third (1) and lower 1/3rd (1) of the auricle. They were managed by debridement and primary closure in 5 cases, post auricular flap in 5 cases, preauricular flap in 2 cases, peninsular conchal island flap+postauricular flap in 1 case, and bilobed flap in 1 case. All the flaps settled well. 4 patients needed secondary procedures in the form of flap division and contour corrections. This study employed a variety of reconstruction methods of the auricle as per the reconstructive ladder. Some of the patients required secondary procedures. All patients in this study had a satisfactory end aesthetic outcome with no major complications.

Transesophageal echocardiography for guiding left atrial appendage closure with LAmbre occluder / 中国医学影像技术

Objective To observe the value of transesophageal echocardiography(TEE)for guiding left atrial appendage closure(LAAC)with LAmbre occluder.Methods Data of 40 non-valvular atrial fibrillation(NVAF)patients who underwent LA AC with LAmbre occluder were retrospectively analyzed.CT angiography(CTA)before treatment,TEE and digital subtraction angiography(DSA)findings during LAAC were comparatively observed,and the correlations of the anchor area diameter and left atrial appendage opening diameter measured with the above three as well as occluder size were analyzed,and TEE and DSA for evaluating peri-device leak(PDL)were compared.Results LAAC were successfully performed with LAmbre occlude in all 40 cases.The diameter of the fixed umbrella was positively correlated with anchor area diameter measured with CTA,TEE and DSA(r=0.79,0.82,0.91,all P＜0.01),of occlusion umbrella was positively correlated with left atrial appendage opening diameter measured with CTA,TEE and DSA(r=0.56,0.89,0.86,all P＜0.01).Immediately after the release of occluder in LAAC,PDL occurred in 16 cases and were detected with both TEE and DSA,while in the rest 24 cases no PDL was found with neither TEE nor DSA.Conclusion TEE had comparable value to DSA for guiding LAAC using LAmbre occluder.

HeberFERON en el tratamiento de pacientes con carcinoma basocelular de la oreja / HeberFERON in the treatment of patients with basal cell carcinoma of the ear

Fundamento: El carcinoma basocelular de la región auricular es considerado uno de los más agresivos y con peor pronóstico, suele ser destructivo y mutilante por lo que el tratamiento conservador, como es el uso de los interferones, es importante en la práctica médica habitual. Objetivo: Evaluar los resultados de la aplicación del HeberFERON en una serie de pacientes con carcinoma basocelular en la región auricular. Metodología: Se realizó un estudio observacional, descriptivo y longitudinal en una serie de casos con diagnóstico clínico, dermatoscópico e histopatológico de carcinoma basocelular de la oreja que recibieron tratamiento con HeberFERON en el Policlínico Centro de la ciudad Sancti Spíritus, durante el período del 20 de febrero de 2017 a 20 de diciembre de 2022. En total se incluyeron 29 pacientes. Se realizó una evaluación inicial, durante y 16 semanas después del tratamiento; se les inyectó 10.5 UI de HeberFERON 3 veces por semana perilesional e intradérmico hasta completar 9 dosis. Las variables fueron la respuesta al tratamiento y presencia o no de eventos adversos. Resultados: Predominó el sexo masculino, la localización en la concha de la oreja, subtipo clínico nódulo ulcerativo y el histológico sólido, con respuesta completa en la mayoría de los pacientes. Como eventos adversos más comunes se presentaron dolor en el sitio de inyección, fiebre, edema y eritema perilesional. Conclusiones: La respuesta al tratamiento fue favorable en la mayoría de los pacientes y los eventos adversos que se observaron fueron los descritos en la literatura sin cambio en la actitud farmacológica.

Background: Basal cell carcinoma of the auricular region is one of the most aggressive cancers and with the worst prognosis, is usually destructive and mutilating, therefore conservative treatment, such as the use of interferons, is important in routine medical practice. Objective: To evaluate the results of HeberFERON application in a series of patients with basal cell carcinoma in the auricular region. Methodology: An observational, descriptive and longitudinal study was conducted on a series of cases with clinical, dermoscopic and histopathologic diagnosis of basal cell carcinoma of the ear treated with HeberFERON at the Center Polyclinic in Sancti Spíritus city, during the period from February 20, 2017 through December 20, 2022. A total of 29 patients were included in the study. An evaluation was conducted at the start of treatment, during treatment, and 16 weeks after treatment; the patients were treated with 10.5 IU of HeberFERON by perilesional and intradermal injections three times a week until completing nine doses. The variables were the response to the treatment and the presence or absence of any adverse events. Results: The male sex predominated, location in the ear turbinate, clinical subtype ulcerative nodule and solid histologic subtype, with a complete response in the majority of patients. The most common adverse events were injection site pain, fever, edema, and perilesional erythema. Conclusions: The response to treatment was favorable in most patients, and the adverse events observed were those described in the literature, with no change in pharmacologic attitude.

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.

Application of free skin graft or auricle composite tissue in the correction of nasal flange retraction / 中华医学美学美容杂志

Objective:To investigate the clinical effect and application value of free skin or auricle composite tissue transplantation in the correction of nasal alar retraction.Methods:From August 2019 to January 2023, a total of 45 patients with nasal retraction (7 males and 38 females) were treated in Shanghai United Regal Medical Cosmetology Hospital. Age ranged from 18 to 46 years, with a mean of 26.6 years. All patients had retroalar margin retraction caused by insufficient alar lining to varying degrees, with a retraction distance between 2-5 mm, with an average retraction distance of 3.3 mm. 11 cases of nasal flange retraction were corrected by free transplantation of composite tissue of auricle directly. The remaining 34 patients were corrected by alar border cartilage graft and free skin graft.Results:During 2-18 months of follow-up, 41 patients had satisfactory results and no obvious complications. Partial necrosis of free skin was observed in 2 patients, ischemic necrosis of complex flap of auricle was observed in 1 patient, and necrosis of free skin was observed in 1 patient. In addition to the above complications, 3 patients reported that the correction of alar retraction did not achieve the expected effect, but indicated that they were satisfied with the surgical effect, which was considered to be caused by skin contracture and other factors. The overall satisfaction rate of all patients was 91.1%. After follow-up and statistics, 41 patients in this group were satisfied with the results, with an overall satisfaction rate of 91.12%.Conclusions:The application of free skin graft (or auricle composite tissue) to correct nasal alar retraction has the advantages of simple operation, wide indications and accurate efficacy, and is worthy of clinical promotion.

Prurito ótico por carcinoma basocelular en conducto auditivo externo / Otic pruritus due to basal cell carcinoma of the external auditory canal

El carcinoma basocelular es el tumor cutáneo más frecuente en el área de cabeza y cuello; la exposición crónica al sol es el factor de riesgo más importante para este tumor. Suele manifestarse clínicamente con síntomas anodinos en estadios iniciales, lo que contribuye a que su diagnóstico sea difícil y tardío. Tiene un comportamiento localmente invasivo, especialmente a nivel del pabellón auricular. Este es el único caso descrito en el conducto auditivo externo no relacionado con la exposición al sol, con características clínicas y terapéuticas que lo hacen peculiar.

Basal cell carcinoma is the most frequent skin tumor in the head and neck area, and chronic sun exposure is the most important risk factor. It usually manifests clinically with anodyne symptoms in the early stages, which contributes to its difficult late diagnosis. It is locally invasive, especially at the level of the pinna. It is the only case described in the external auditory canal not related to sun exposure; it presents clinical and therapeutic characteristics that make it peculiar.

Efectividad de la reconstrucción de la oreja con cartílago costal en el tratamiento de microtias / Effectiveness of Auricle Reconstruction with Costal Cartilage for the Treatment of Microtias

Introducción: La reconstrucción de la oreja en la actualidad es un problema difícil de solucionar. Se han propuesto varias técnicas quirúrgicas y solo las que se basan en el uso de cartílago costal autólogo son las que se aceptan a nivel mundial. Objetivo: Evaluar la efectividad de la técnica de reconstrucción del pabellón auricular descrita por Burt Brent. Métodos: Se realizó un estudio cuantitativo con diseño descriptivo de corte transversal con 41 pacientes que presentaron microtia congénita o perdida adquirida de la oreja; a quienes se les realizó reconstrucción auricular con cartílago costal autólogo tratados en el Hospital "William Soler", el Centro de Investigaciones Médico-Quirúrgica y Clínica Central "Cira García" en el Servicio de Cirugía Plástica desde 1994 hasta 2019. Se describió y se documentó la técnica empleada descrita por Burt Brent. Se utilizó una escala de 10 puntos que se basó en la anatomía auricular normal para la valoración de los resultados. Resultados: Se encontraron 32 pacientes portadores de microtia congénitas (78,04 %) y 9 pérdidas traumáticas (21,95 %), predominó el sexo femenino (56,09 %). La incidencia fue mayor en el lado derecho (68,75 %) en pacientes con microtia congénita. En el 95 % de los casos se alcanzaron resultados favorables y satisfactorios. Conclusiones: La reconstrucción del pabellón auricular requiere el empleo de un fragmento de cartílago costal de suficiente tamaño, forma y proyección. La clave consiste en esculpir un marco cartilaginoso de la oreja y mantener estos detalles a través de la piel lo más semejante a la oreja normal. Para un resultado satisfactorio se requiere una alta especialización.

Introduction: Auricle reconstruction is, nowadays, a difficult problem to solve. Several surgical techniques have been proposed and only those based on the use of autologous costal cartilage are accepted worldwide. Objective: To evaluate the effectiveness of the auricle reconstruction technique described by Burt Brent. Methods: A quantitative study with a cross-sectional descriptive design was carried out with 41 patients who presented congenital microtia or acquired loss of the ear and who were performed auricle reconstruction with autologous costal cartilage in the plastic surgery service at Hospital "William Soler", Centro de Investigaciones Médico-Quirúrgicas and Clínica Central "Cira García", from 1994 to 2019. The used technique described by Burt Brent was, in turn, described and documented. A 10-point scale based on the normal atrial anatomy was used to assess the outcomes. Results: Thirty-two patients with congenital microtia (78.04 %) and nine traumatic losses (21.95 %) were found, with a predominance of the female sex (56.09 %). The incidence was higher on the right side (68.75 %) in patients with congenital microtia. Favorable and satisfactory outcomes were achieved in 95 % of cases. Conclusions: Auricle reconstruction requires the use of a costal cartilage piece of enough size, shape and projection. The key is to sculpt a cartilaginous framework of the ear and to maintain these details through the skin as close as possible to the normal ear. A high level of specialization is required for a satisfactory outcome.

Replantation of severed auricle distal to helix with microsurgical technique: Report of 5 cases / 中华显微外科杂志

Objective:To summarise the clinical experience in replantation of the severed auricle distal to helix with microsurgical technique.Methods:From December 2018 to October 2021, a total of 5 patients with severed auricle injury were treated in the Department of Hand and Foot Surgery of The Affiliated Hospital of Qingdao University. They were 4 males and 1 female with 23-62 years old. After complete debridement of the auricular pinna, the retrograde replantation method was used. For arteries: a dorsal vein of the foot was used to bridge the posterior auricular artery. For veins: 2 patients had the veins directly anastomosed, 2 had the arteriovenous bridging to the posterior ear vein with dorsal foot veins, and the veins in 1 case were not anastomosed. Among the patients, 2 developed venous occlusions after severed auricle, and were treated with bloodletting through small incision at the skin margin. Two patients who received the arteriovenous of the severed auriclse achieved good blood supply. All the patients underwent treatments including anti-freezing, anti-spasm and anti-infection after the emergency surgery. The follow-ups were conducted regularly by telephone and by display photos via WeChat after surgery.Results:All 5 severed auricles were successfully replanted and survived. Postoperative follow-up ranged from 3 months to 2 years, with an average of 10 months. In the 2 cases with venous crisis, the auricles had mild atrophy. All auricles had no obvious pigmentation, and had the sensation recovery back to normal in 1 year after surgery.Conclusion:The pre-judgment of blood vessel quality and high-quality microsurgery skills are the necessary pre-conditions for auricle replantation. For replantation of severed auricle, it is the key to prevent vascular crisis by having the injured blood vessels thoroughly removed.

Efficacy of noninvasive correction on congenital auricle deformities at different time points: a meta analysis / 中华医学美学美容杂志

Objective:To evaluate the efficacy and safety of nonsurgical methods in early postnatal correction of congenital auricle malformation.Methods:The clinical trials regarding non-surgical treatment for congenital ear deformity published before May 2021 were searched in databases of Cochrane Library, PubMed, Medline, CNKI, VIP and Wanfang. The information of included studies was extracted. The Meta-analysis was performed by using RevMan 5.3 software.Results:A total of 15 trials were included, involving 1 349 patients. The Meta-analysis results showed that the effect of the group <6 weeks was better than the group over 6 weeks ( OR=4.67, 95% CI: 3.21, 6.78, Z=8.09, P<0.001); The complications incidence of the group < 6 weeks was lower than the group over 6 weeks ( OR=0.27, 95% CI: 0.08, 0.88, Z=2.18, P=0.03); The correction time required of the group <6 weeks was shorter than the group over 6 weeks ( MD=-11.81, 95% CI: -18.36, -5.26, Z=3.54, P=0.001). Conclusions:Non-surgical correction of congenital ear malformation within 6 weeks after birth has better efficacy and safety.

Effect of continuous shaping and compression in the comprehensive treatment of auricle keloids / 中华医学美学美容杂志

Objective:To observe the effect of continuous shaping and compression in the comprehensive treatment of auricle keloids.Methods:From June 2018 to April 2020, 40 patients with auricular keloids (53 ears) admitted to the Plastic Surgery Department of Henan Provincial People＇s Hospital were divided into surgical injection group (20 cases, 27 ears) and surgical injection compression group (20 cases, 26 ears) according to the treatment method. The patients were followed up for more than 18 months continuously; the clinical efficacy, satisfaction with auricle morphology, and the occurrence of infection and recurrence were observed in the two groups.Results:The effective rate of surgical injection compression group (24 ears, 92.31%) was higher than that of surgical injection group (16 ears, 59.26%), and the difference was statistically significant (χ 2=5.121, P<0.05). The Vancouver scar scale (VSS) scores of the two groups at 6 months and 12 months after treatment were significantly lower than that before treatment, and the VSS score of the surgical injection compression group was lower than that of the surgical injection group, the difference was also statistically significant ( P<0.05). The satisfactory rate of the surgical injection compression group (22 ears, 84.62%) was higher than that of the surgical injection group (13 ears, 48.15%), and the difference was statistically significant (χ 2=4.048, P<0.05). The recurrence rate of the surgical injection compression group was significantly lower than that of the surgical injection group (χ 2=5.779, P<0.05); there was no significant difference in the infection rate between the two groups of patients after treatment (χ 2=0.001, P>0.05). Conclusions:Surgical resection of auricle keloids combined with local injection of corticosteroids and local shaping and compression can significantly improve the clinical efficacy, maintain the shape of the auricle, and the therapeutic effect is satisfactory.

Comparative assessment of auricular measurements in young males and females / Evaluación comparativa de las medidas auriculares en hombres y mujeres jóvenes

SUMMARY: Personal identification is mostly done by facial assessment. The auricle plays a key role in the evaluation and recognition of the craniofacial complex. The aim of this study was to provide normative database using the measurements of the auricle among young males and females by anthropometric methods. Anthropometric measurements were taken from 115 participants, (56 men and 59 women) between 18-30 years old. Participants werestudents at Yasar Dogu Faculty of Sport Sciences of Ondokuz Mayis University. Each participant signed an informed consent form and then participated to the study. We found that the mean length of the right and left auricles were 58.30-58.52 mm, the mean width of the right and left auricles were 30.04-29.73 mm, the mean length of right and left lobules were 16.05-16.45 mm, and the mean width of the right and left lobules were 17.61-18.76 mm in female participants. The mean length of right and left auricles were 62.33-62.49 mm, the mean width of the right and left auricles were 33.60-33.96 mm, the mean length of right and left lobules were 18.49-18.11 mm, and the mean width of the right and left lobules were 19.19-20.47 mm in male participants. The data obtained from the present study may be useful for further studies. Also, the results may be useful for reconstructive surgeons to analyze the size and shape of the auricle.

RESUMEN: La identificación personal se realiza principalmente mediante evaluación facial. El pabellón auricular tiene un papel clave en la evaluación y el reconocimiento del complejo craneofacial. El objetivo de este estudio fue proporcionar una base de datos normativa utilizando las medidas de la oreja entre hombres y mujeres jóvenes por métodos antropométricos. Se tomaron medidas antropométricas de 115 participantes, (56 hombres y 59 mujeres) entre 18 y 30 años. Los participantes eran estudiantse de la Facultad de Ciencias del Deporte Yasar Dogu de la Universidad Ondokuz Mayis. Cada participante firmó un formulario de consentimiento informado y luego participó en el estudio. Encontramos que en las mujeres la longitud media de las aurículas derecha e izquierda era de 58,30-58,52 mm, el ancho medio de las aurículas derecha y izquierdas era de 30,04 a 29,73 mm, la longitud media de los lóbulos derecho e izquierdo era de 16,05 a 16,45 mm y el ancho medio de los lóbulos derecho e izquierdo era de 17,61 a 18,76 mm. En los hombres, la longitud media de las aurículas derecha e izquierda era de 62,33-62,49 mm, el ancho medio de las aurículas derecha e izquierda era de 33,60-33,96 mm, la longitud media de los lóbulos derecho e izquierdo era de 18,49-18,11 mm, y el ancho medio de los lóbulos derecho e izquierdo era de 18,49-18,11 mm. Los datos obtenidos del presente estudio pueden ser útiles para estudios posteriores. Además, los resultados pueden ser útiles para que los cirujanos reconstructivos analicen el tamaño y la forma del pabellón auricular.

Case for diagnosis. Pruritic erythematosquamous lesion in the auricle

Abstract Chromoblastomycosis is a subcutaneous mycosis with chronic evolution that mainly affects the lower limbs and, less frequently, the auricles. Clinically, it presents with papillary verrucous, nodular, and/or tumoral lesions, whether isolated or infiltrated, forming plaques and, sometimes, atrophic in some areas. Histopathologically, it is characterized by a dermal granulomatous inflammatory infiltrate, and the diagnosis can be confirmed by the presence of fumagoid bodies in anatomopathological or direct mycological exams. The treatment to be indicated will depend on the extent and location of the lesions, using systemic antifungals, surgical removal, cryotherapy, thermotherapy, and immunoadjuvants. The present study reports an atypical presentation of chromoblastomycosis on the auricle.

Resultados de la cirugía reconstructiva del pabellón auricular en Cienfuegos / Results of reconstructive surgery of the auricle in Cienfuegos

RESUMEN Fundamento: Los traumatismos del pabellón auricular, producidos por diversas causas, no se presentan con frecuencia, pero siempre son un reto para el cirujano encargado de la reconstrucción. Objetivo: describir los resultados de la cirugía reconstructiva del pabellón auricular. Métodos: estudio descriptivo, de serie de casos, realizado en el Hospital Dr. Gustavo Aldereguía Lima, de Cienfuegos, en el periodo 2015-2019. Se aplicó anestesia local en todos los casos (5), y las técnicas Tubo de Filatov, y la retro auricular, de Dieffenbach, las cuales fueron ilustradas a través de imágenes de los diferentes casos. Se analizó para cada paciente la edad, sexo y causa del traumatismo. Resultados: los pacientes presentados fueron relativamente jóvenes, y solo uno fue del sexo femenino. En 4 de ellos la pérdida parcial del pabellón auricular fue causada por traumatismos con armas blancas y mordidas humanas, respectivamente; en el paciente restante la ausencia de la estructura era congénita. En todos se combinaron ambas técnicas (Filatov y Dieffenbach) para la reconstrucción quirúrgica, con un resultado estético favorable. Conclusión: La serie presentada, aunque no es extensa, evidencia que es posible la rehabilitación de los defectos estructurales del pabellón auricular, ya sea parcial o total, mediante técnicas quirúrgicas sencillas que permiten alcanzar el resultado estético esperado.

ABSTRACT Background: Injuries to the pinna, caused by various causes, are not frequent, but they are always a challenge for the surgeon in charge of reconstruction. Objective: to describe the results of reconstructive surgery of the pinna. Methods: descriptive study, case series, carried out at the Dr. Gustavo Aldereguía Lima Hospital, Cienfuegos, in the period 2015-2019. Local anesthesia was applied in all the cases (5), and the Filatov tube techniques, and the retro auricular, of Dieffenbach, which were illustrated through images of the different cases. The age, sex and cause of the trauma were analyzed for each patient. Results: the patients presented were relatively young, and only one was female. In 4 of them, the partial loss of the auricle was caused by trauma with sharp weapons and human bites, respectively; in the remaining patient, the absence of the structure was congenital. Both techniques (Filatov and Dieffenbach) for surgical reconstruction were combined in all, with a favorable aesthetic result. Conclusion: The series presented, although not extensive, shows that it is possible to rehabilitate the structural defects of the auricle, either partially or totally, using simple surgical techniques that allow achieving the expected aesthetic result.

Comparação de técnicas cirúrgicas de correção de orelhas proeminentes: Mustardé versus Converse / Comparison of surgical techniques for prominent ear correction: Mustardé versus Converse

Introdução: As orelhas proeminentes, popularmente chamadas de "orelhas em abano", representam a deformidade congênita mais comum da orelha externa, atingindo cerca de 5% da população. Métodos: Estudo primário, prospectivo e de intervenção comparando os resultados de pacientes submetidos ao procedimento cirúrgico de correção de orelhas proeminentes por meio da técnica de Converse e de Mustardé, realizado no Serviço de Cirurgia Plástica do Hospital das Clínicas da Universidade Federal de Pernambuco (HC-UFPE). Resultados: Foram avaliados 20 pacientes, 10 por meio da técnica de Converse e 10 por meio de Mustardé, no período de junho de 2016 a dezembro de 2017. Ambos os grupos mostraram diminuição das distâncias mastoideas auriculares ao final do período de observação, variando de 6.67 a 14.6 mm, a depender da técnica cirúrgica e do ponto de avaliação, mas sem significância estatística. Quanto às distâncias mastoideas auriculares médias ao final do período de observação, observou-se diferença de no máximo 6.3mm entre os grupos avaliados, mas sem significância estatística. Em relação a simetria das orelhas dentro do mesmo grupo, o nível máximo de assimetria média nos grupos Mustardé e Converse foi de respectivamente 0.9mm e 0.5mm. A porcentagem da perda de correção das medidas obtidas cirurgicamente ao longo do período de observação em ambos os grupos variaram de 15-19%, no entanto, sem significância estatística. No que se refere as complicações, houve 1 (10%) caso de hematoma no grupo Mustardé. Conclusão: As técnicas de Converse e Mustardé demostraram não ter diferença estatística nos resultados.

Introduction: prominent ears, popularly called "flappy ears," represent the most common congenital deformity of the external ear, affecting approximately 5% of the population. Methods: Primary, prospective and intervention study comparing the results of patients undergoing the surgical procedure to correct prominent ears using the Converse and the Mustardé techniques, performed at the Plastic Surgery Service of the Hospital das Clínicas, Federal University of Pernambuco (HC) -UFPE). Results: Twenty patients were evaluated, 10 with the Converse technique, and 10 with the Mustardé technique, from June 2016 to December 2017. Both groups showed a decrease in auricular mastoid distances at the end of the observation period, ranging from 6.67 to 14.6 mm, depending on the surgical technique and the evaluation point, but without statistical significance. Regarding the average auricular mastoid distances at the end of the observation period, a difference of a maximum of 6.3 mm was observed between the evaluated groups, but without statistical significance. Regarding the symmetry of the ears within the same group, the maximum mean level of asymmetry in the Mustardé and Converse groups was 0.9 mm and 0.5 mm, respectively. However, the percentage of loss of correction of the measures obtained surgically during the observation period in both groups ranged between 15 and 19%, without statistical significance. Regarding complications, there was 1 (10%) case of hematoma in the Mustardé group. Conclusion: Converse and Mustardé techniques did not show statistical differences in the results.

Transposição de lóbulo de orelha: um retalho simples para reconstrução de defeito cirúrgico de espessura total do antítrago / Earlobe transposition: a simple flap in the reconstruction of fullthickness surgical defect of anti-tragus

O câncer de pele ocorre com frequência na região do pavilhão auricular. A conformação tridimensional e a disponibilidade limitada de pele redundante regional tornam a reconstrução desta área anatômica desafiadora. Relata-se a reconstrução de antítrago utilizando-se um retalho de transposição de lóbulo de orelha

Skin cancer frequently occurs on the pinna. The three-dimensional conformation and the limited availability of redundant regional skin make the reconstruction of this anatomical area challenging. We report the reconstruction of anti-tragus using an earlobe transposition flap

Clinical study of autologous concha cartilage transplantation to repair auricle deformities / 中华整形外科杂志

Objective@#To investigate the curative effect of auricular deformity repaired by concha cartilage.@*Methods@#From January 2017 to June 2018, 15 cases with auricular deformities were repaired using the autologous concha cartilage which combined with the retroauricular flap or retroauricular fascia with skin grafting. 9 males and 6 females, aged 10-40 with an average age of 19; 3 cases of upper 1/3 traumatic auricle defect, 2 cases of congenital Stahl's ear, 5 cases of congenital cup-shaped ear and 5 cases of congenital cryptotia.@*Results@#Total 15 patients were followed up for 12-18 months after the surgery. The area of concha cartilage resection was about 0.5 cm×1.0 cm. The shape and size of the repaired ears were similar to the healthy ear. The transplanted cartilages were not absorbed or deformed. The incision was healed well and retroauricular flap, retroauricular fascia, and skin grafting were preserved well without complications like hemorrhage, necrosis, and infection.@*Conclusions@#This method is harmless and simple, which has reliable and satisfactory effects on various auricular deformities.

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.

Effectiveness of auricular orthosis in the treatment of children with congenital auricular deformity / 中华整形外科杂志

Objective@#To explore the treatment effects of domestic auricular orthosis on children born with congenital auricular deformity.@*Methods@#Children born with congenital auricle deformity were treated by "Yi Er" auricle orthosis, included 42 ears of 29 cases.These children were divided into three groups according to the birth age. The age less than 7 days was divided into group 1, 7-42 days for group 2, and more than 42 days for group 3. Compare the therapeutic effect of children in different ages.@*Results@#The therapeutic effect was divided into three grades: markedly effective and cured (basically return to normal appearance); effective (improved, but not reached the normal appearance); invalid (no improvement after treatment). The markedly effective and cured rate in group 1, group 2 and group 3 were 100%, 85.7% and 45.0%, the difference was statistically significant(P<0.05), and the average correction time was(20.75±6.50)d, (32.64±15.40)d, (48.23±17.32) d, the difference was statistically significant(P<0.05).@*Conclusions@#The domestic auricle orthosis has a significant effect on the correction of children born with congenital auricular deformity. The better treatment effect and the shorter wearing time can be acquired in the early correction.

The growth of ear of paediatric subjects in Hong Kong—A timely reconstruction for unilateral microtia / 中华整形外科杂志

Objective@#To establish the local data on the growth of ear in Hong Kong children and provide a reference for the timing of reconstruction in unilateral microtia.@*Methods@#We reviewed case notes of paediatric patients up to 18 years of age who had attended our Ear, Nose and Throat Out-patient Clinic from March to November 2017. We recorded the pinna length of these patients and that of their parents, compared the patients’ ear length against that of their parents, and investigated any discrepancy of pinna.@*Results@#We recruited 226 local individuals (139 males and 87 females). The patients were divided into different age groups. The means of ear length of patients were compared with the mean length of pinna of their parents. Data of boys and girls are analyzed separately. Boys at 7-8 years old achieved 87.33% and 93.54% of their fathers’ and mothers’ ear length respectively. Girls at 7-8 years old achieved 83.00% and 90.80% of their fathers’ and mothers’ ear length respectively. Moreover, the average ratio of the length of left and right ear ratio is 97.3% in all groups of children.@*Conclusions@#In Hong Kong children, at the age of 7-8 the ear approaches the size of normal adult ear and is the feasible age with less asymmetry after reconstruction of the microtia.

Auricular cartilage multi-point suspension fixed to craniofacial deep fascia in correcting mild to moderate cupped ear malformation / 中国修复重建外科杂志

Objective: To explore the feasibility and effectiveness of using auricular cartilage multi-point suspension fixed on deep craniofacial fascia in correcting mild to moderate cupped ear malformation. Methods: Between January 2014 and March 2016, 22 patients (12 males and 10 females) with mild to moderate cupped ear malformation were admitted, aged from 6 to 28 years, with an average age of 15 years. Sixteen cases were unilateral and 6 cases were bilateral. According to Tanzer classification, there were 18 sides of type Ⅰ and 10 sides of type Ⅱ. The otocranial groove incision was selected to expose and release the posterior auricular muscles and ligaments. The abnormal structure of auricle subunits was remolded. The auricle cartilage was suspended and fixed on the deep craniofacial fascia with non absorbable line to remodel the shape and position of auricle. Results: The incision healed by first intention, without hematoma, infection, and skin necrosis. All the patients were followed up 3-48 months, with an average of 12 months. In addition to 1 case of slippage of the fixed line knot, the effect was good after being suspended and fixed again, the auricles of the other patients were not drooping and tilted forward, the shape of the outer ear was good, the ear boat was obvious, the shape of the upper and lower feet of the ear wheel and the pair of ears was natural, the bilateral symmetry was good, and the patients and their families were satisfied. Conclusion: Auricular cartilage multi-point suspension fixed on deep craniofacial fascia is effective in the treatment of mild to moderate cupped ear malformation.