Clinical efficacy of modified total auricular reconstruction technique by using reformative inflation method and remnant ear without skin grafting

AbstractThis article investigates an effective method with which to reconstruct the tragus and external auditory meatus for microtia reconstruction. The external ear was reconstructed using a delayed postauricular skin flap in patients with congenital microtia. After the first stage of delaying the postauricular skin flap and the second stage of otoplasty with ear framework fabricated from autogenous rib cartilage draping with the delayed skin flap, the third stage involved tragus and external auditory meatus canaloplasty. After designing the remnant auricle flap, the lower part was trimmed and the tragus was reconstructed. The upper part was trimmed into a thin skin flap, which was rotated and used to cover the hollowed wound posterosuperior to the tragus so as to mimic the external auditory meatus. If remnant wounds were present, skin grafting was conducted. In total, 121 patients with congenital microtia were treated from March 2010 to March 2016. The reconstructed tragus and external auditory meatus were well formed, and all wounds healed well. No severe complications such as flap necrosis occurred. Six months postoperatively, the morphology of the reconstructed tragus and external auditory meatus was good. Overall, the patients and their families were satisfied. The use of remnant auricle to reconstruct the tragus and external auditory meatus is an effective auricular reconstruction technique.

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Clinical Efficacy of Combination of Rifampin and Streptomycin for Treatment of Mycobacterium ulcerans Disease

Antimicrobial Agents and Chemotherapy ◽

10.1128/aac.00299-10 ◽

2010 ◽

Vol 54 (9) ◽

pp. 3678-3685 ◽

Cited By ~ 86

Author(s):

Fred Stephen Sarfo ◽

Richard Phillips ◽

Kingsley Asiedu ◽

Edwin Ampadu ◽

Nana Bobi ◽

...

Keyword(s):

Body Weight ◽

Clinical Efficacy ◽

Healing Rate ◽

Average Rate ◽

Community Setting ◽

Skin Grafting ◽

Complete Healing ◽

Mycobacterium Ulcerans ◽

The Times

ABSTRACT We have evaluated the clinical efficacy of the combination of oral rifampin at 10 mg/kg of body weight and intramuscular streptomycin at 15 mg/kg for 8 weeks (RS8), as recommended by the WHO, in 160 PCR-confirmed cases of Mycobacterium ulcerans disease. In 152 patients (95%) with all forms of disease from early nodules to large ulcers, with or without edema, the lesions healed without recourse to surgery. Eight patients whose ulcers were healing poorly had skin grafting after completion of antibiotics. There were no recurrences among 158 patients reviewed at the 1-year follow-up. The times to complete healing ranged from 2 to 48 weeks, according to the type and size of the lesion, but the average rate of healing (rate of reduction in ulcer diameter) varied widely. Thirteen subjects had positive cultures for M. ulcerans during or after treatment, but all the lesions healed without further antibiotic treatment. Adverse events were rare. These results confirm the efficacy of RS8 delivered in a community setting.

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Clinical Efficacy of a Modified Nagata Method That Retains the Fascia Pedicle of the Mastoid Skin Flap in Auricular Reconstruction of Chinese Microtia Patients

Plastic & Reconstructive Surgery ◽

10.1097/01.prs.0000479997.42304.cc ◽

2016 ◽

Vol 137 (3) ◽

pp. 977-979 ◽

Cited By ~ 6

Author(s):

Wang-Shu Wang ◽

Dong-Mei Yan ◽

Jun-Yang Chen ◽

Duo Zhang ◽

Ying Shao ◽

...

Keyword(s):

Clinical Efficacy ◽

Skin Flap ◽

Auricular Reconstruction

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1322 Two Staged Skin Pedicle Reconstruction of Superior Helical Rim

British Journal of Surgery ◽

10.1093/bjs/znab259.634 ◽

2021 ◽

Vol 108 (Supplement_6) ◽

Author(s):

Adam Holden ◽

Stergios Doumas ◽

Jag Dhandar

Keyword(s):

Local Anaesthetic ◽

Skin Flap ◽

Skin Grafting ◽

Skin Incision ◽

Outpatient Setting ◽

Reconstruction Technique ◽

Oral Antibiotics ◽

Posterior Aspect ◽

Skin Loss ◽

Staged Reconstruction

Abstract Introduction Skin grafting onto the ear has its challenges, loss of the skin results in inadequate vascular bed for the graft leading to decreased uptake 1,2. As a result, advancement flaps or sacrifice of the underlying cartilage allows primary closure with compromised aesthetics. A two staged procedure however leads to acceptable scarring, can be performed under local anaesthetic, is quick and easy enabling transfer of skin to acutely exposed cartilage. The authors demonstrate a two staged reconstruction technique of the superior helix after traumatic degloving of the dermal tissues. Method Under local anaesthetic an incision in line with the most inferior extent of the skin loss is made. A subdermal plane is expanded superiorly, and the exposed auricular cartilage inserted, healing of the adjacent margins occurs and enables later skin transfer. The patient was discharged on oral antibiotics and returns at two weeks to have the pedicle divided in an outpatient setting. A further skin incision superior to the extent of the tip of the helix is performed. This skin flap is then thinned and folded to reconstruct the posterior aspect of the ear. The skin is sutured in place and the patient is sent home on oral antibiotics. A further reviewed in two weeks to check healing is advised and the patient was subsequently discharged. Conclusions In conclusion, this is demonstrated to be a useful technique to add to the Oral and Maxillofacial Surgeons armament for reconstruction of the superior helix when iatrogenic or traumatic loss of skin coverage occurs.

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