Baseblock Sculpturing Using the Scoring Technique for the Reconstruction of Ear

다발성 부분층 절개술을 이용한 늑연골 조각을 통한 이개재건

  • Lee, Yoonho (Department of Plastic and Reconstructive Surgery, Seoul National University College of Medicine) ;
  • Kim, Hyun Seok (Department of Plastic and Reconstructive Surgery, Seoul National University College of Medicine)
  • 이윤호 (서울대학교 의과대학 성형외과학교실) ;
  • 김현석 (서울대학교 의과대학 성형외과학교실)
  • Received : 2004.09.20
  • Published : 2005.01.10

Abstract

Total auricular reconstruction with autogenous tissue remains one of the greatest technical challenges for reconstructive plastic surgeons because of the ear's complex morphology with delicately convoluted cartilages and very thin skin. In a successfully created ear, a natural three-dimensional illusion visualized from the patient's profile, frontal, and posterior views is crucial. Accordingly ear framework should have adequate lateral aspect as well as suitable frontal aspect even before being lifted to this purpose. For this goal, rib cartilage should be harvested from three-dimensionally adequate area. It is the most essential point in framework fabrication that the baseblock should have semi-cup curvature via multiple parallel cuts made on its medial surface. Between January 1999 and May 2003, we performed 29 cases of total ear reconstruction with autogenous rib cartilage graft using this scoring technique and obtained satisfactory results, which showed more natural appearance visualized from the patient's profile, frontal, and posterior views.

Keywords

References

  1. Nagata S: A new method of the total reconstruction of the auricle for microtia. Plast Reconst Surg 92: 187, 1993 https://doi.org/10.1097/00006534-199308000-00001
  2. Lee YH, Kil MS: Total reccnstruction of the auricle for microtia using a modified Nagata's method with canaloplasty. J Korean Soc Plast Reconsir Surg 24: 1415, 1997
  3. Gibson T, Davis WB: The distortion of autogenous cartilage grafts: its cause and prevention. Br J Plast Surg 10: 257, 1957 https://doi.org/10.1016/S0007-1226(57)80042-3
  4. Kenedi RM, Gibson T, Abrahams M: Mechanical characteristics of skin and cartilage. Hm Factors 5: 525, 1963
  5. Stenstrom SJ: A 'natural' technique for correction of congenitally prominent ears. Plast Reconst Surg 32: 509, 1963 https://doi.org/10.1097/00006534-196311000-00003
  6. Fry HJ: Interlocked stresses in human nasal septal cartilage. Br J Plast Surg 19: 276, 1966 https://doi.org/10.1016/S0007-1226(66)80055-3
  7. Fry HJ, Robertson WV: Interlocked stresses in cartilage. Nature 215: 53, 1967 https://doi.org/10.1038/215053a0
  8. Fry HJ: Cartilage and cartilage grafts: the basic properties of the tissue and the components responsible for them. Plast Reconsi Surg 40: 426, 1967 https://doi.org/10.1097/00006534-196711000-00002
  9. ten Koppel PG, van der Veen JM, Hein D, van Keulen F, van Osch GJ, Verwoerd-Verhoef HL, Verwoerd CD: Controlling incision-induced distortion of nasal septal cartilage: a model to predict the effect of scoring of rabbit septa. Plast Reconst Surg 111: 1948, 2003 https://doi.org/10.1097/01.PRS.0000055427.13139.35
  10. Fries R, Platz H, Haidenthaler A: Surgical correction of cartilaginous nasal septum deformities. J Maxillofac Surg 6: 163, 1978 https://doi.org/10.1016/S0301-0503(78)80086-1
  11. Murakami WT, Wong LW, Davidson TM: Applications of the biomechanical behavior of cartilage to nasal septoplastic surgery. Laryngoscope 92: 300, 1982
  12. Murray JA: The behaviour of nasal septal cartilage in response to trauma. Rhinology 25: 23, 1987
  13. Orneal RM, Dodenhoff RJ, McClatchey KD: The role of perichondrium in modifying curved cartilage: an experimental study. Ann Plast Surg 19: 343, 1987 https://doi.org/10.1097/00000637-198710000-00010
  14. Avelar J: Importance of ear reconstruction for the aesthetic balance of the facial contour. Aesth Plast Surg 10: 147, 1986 https://doi.org/10.1007/BF01575285
  15. Thomson HG, Winslow J: Microtia reconstruction: does the cartilage framework grow? Plast Reconst Surg 84: 908, 1989 https://doi.org/10.1097/00006534-198912000-00007