DOI QR코드

DOI QR Code

Reconstruction Techniques for Tissue Defects Formed after Preauricular Sinus Excision

  • Lee, Myung Joon (Department of Plastic and Reconstructive Surgery, Eulji University Hospital, Eulji University School of Medicine) ;
  • Yang, Ho Jik (Department of Plastic and Reconstructive Surgery, Eulji University Hospital, Eulji University School of Medicine) ;
  • Kim, Jong Hwan (Department of Plastic and Reconstructive Surgery, Eulji University Hospital, Eulji University School of Medicine)
  • Received : 2013.03.18
  • Accepted : 2013.05.23
  • Published : 2014.01.15

Abstract

Background Preauricular sinuses are congenital abnormalities caused by a failure of fusion of the primitive tubercles from which the pinna is formed. When persistent or recurring inflammation occurs, surgical excision of the infected tissue should be considered. Preauricular defects inevitably occur as a result of excisions and are often difficult to resolve with a simple suture; a more effective reconstruction technique is required for treating these defects. Methods After total excision of a preauricular sinus, the defect was closed by a plastic surgeon. Based on the depth of the defect and the degree of tension when apposing the wound margins, the surgeon determined whether to use primary closure or a posterior auricular flap. Results A total of 28 cases were examined. In 5 cases, including 2 reoperations for dehiscence after primary repair, reconstruction was performed using posterior auricular transposition flaps. In 16 cases of primary closure, the defects were closed using simple sutures, and in 7 cases, closure was performed after wide undermining. Conclusions If a preauricular defect is limited to the subcutaneous layer and the margins can be easily approximated, primary closure by only simple suturing may be used to perform the repair. If the defect is deep enough to expose the perichondrium or if there is tension when apposing the wound margins, wide undermining should be performed before primary closure. If the extent of the excision exposes cartilage, the procedure follows dehiscence of the primary repair, or the tissue is not sufficiently healthy, the surgeon should use a posterior auricular flap.

Keywords

References

  1. Tan T, Constantinides H, Mitchell TE. The preauricular sinus: a review of its aetiology, clinical presentation and management. Int J Pediatr Otorhinolaryngol 2005;69:1469-74. https://doi.org/10.1016/j.ijporl.2005.07.008
  2. Thorne CH, Brecht LE, Bradley JP, et al. Auricular reconstruction: indications for autogenous and prosthetic techniques. Plast Reconstr Surg 2001;107:1241-52. https://doi.org/10.1097/00006534-200104150-00024
  3. Gan EC, Anicete R, Tan HK, et al. Preauricular sinuses in the pediatric population: techniques and recurrence rates. Int J Pediatr Otorhinolaryngol 2013;77:372-8. https://doi.org/10.1016/j.ijporl.2012.11.029
  4. Baatenburg de Jong RJ. A new surgical technique for treatment of preauricular sinus. Surgery 2005;137:567-70. https://doi.org/10.1016/j.surg.2005.01.009
  5. Bae SC, Yun SH, Park KH, et al. Preauricular sinus: advantage of the drainless minimal supra-auricular approach. Am J Otolaryngol 2012;33:427-31. https://doi.org/10.1016/j.amjoto.2011.10.015
  6. Schonauer F, Vuppalapati G, Marlino S, et al. Versatility of the posterior auricular flap in partial ear reconstruction. Plast Reconstr Surg 2010;126:1213-21. https://doi.org/10.1097/PRS.0b013e3181ec1f03
  7. Lam HC, Soo G, Wormald PJ, et al. Excision of the preauricular sinus: a comparison of two surgical techniques. Laryngoscope 2001;111:317-9. https://doi.org/10.1097/00005537-200102000-00024
  8. Kumar KK, Narayanamurthy VB, Sumathi V, et al. Preauricular sinus: operating microscope improves outcome. Indian J Otolaryngol Head Neck Surg 2006;58:6-8.
  9. Yoshimura K, Nakatsuka T, Ichioka S, et al. One-stage reconstruction of an upper part defect of the auricle. Aesthetic Plast Surg 1998;22:352-5. https://doi.org/10.1007/s002669900216
  10. Yanai A, Okabe K, Nakamura Y. Epidermal cyst originating from the preauricular sinus. Plast Reconstr Surg 1987;79: 265-6. https://doi.org/10.1097/00006534-198702000-00021
  11. Chang YL, Chen YR, Noordhoff MS. Reconstruction of middle-third auricular defect based on aesthetic perception theory. Aesthetic Plast Surg 1990;14:223-5. https://doi.org/10.1007/BF01578353
  12. Choi JH, Kim JY, Yoo YS, et al. Chondrocutaneous advancement flap for helical rim defect. Korean J Otorhinolaryngol-Head Neck Surg 2010;53:252-5. https://doi.org/10.3342/kjorl-hns.2010.53.4.252

Cited by

  1. Ectopic Preauricular Sinus in a Facial Cleft and Microtia Patient vol.18, pp.4, 2017, https://doi.org/10.7181/acfs.2017.18.4.287