소이증의 재건: 단일기관 경험
Auricular Reconstruction in Microtia Patients: A Single Institution Experience
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Background and Objectives Microtia is a congenital deformity where the pinna and mid- dle ear structures are underdeveloped. Auricular reconstruction in microtia is one of the most difficult surgeries in otolaryngology due to the complex three-dimensional structure of the auricle. This study investigated the post-operative results in total auricular reconstruction per- formed by otologic surgeons in a single institution. Subjects and Method We analyzed data from 27 microtia patients who underwent auricu- lar reconstruction in our institution from 2011 to 2019. The post-operative results were evalu- ated in terms of the shape of the auricle, the symmetry of the ear, and the degree of auriculo- cephalic sulcus stricture. The type and frequency of post-operative complications associated with the reconstruction were also evaluated. Results Of the 24 patients, the shape of the auricle was good in 11 (40.7%), moderate in 11 (40.7%), and poor in 5 (18.6%) patients. The symmetry of the ear size was symmetric in 24 (88.9%) and asymmetric in 3 (11.1%) patients. The degree of auriculocephalic sulcus stricture was good in 11 (40.7%), partial stricture in 12 (44.4%), and severe stricture in 4 (14.8%) patients. Postoperative complications included skin necrosis, suture material exposure, and wound in- fection with cartilage deformation. Conclusion Total auricular reconstruction is a complex and sophisticated operation utiliz- ing either autologous rib cartilage or artificial implant material. Considering that microtia is often accompanied by ear canal stenosis and hearing impairment, otolaryngologists should be more interested in the field of auricular reconstruction.
Abstract
Background and Objectives Microtia is a congenital deformity where the pinna and mid- dle ear structures are underdeveloped. Auricular reconstruction in microtia is one of the most difficult surgeries in otolaryngology due to the complex three-dimensional structure of the auricle. This study investigated the post-operative results in total auricular reconstruction per- formed by otologic surgeons in a single institution. Subjects and Method We analyzed data from 27 microtia patients who underwent auricu- lar reconstruction in our institution from 2011 to 2019. The post-operative results were evalu- ated in terms of the shape of the auricle, the symmetry of the ear, and the degree of auriculo- cephalic sulcus stricture. The type and frequency of post-operative complications associated with the reconstruction were also evaluated. Results Of the 24 patients, the shape of the auricle was good in 11 (40.7%), moderate in 11 (40.7%), and poor in 5 (18.6%) patients. The symmetry of the ear size was symmetric in 24 (88.9%) and asymmetric in 3 (11.1%) patients. The degree of auriculocephalic sulcus stricture was good in 11 (40.7%), partial stricture in 12 (44.4%), and severe stricture in 4 (14.8%) patients. Postoperative complications included skin necrosis, suture material exposure, and wound in- fection with cartilage deformation. Conclusion Total auricular reconstruction is a complex and sophisticated operation utiliz- ing either autologous rib cartilage or artificial implant material. Considering that microtia is often accompanied by ear canal stenosis and hearing impairment, otolaryngologists should be more interested in the field of auricular reconstruction.
참고문헌 (32)
- Kelley PE, "Microtia and congenital aural atresia", Otolaryngol Clin North Am, 40(1), pp.61~80 (2007)
- Bartel-Friedrich S, "Congenital auricular malformations : Description of anomalies and syndromes", Facial Plast Surg, 31(6), pp.567~580 (2015)
- Luquetti DV, "Microtia : Epidemiology and genetics", Am J Med Genet A, 158A(1), pp.124~139 (2012)
- Nagata S, "A new method of total reconstruction of the auricle for microtia", Plast Reconstr Surg, 92(2), pp.187~201 (1993)
- Zhang TY, "International consensus recommendations on microtia, aural atresia and functional ear reconstruction", J Int Adv Otol, 15(2), pp.204~208 (2019)
- Brent B, "Auricular repair with autogenous rib cartilage grafts : Two decades of experience with 600 cases", Plast Reconstr Surg, 90(3), pp.355~374 (1992)
- Brent B, "The correction of microtia with autogenous cartilage grafts: II. Atypical and complex deformities", Plast Reconstr Surg, 66(1), pp.13~21 (1980)
- Nagata S, "Modification of the stages in total reconstruction of the auricle: Part II. Grafting the three-dimensional costal cartilage framework for concha-type microtia", Plast Reconstr Surg, 93(2), pp.231~242 (1994)
- Gosain AK, "Prominent ears in children younger than 4 years of age : What is the appropriate timing for otoplasty?", Plast Reconstr Surg, 114(5), pp.1042~1054 (2004)
- Firmin F, "State-of-the-art autogenous ear reconstruction in cases of microtia", Adv Otorhinolaryngol, 68, pp.25~52 (2010)
- Siegert R, "Basic techniques in autogenous microtia repair", Facial Plast Surg, 25(3), pp.149~157 (2009)
- Alexander KS, "A morphometric study of the human ear", J Plast Reconstr Aesthet Surg, 64(1), pp.41~47 (2011)
- Skiles MS, "The anesthetics of ear placement : An experimental study", Plast Reconstr Surg, 72(2), pp.133~140 (1983)
- Li Q, "Auricular reconstruction of congenital microtia by using the modified Nagata method : Personal 10-year experience with 1350 cases", J Plast Reconstr Aesthet Surg, 71(10), pp.1462~1468 (2018)
- Wilkes GH, "Microtia reconstruction", Plast Reconstr Surg, 134(3), pp.464e~479e (2014)
- Xu Z, "New strategies for tragus and antitragus complex fabrication in lobule-type microtia reconstruction", Plast Reconstr Surg, 144(4), pp.913~921 (2019)
- Cabin JA, "Microtia reconstruction : Autologous rib and alloplast techniques", Facial Plast Surg Clin North Am, 22(4), pp.623~638 (2014)
- Beahm EK, "Auricular reconstruction for microtia: Part I. Anatomy, embryology, and clinical evaluation", Plast Reconstr Surg, 109(7), pp.2473~2482 (2002)
- Moon IY, "Estimation of eighth costal cartilage in surgical timing of microtia reconstruction", J Craniofac Surg, 26(1), pp.48~51 (2015)
- Limandjaja GC, "Complications of otoplasty : A literature review", J Plast Reconstr Aesthet Surg, 62(1), pp.19~27 (2009)
- Brent B, "Plastic Surgery", pp.633~698 (2007), Elsevier
- Murabit A, "Teaching ear reconstruction using an alloplastic carving model", J Craniofac Surg, 21(6), pp.1719~1721 (2010)
- Yamada A, "New training method of creating ear framework by using precise copy of costal cartilage", J Craniofac Surg, 20(3), pp.899~902 (2009)
- Sabbagh W, "Early experience in microtia reconstruction : The first 100 cases", J Plast Reconstr Aesthet Surg, 64(4), pp.452~458 (2011)
- Long X, "Complication rate of autologous cartilage microtia reconstruction : A systematic review", Plast Reconstr Surg Glob Open, 1(7), pp.e57~ (2013)
- Liu T, "Expansion method in secondary total ear reconstruction for undesirable reconstructed ear", Ann Plast Surg, 73(Suppl 1), pp.S49~S52 (2014)
- Fu YY, "Autologous cartilage microtia reconstruction : Complications and risk factors", Int J Pediatr Otorhinolaryngol, 116, pp.1~6 (2019)
- Park C, "An analysis of 123 temporoparietal fascial flaps : Anatomic and clinical considerations in total auricular reconstruction", Plast Reconstr Surg, 104(5), pp.1295~1306 (1999)
- Zhang Q, "Auricular reconstruction for microtia : Personal 6-year experience based on 350 microtia ear reconstructions in China", Plast Reconstr Surg, 123(3), pp.849~858 (2009)
- Siegert R, "Combined reconstruction of congenital auricular atresia and severe microtia", Adv Otorhinolaryngol, 68, pp.95~107 (2010)
- Fuchsmann C, "Hearing rehabilitation in congenital aural atresia using the bone-anchored hearing aid : Audiological and satisfaction results", Acta Otolaryngol, 130(12), pp.1343~1351 (2010)
- Cho BC, "Surgical results of two-stage reconstruction of the auricle in congenital microtia using an autogenous costal cartilage alone or combined with canaloplasty", Plast Reconstr Surg, 117(3), pp.936~947 (2006)
