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<<< < Предыдущая 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 1617 / 1717

148 / Index

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Bull’s method, 95–97 Burstein’s method, 108–111, 109f–110f

Caouette-Laberge’s method, 103–105, 104f cartilage

anatomy of, 10f matrix, 74 necrosis, 128, 129f perichondrium and, 74 pliability of, 27 quality of, 27

cartilage-cutting otoplasty

aesthetic sequelae in, 138t alternative conchal ﬂ ap technique, 70, 70f Bauer’s method, 68, 69f, 70 complications from, 125t criticism of, 71 lateral conchal ﬂ ap setback, 70, 70f Nachlas’s method, 65, 66f outcomes in, 71 patient satisfaction with, 136t Pitanguy’s method, 68 Siegert’s technique, 63–65, 64f surgeon satisfaction with, 136t surgical techniques, 63–71

Walter’s method, 65, 67, 67f cartilage island shaving, 39f cartilage-scoring otoplasty

aesthetic sequelae in, 138t

Azuara’s method, 83

cartilage-suturing vs., 118

Chait and Nicholson’s method, 78, 83

Chongchet’s method, 76

complications from, 125t

dermabrader drill for, 85

effect of, 73, 73f

with endoscopic carpal tunnel release

instruments, 85 Martin’s method, 78 Nolst Trenité method, 76–77 Nordzell’s method, 74, 75f, 76 overview of, 73–74 patient satisfaction with, 136t Peker and Celiköz’s method, 83, 84f posterior, 83, 85f Raunig’s method, 77–78, 77f, 79f–82f surgeon satisfaction with, 136t

cartilage-sparing otoplasty

antihelix repositioning, 39–42, 39f, 40f, 41f conchal setback, 36–39 dressings in, 56–57 evolution to, 3, 3f loss of correction with, 137 overview of, 35 supplementary maneuvers in, 42–43, 42f surgical techniques in, 36–43

suturing in, 35

undercorrection with, 137 cartilage splitting, evolution from, 3, 3f cartilage-suturing otoplasty

aesthetic sequelae in, 138t–139t

anteriorly-placed Kaye-type sutures

for, 98 Bull’s method, 95–97 cartilage-scoring vs., 118 complications from, 125t–126t Mustardé’s technique in, 98–99 overview of, 95 patient satisfaction with, 136t perichondrioplasty in, 99, 99f surgeon satisfaction with, 136t Tardy’s method for, 97–98 techniques, 95–99

caudaconchal sutures, 35, 42f cauda helical incision, 50f cavum concha, 10f

eminence of, 10f

cellulitis, postoperative, 127f cephaloconchal angle, 16 Chait and Nicholson’s method, 78, 83 chondrocutaneous malignancy, 47 chondrocytes, 74 Chongchet’s method, 76 closure, 55–57, 55f, 56f, 57f combination otoplasty

aesthetic sequelae in, 139t anterior, 113 anterior-posterior otoplasty, 111–112, 111f, 112f Burstein’s method, 108–111, 109f–110f Caouette-Laberge’s method, 103–105, 104f complications from, 126t cutting-molding, 113 Farrior’s method, 102–103, 123 overview of, 101 patient satisfaction with, 136t posterior, 113, 114f Spira’s method, 105–108, 106f–107f Stucker’s method, 101–102 surgeon satisfaction with, 136t techniques, 101–114

comparisons

animal, 120–121 Bologna experience, 119 Edinburgh experience, 117–118 Feldkirch/Zürich experience, 118–119

complications. see also aesthetic pitfalls

early, 124–129 late, 129–132 organization of, 123 rates of, 123 reporting of, 123 by technique, 125t–126t

compressive dressing, 56, 57f

Index / 149

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concha

embryology of, 9

hypertrophy of, 81f conchal bowl deformity, 17 conchal ﬂ ap techniques, 70, 70f conchal irregularities, as aesthetic outcome, 143 conchal setback, 36–39 conchamastoid sutures, 36f, 38f, 42f contour irregularity, as aesthetic outcome, 138t–139t Converse’s technique, 2, 2f, 118–119, 119–120 cotton bolsters, 56, 56f crus helicus, 10f cryptotia, 18f, 26 culture, prominauris and, 25 cup ear, 18f

deﬁ nition of, 18

diamond-coated ﬁ le technique for, 80f cymba concha, eminence of, 10f

Darwinian tubercle, excision of, 46f deformities, auricular, 16–17 dermabrader drill, for cartilage scoring, 85 dermatitis, postoperative, 124, 127, 131 diamond-coated ﬁ le technique, 77, 79f–82f diazepam, 30 Dieffenbach, Johann Friedrich, 1 dissatisfaction, patient, 135–136, 136t dressing, 55–57, 55f, 56f, 57f dressing removal, 57 dumbbell excision, 34f dysesthesias, 130–131

Edinburgh experience, 117–118 elﬁ n ear, deﬁ nition of, 18 Ely’s technique, 1, 1f embryology, auricular, 8–9 enlarged lobule, reduction of, 51, 51f, 52f examination, physical, 21–22 excision

dumbbell, 34f

lobule-correcting inferior, 34f

postauricular skin, 30–31, 31f, 32f, 34f exercise resumption, 57 external carotid artery, 12f external molding device, 26f extrinsic ligaments, 10

Farrior’s method, 102–103, 123 Feldkirch/Zürich experience, 118–119 fossa triangularis, 10f

eminence of, 10f fossa triangularis-temporalis fascia sutures, 35, 42f Francesconi otoplasty, 118–119 Fritsch’s method, 87–92

Furnas-type horizontal mattress sutures, 36

goals, surgical, 22–25, 25t granuloma, postoperative, 132, 132f great auricular nerve, 12f

Haecker & Joseph method, 119–120 helical fold, amelioration of deﬁ cient, 46, 47f helical prominences, reduction of, 45–46, 46 helical rim

deﬁ cient, 45–46 kinked, 18f measuring, 22 normal projection of, 16

helix, 10f

hidden, 141–142, 142f hematoma, postoperative, 125t–126t, 127 hidden helix deformity, 141–142, 142f histology, auricular, 7–8 history, 1–4

incision, 30, 30f

in cartilage splitting, 64f

cauda helical, 50f

in reduction of helical prominences, 45

in reduction of large scapha, 47–48 infection, postoperative, 125t–126t, 127–128, 127f inferior auriculocephalic distance, 24f inferior crus, 10f

underdevelopment of, 17 innervation, auricular, 11, 12f, 13f

Japanese babies, auricular deformities in, 26

keloid scarring, 125t–126t, 131, 131f kinked helical rim, 18f

lateral conchal ﬂ ap setback, 70, 70f lesser occipital nerve, 12f literature reviews, 120 lobular abnormalities, 48–52 lobular prominence, 144 lobule

medialization of protruding, 48–51, 50f

reduction of enlarged, 51, 51f, 52f lobule-correcting inferior excision, 34f lobule-sternomastoid muscle sutures, 35 local anesthesia, 30 lop-ear deformity, 18f

before and after, 58f, 59f, 60f, 61f, 62f

cartilage-suture otoplasty for, 96f, 97f

150 / Index

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lop-ear deformity (Continued)

deﬁ nition of, 17–18 history of, 1–2, 2f nonsurgical interventions for, 26

Luckett’s technique, 1–2, 2f

Machiavellian ear, deﬁ nition of, 18 Martin’s method, 78 mastoid dressing, 56, 57f mastoid-helical distance measurements, 22 McDowell’s goals, 25t medial auriculocephalic distance, 24f medially-based postauricular ﬂ ap, 34f microtia, 47 molding device, 26f Mustardé’s technique, 4, 4f, 98–99 Mustardé-type scaphaconchal sutures, 39f

Nachlas’s method, 65, 66f nausea, postoperative, 124 New Zealand white rabbit model, 120–121 Nolst Trenité method, 76–77 nonsurgical intervention, 26 Nordzell’s method, 74, 75f, 76

“open book” approach, 49 overcorrection, 29–30, 137, 138t–139t, 140

pain, postoperative, 124 palpation, in physical examination, 22 patient dissatisfaction, 135–136, 136t Peker and Celiköz’s method, 83, 84f perichondrioplasty, 99, 99f perichondritis, 128 perichondrium, 74 photographic assessment, 22 physical examination, 21–22 pinna, congenital deformities of, 9 Pitanguy’s method, 68 pliability, of auricular cartilage, 27 “pointer,” 10f postauricular ﬂ ap, medially-based, 34f postauricular skin excision, 30–31, 31f, 32f, 34f posterior auricular nerve, 12f posterior cartilage scoring, 83, 85f postoperative care, 57–58 postoperative nausea and vomiting (PONV), 124 postoperative pain, 124 preparation, for surgery, 30 Prolene suture, 36 prominauris

behavior problems and, 25 culture and, 25

incidence of, 16–17 psychological implications of, 25–26 scaphaconchal angle in, 17 self-esteem and, 25

proportions, 15f protruding ear, deﬁ nition of, 18 protruding lobule, medialization of, 48–51, 50f psychological implications, 25–26

rabbit model, 120–121 radix helicus, 10f Raunig’s method, 77–78, 77f, 79f–82f reprotrusion, 136–137, 138t–139t residual deformity, 136–137, 138t–139t retroauricular sulcus obliteration, 143, 143f reverse telephone ear deformity, 141 revision, 138t–139t, 140 ridges, auricular, 142–143

satisfaction

patient, 135–136, 136 surgeon, 136t

satyr ear, deﬁ nition of, 18 scapha

eminence of, 10f reduction of large, 46–48, 48f, 49f

scaphaconchal angle

deﬁ nition of, 16 in prominauris, 17

scaphaconchal sutures, 35, 39f, 40f, 41f, 42f scapha-fossa triangularis sutures, 35 scarring, unacceptable, 131, 131f self-esteem, prominauris and, 25 sensory abnormalities, postoperative, 130–131 shaving, cartilage, 39f shell ear, deﬁ nition of, 18 Siegert’s method, 63–65, 64f skin reactions, postoperative, 124, 127, 128–129, 131–132,

132f skin ulceration/necrosis, 125t–126t, 128–129 small access techniques

advantages of, 87 criticism of, 87 Fritsch’s method, 87–92 history of, 92–93 instruments in, 87 scoring in, 93 sutures in, 88f, 89f, 90f, 91f

techniques in, 87–94 soft tissue management, 31, 32f, 33 Spira’s method, 105–108, 106f–107f splinting methods, 26 Spock ear, 45 Stahl’s ear, 18f

deﬁ nition of, 18

Index / 151

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nonsurgical interventions for, 26 Stenstrom’s technique, 3, 3f Stucker’s method, 101–102 subdermal cyst, postoperative, 132, 132f superior auriculocephalic distance, 24f superior crus, 10f superior temporal artery, 12f surgeon satisfaction, 136t surgery

alternatives to, 26

anesthesia in, 30

cartilage-sparing, 36–43

closure in, 55–57, 55f, 56f, 57f

dressing in, 55–57, 55f, 56f, 57f

general avenues for, 29

goals of, 22–25, 25t

incision in, 30, 30f

overcorrection in, 29–30

postauricular skin excision in, 30–31, 31f, 32f, 34f

postoperative care in, 57–58

preparation for, 30

psychological implications of, 25–26

soft tissue management in, 31, 32f, 33

technique in, 30–34

timing of, 26–27 Sushruta, 1 sutures. see also cartilage-suturing otoplasty

absorbable, 36

for cartilage sparing, 35

caudaconchal, 35, 42f

complications with, 129–130, 130f

conchamastoid, 36f, 38f, 42f

extrusion of, 129–130, 130f

failure of, 137

fossa triangularis-temporalis fascia, 35, 42f

Furnas-type horizontal mattress, 36

lobule-sternomastoid muscle, 35 overtightening of conchal, 37 Prolene, 36 reactions, 125t–126t, 129–130, 130f scaphaconchal, 35, 39f, 40f, 41f, 42f scapha-fossa triangularis, 35 sequence, in cartilage sparing, 37 types of, 35

Tagliacozzi, 1 Tardy’s method, 97–98 telephone-ear deformity, 141, 141f timing, of surgery, 26–27 topography, auricular, 9f tragal prominence, 143–144 tragus, 10f

unacceptable scarring, 131, 131f undercorrection, 137

variation, in auricular composition, 10–11, 11f vasculature, auricular, 11–12, 12f, 13f vertical post deformity, 141 “vertical post” deformity, 41 vomiting, postoperative, 124

Walter’s method, 65, 67, 67f Webster’s technique, 4 wound complications, 128–129

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