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At least 379 records · Page 21Linked to original sources
PubMed1992

[Reconstruction of the external ear].

The authors after a short morphological description of the microtia, expose the surgical evolution which had led to the actual auricular reconstruction technique, using a costal cartilage framework. This technique requiring several steps is exposed in the typical case of microtia. It is the preferential method. The difficult reconstructions due to the poor quality of the skin are exposed by degree of complexity: in these cases, tissue expansion, fascia temporalis superficialis can be useful and finally auricular prostheses, attached to bone-integrated implants, can be recommended. The functional surgery of the middle ear is also replaced in the context of the auricular reconstruction which is done around 8 years old.

Burns↗
PubMed1992

[The external ear--a marker in identification].

The ear, well known anatomically in earlier investigations was only measured. We looked for 144 newborns and children (sex, age, morphology). We studied carefully and first of all systematically size, form and condition of the auricula. The form is genetically determined. Babies have a relative big ear between 9 and 15 months of age (accelerated?). In early time (20 century) this development only seen by children 3 years old. Eight specific characters changes with age (months). Outcome are proofed on 732 pupils. In forensic medicine a scientist should know this results before expertise of identification by mass disasters or unknown children.

Adolescent↗
PubMed2004

Reconstruction of partially amputated external ear with costal cartilage graft: case report.

Many causes are responsible for secondary anomalies of the outer ear, such as: car accidents, sport- or work-related accidents, assaults, bites from animals or humans, benign or malignant tumours, burns and the effects of surgical interventions of the ear (plastic surgery on the ear or attempts at correction of primary malformations of the ear). The anatomical complexity of the ear makes its reconstruction particularly complicated with post-operative results that are often disappointing. The Authors describe their experience in the reconstruction of a partially amputated outer ear following a dog bite. The therapeutic protocol required various surgical stages. Initially, a cutaneous expander was applied at the level of the mastoid in order to ensure a sufficient quantity of local skin. The second stage was to remove cartilage from the ribs, followed by construction of a cartilaginous model of the ear and its insertion into the subcutaneous mastoid region after removal of the cutaneous expander and any residual ear cartilage. The last stage was to separate the neo-formed outer ear from the mastoid skin with the insertion of a cartilage graft to the posterior region of the reconstructed ear. This graft was covered by the occipital fascia rotated at 180 degrees and by a skin graft removed from the pubis. The postoperative result was satisfactory with recuperation of a good aesthetic appearance of the ear. Aim of the present report is to describe the surgical technique employed in the reconstruction of secondary anomalies of the ear and to highlight errors committed during this procedure. These considerations have allowed us to stress some fundamental elements in the reconstruction of the ear. In particular, the watershed was the awareness that we had to create a cartilaginous model that respected, as far as possible, the anatomy of the outer ear with all its ridges, trenches and cavities. This as well as ensuring a sufficient quantity of local skin in order to cover the cartilaginous graft and, therefore, reduce the risk of exposing the cartilage and subsequent infection, to guarantee an optimal end result.

Adult↗
PubMed1992

The external ear canal contralateral lower limb reflex: a case report.

A tactile stimulus applied to the EEC can reflexly cause the contralateral hip-thigh to flex at the hip joint and the leg to extend. Various stimuli, e.g., pressure, thermal or nociceptive, may also initiate the above reflex. The conjectured reflex is considered to be mediated via afferent fibers to the spinal tract and nucleus of the fifth cranial nerve, synapsing with the brainstem reticular core in the medulla and/or pons. The reticulospinal motor system descending in the spinal cord relays the afferent fibers to the contra lower limb appropriate musculature. The overt reflex is indeed rare.

Afferent Pathways↗
PubMed1991

[Procedure to follow in post-traumatic reimplantation of the external ear].

Cases of complete traumatic amputation of the auricle successfully treated by reimplantation are rare. The author used the Baudet technique: it consist of suppression of the skin cover of the posterior aspect of the mutilated fragment and creation through the cartilage of appropriately sized and arranged windows. This mutilated fragment is then sutured by its anterior edge to the remaining portion of the auricle and by its peripheral rim to a posteriorly based mastoid flap.

Ear, External↗
PubMed1991

Angiosarcoma of the external ear: a case report.

A case of an angiosarcoma of the pinna in an 82-year-old male is reported. Variability of presentation and lack of clinical awareness may result in a delay in the diagnosis of this rare tumor. Initial confusion may arise because of the deceptively benign clinical appearance of the lesion, which may resemble a bruise or superficial infection. Early biopsy is mandatory in view of the prognostic significance of tumor diameter at the time of diagnosis. Untreated, the mean survival of patients with angiosarcoma is 7 months. This increases to 15 to 20 months in treated patients, 12 percent being alive at 5 years. A combination of surgery and radiotherapy offers the best chance of cure. The need for wide local treatment of apparently normal tissue has been advocated because of imperceptible local spread of the tumor. Apparent cure may be followed by late local recurrence or distant metastasis, so lifelong follow-up is necessary.

Aged↗
PubMed1990

[Reconstruction of the external ear in children. Contribution of the clay model cartilage sculpture].

The use of rib cartilage graft in ear reconstruction gives good cosmetic results after the age of 8. However three main conditions must be taken into account: 1) a perfect framework sculpture; 2) good quality of the skin in order to provide a soft tissue free of scars and able to drape the framework in all the details of the sculpture; 3) a soft but useful succion system allowing a good coaptation between the framework and the skin without vascular damage. Most of the surgical failures are due to skin scars which compromise the elasticity of the cutaneous pocket. The authors recommend to wait until the age of 8 before any surgery in order to keep the skin intact and to let the ribs grow. The problem of hearing can be treated as secondary.

Cartilage↗
PubMed1990

Injuries of the external ear.

Ear injuries occur in people of all ages but predominate in active people such as wrestlers, boxers, and bike riders. The types and extent of injury are a function of the force causing the injury. Shearing forces of moderate intensity cause hematoma formation, whereas greater force causes lacerations or even amputation. Sharp objects cause lacerations determined by the force, direction, and point of impact. The high ratio of surface area to mass makes the auricle vulnerable to extremes of temperature. People participating in high-risk activities should wear protective headgear. The goal of treatment is to restore the normal contours while preventing infection. Hematoma results in disfigurement by organization or chondritis. Evacuation and pressure dressings using sterile technique correct the condition. Second-degree burns are treated by regular cleansing and application of topical antimicrobials. Deeper burns require debridement, biologic dressings, or burying the cartilage subcutaneously for later reconstruction. Simple lacerations are closed under aseptic technique using either skin-to-skin sutures only or sutures of the skin combined with intercartilage sutures. Extensive and complex lacerations require meticulous care to match all fragments and prevent infection or loss of tissue. Bare cartilage must be covered with vascularized tissue. The treatment of total amputation is controversial. Some advocate reattachment as a composite graft using intravenous low molecular weight dextrans and heparin as adjuvants. Mladick dermabrades the amputated pinna, reattaches it with sutures, and then slips it into a pocket of elevated postauricular skin for 2 weeks. Others urge microvascular reanastomosis of the small nutrient vessels. Brent and Byrd separate the cartilage from its overlying skin and envelope it first with vascularized temporoparietal fascia and then a split-thickness skin graft. Chondritis is the most feared complication of injury or surgery of the pinna. It is an aggressive process, and prompt removal of pus and necrotic cartilage is required. Exteriorization and removal of all cartilage is effective but disfiguring. Removal of only affected cartilage and constant irrigation with antibiotic solutions is effective but requires prolonged hospitalization. Iontophoresis of antibiotics into the auricle may be effective and conserve tissue. Traumatic deformities are corrected with composite grafts from the opposite ear, costal cartilage, and local pedicled flaps.(ABSTRACT TRUNCATED AT 400 WORDS)

Amputation, Traumatic↗