Carcinoma of the external ear. A guide to surgical management.
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Surgery of moderate cup ear deformities, severe cup ear deformities and microtia is described. In cases of unilateral atresia auris we usually do not perform middle ear surgery. In cases of bilateral atresia the child is fitted with a bone conducting hearing aid as soon as possible and operated on when the child is 4 to 5 years old. After bilateral middle ear surgery we reconstruct the auricle at the age of 5 or 6 years.
Disturbances observed int he thermoregulation of replanted extremities were the stimulus for this experimental study. We chose the auricular conchae of rabbits as an experimental model, as these show--as do the fingers--innervation with the sympathic nervous system and fulfil thermoregulatoric functions. Twenty-five of thirty auricular conchae of rabbits took completely after amputation and replantation. Blood flow measurements with 133 Xenon, thermographic and histologic examinations were performed. Thermography showed dysfunction with temperature provocation even one year after replantation. Histological examinations revealed partly deficient reinnervation in vessels and also in cutaneous appendages.
Similar to the method of Davis (1) we make a wedge-shaped incision in the miniear and the severe cup ear deformity (Fig. 1, 3) to enlarge the auricle. The defects are covered by a composite graft of the normal auricle or by a retroauricular flap. Two examples are described.
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At the constant ambient temperature 28--30 degrees C the rabbit ear vessels were dilated and their temperature was 34.8/0.1 degrees C. Administration of the 23--29 degrees water into the stomach entailed thermoregulatory constriction of the ear vessels within 15--25 min. The response occurred at various combinations of temperature changes in different parts of the body. The heat content of the rabbit body, as calculated by the blood temperature in the aorta arc, reduced by 266.3 +/- 26.2 cal/kg at the beginning of the response. The decrease in the organism heat content seems to serve as a signal for occurrence of a corresponding thermoregulatory response.
A new application method was developed and tested for the immunoprophylaxis of rabbits against myxomatosis using a live MXT vaccine. This new application method--injection of the ear with a special double needle--is very simple and easy. Its use enables a five-fold increase in vaccination doses as compared with subcutaneous application while the amount of vaccine remains the same. In laboratory this method with the MXT vaccine secured a 98.2% protection of the vaccinated animals. One vaccination dose contains 18.1 to 37.2 PD50. Eleven months from a single vaccination by injecting the ear, 83% of the rabbits still remained protected against experimental infection. With the use of the new application method of injecting the ear with the special double needle, the live MXT vaccine against myxomatosis in rabbits represents an effective, easily practicable and economically advantageous direction in the immunoprophylaxis of rabbits against myxomatosis.
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