• 대한두개안면성형외과학회지
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• 제10권2호
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• pp.127-130
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• 2009

Purpose: In an amputated auricle, a microvascular anastomosis is the best treatment of choice. But, the neartotally amputated auricle which is connected by very narrow tissue pedicle to the head, can survive by simple attachment without a microvascular anastomosis owing to the rich vascular network through the superficial temporal artery and posterior auricular artery. In cases of venous congestion resulting from a lack of vein anastomosis, medical leeches (Hirudo medicinalis) can solve the problem. We are reporting the case of a 6-year-old boy who had a neartotally amputated auricle with successful results by simple closure and medical leech treatment without a microvascular anastomosis. Methods: A 6-year-old male patient had an left auricular injury by an escalator accident. The left auricle was neartotally amputated from the temporal head with connection only by very narrow skin and subcutaneous pedicle (about 1 cm in width) at the helical root of upper and anterior part of auricle. Marginal bleeding from the avulsed auricle was noted and the arterial blood was supplied from a branch of upper auricular branch of the superficial temporal artery. The auricle was repaired by simple closure including cartilage and skin without any vascular anastomosis. After simple closure, the auricle showed good circulation with pink color. But on the 2nd day after the operation, there was a venous congestion with severe swelling, which resulted in a purplish colored auricle. The venous congestion disappeared after using medical leeches by the 5th day after the operation. Results: The repaired auricle showed aesthetically and functionally satisfactory result with normal development at the 9 months follow-up check after the operation. Conclusion: In cases of neartotally amputated auricles of children or crushing injury in which microsurgery is difficult, we can try simple closure with the use of medical leeches in treating a of venous congestion for a successful result.

• 대한두개안면성형외과학회지
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• 제19권4호
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• pp.287-290
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• 2018

Tumoral calcinosis is a condition characterized by deposition of calcium salts in the skin and subcutaneous tissue, commonly found around the joints. However, tumoral calcinosis of the auricle is extremely rare. We present the case of a 13-year-old boy with tumoral calcinosis of the helix of the ear auricle. A 13-year-old boy presented with a 10-year history of an enlarging mass on the left auricle. The mass was hard, non-tender, and non-compressible. The patient had no history of trauma. Complete surgical excision and pathological examination of the specimen was performed. The final diagnosis of the excised mass was tumoral calcinosis. After 9 months of follow-up, there were no signs of recurrence of the tumor and the patient was satisfied with the surgical results. Tumoral calcinosis of the auricle is extremely rare and may be misdiagnosed as other tumors. Pathological examination is essential for definitive diagnosis and complete surgical excision should be considered as the treatment of choice.

• 대한두경부종양학회지
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• 제37권1호
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• pp.39-42
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• 2021

Schwannomas are benign tumors of neuroectodermal origin and can be found in any part of the body. Although schwannomas are common in the head and neck region, they are rare in the auricle. Auricular schwannomas are rarely symptomatic but the mass itself or a surgical procedure to remove it may disrupt the complicated structure of the auricle. We report a rare case of auricular schwannoma with a literature review and describe the surgical technique used in this case.

• International journal of advanced smart convergence
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• 제10권4호
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• pp.241-255
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• 2021

The human auricle is the first part to receive sound from the outside. In this part, the frequency range of human recognizable form is divided and organized. In this study, we propose modeling by applying a single sound source to the surface of the human auricle. This means that when the sound pressure of a low frequency (low frequency) sound enters the pinna, the impedance felt at the tip of a part of the non-linear surface of the pinna is mainly due to the tensile force at the end of the part of the non-linear surface of the pinna. By expressing the situation of moving at a very small speed, the characteristic impedance of the pinna was confirmed to be negative infinity, and it was also confirmed that the speed at the tip of a part of the non-linear surface of the pinna was 0 in the anti-resonance state. It was found that the wave propagation phenomenon that determines the characteristics of the filter is determined by how large the wavelength, kL, is compared to the length of the tip of a part of the non-straight surface of the pinna. Humans first receive sounds from outside through their ears. The auricle is non-linear and has a curved shape, and it is known that it analyzes frequencies while receiving external sounds. The human ear has an audible frequency range of 20Hz - 20,000Hz. Through the study, we applied the characteristics of the notch filter to hypothesize that the human audible frequency range is separated from the auricle, and applied filter theory to analyze it, and as a result, meaningful results were obtained. The curved part and the inner part of the auricle function as a trumpet, collecting sounds, and at the same time amplifying the weak sound of a specific band. The point was found and the shape of the envelope detected in the auricle was found. Selectivity for selecting sounds coming from the outside is the formula of the pinna that implements the function of Q. The function of distinguishing human-recognizable sound from the pinna from low to high through frequency analysis is performed in the pinna, and the 2-3kHz area, where human hearing threshold is the most sensitive, is also the acoustic impedance of the most recessed area of the pinna. It can be seen that starting from.

• Archives of Plastic Surgery
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• 제40권3호
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• pp.209-213
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• 2013

Background A cartilage wedge block and covering flap are standard procedures for firm elevation of the ear in microtia correction. However, using costal cartilage for elevation of the reconstructed auricle can be insufficient, and the fixed cartilage wedge block may be absorbed or may slip out. Furthermore, elevating covering flaps is time-consuming and uses up fascia, a potential source of reconstruction material. Therefore, we propose an innovative method using autologous onlay rib bone graft for auricular elevation of microtia. Methods From February 1995 to August 2012, 77 patients received a first stage operation with a rib cartilage framework graft. In the second stage operation, a small full thickness of rib bone was harvested through the previous donor scar. The bihalved rib bone was inserted into the subperiosteal pocket beneath the cartilage framework. Results The follow-up time ranged from 1 month to 17 years, with a mean of 3 years. All of the patients sustained the elevation of their ears very well during the follow-up period. Donor site problems, except for hypertrophic scars, were not observed. Surgery-related complications, specifically skin necrosis, infection, or hematoma, occurred in 4 cases. Conclusions Onlay rib bone graft used to elevate the reconstructed auricle is a more anatomically appropriate material than cartilage, due to the bone-to-bone contact between the bone graft and the temporal bone. Postoperative minor correction of the elevation degree is straightforward and the skin graft survives better. Therefore, reconstructed auricle elevation using onlay rib bone graft is a useful and valuable method.

• 대한두경부종양학회지
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• 제22권2호
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• pp.159-162
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• 2006

Trichilemmal carcinoma is a rare malignant neoplasm of the hair follicle from the outer root of the hair follicle sheath. This tumor can be misleading, and a false diagnosis of a squamous cell carcinoma. We report a case of trichilemmal carcinoma with a review of literature. The patient presented with an exophytic well circumscribed nodular mass on the left auricle, which was detected 6 months ago. Histopathologically, the tumor consisted of atypical clear cells which contained abundant glycogen. The tumor cells shows lobular growth pattern with necrosis, foci of trichilemmal keratinization and peripheral pallisading. Total excision and repair with full-thickness skin graft was done with minimal surgical morbidity. The patient has been free of recurrence or metastasis for 8 months.

• 대한기관식도과학회:학술대회논문집
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• 대한기관식도과학회 1981년도 제15차 학술대회연제순서 및 초록
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• pp.40.2-40
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• 1981

이개의 기형은 임상적으로 드문 질환으로, 크게 발육장애와 발육과잉으로 나눈다. 발육장애의 하나인 소이의 발생빈도는 약 6,000 : 1, 남 : 여가 2 : 1, 일측대양측은 대체로 8 : 1의 비율이다. 고도의 기형은 외이도와 중이에 까지 기형을 동반할 수 있다. 최근 저자들은 건강한 24세의 남자에서 청력장애나 기타 수반된 장애가 없는 편측성 소이를 Local flap을 이용한 Rotation flap으로 교정했던 좋은 결과를 얻었기에 문헌적 고찰과 함께 보고하는 바이다.

• Archives of Plastic Surgery
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• 제36권3호
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• pp.289-293
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• 2009

Purpose: The retroauricular flap has many advantages for facial reconstruction and is being performed by many surgeons. However, it is difficult for the retroauricular flap to perform reconstruction of the upper region of the auricle and its surroundings, due to limited rotation arc and length of pedicle. We successfully reconstructed the upper region of the auricle and its surroundings with retroauricular flap by using the superior auricular artery as a supplying pedicle. The purpose of this study is to present an anatomic study about the superior auricular artery and its clinical application. Methods: We investigated the relationship between the superior auricular artery and its surrounding structures through anatomic studies with 7 fresh cadavers and then applied the findings clinically. From February to December 2008, we performed 7 cases of the superior auricular artery island flap to reconstruct the defects in patients operated on skin cancer. Sizes of the defects varied form $0.8{\times}0.8cm$ to $3.5{\times}3.0cm$. Results: We found that the superior auricular artery is a reliable pedicle for the retroauricular flap, based on anatomical studies. All wounds of the patients were successfully closed. The flap donor site was primary closed except in one patient with a large defect. The aesthetic outcomes of the donor and recipient sites were satisfying. Conclusions: The superior auricular artery island flap has several advantages. Therefore, we suggest that the superior auricular artery island flap is a treatment of choice for reconstructing soft tissue defect at the upper region of the auricle and its surrounding area.

• Archives of Plastic Surgery
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• 제36권2호
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• pp.229-232
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• 2009

Purpose: Kimura's disease is a relatively rare head and neck tumor that frequently occurs in young orientals accompanied with eosinophila. We shared our experience of two cases of Kimura's disease, treated by radical resection and post operative steroid therapy, so we report the correlation of eosinophil counts and disease progression. Methods: A 25 years old male came to the clinic with a mass localized to the right cheek inferior to the right auricle. We could not resect the mass totally. During the follow up period, we checked the eosinophil counts, and steroid therapy was started 7 months after the surgery. A 34 year old female came to the clinic with a mass localized inferior to the left auricle reaching from the posterior portion of the auricle to the left temporal portion. We tried to remove as much tumor as possible, save the temporal region, in regard to the impairment of blood supply to the auricle. After operation, steroid therapy was started. Results: In the first case, the tumor was easily approachable, and radical resection of the tumor with post operative steroid therapy was an effective treatment. In tumors located at difficult regions to remove, as in the second case, optimal debulking and post operative steroid therapy was also effective in treating Kimura's. There were no recurrences in both cases. Eosinophil counts were always reduced after surgery and steroid therapy, and during the period with low eosinophil counts, there was no recurrence of Kimura's disease. Conclusion: Surgery and post operative steroid therapy were effective in treatment of Kimura's disease, and we could assume eosinophil counts as a good indicator for evaluation of the prognosis of Kimura's disease during the follow up period.

• 대한두개안면성형외과학회지
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• 제25권4호
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• pp.179-186
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• 2024

Background: Auricle reconstruction is among the most challenging procedures in plastic and reconstructive surgery, and the choice of framework material is a critical decision for both surgeons and patients. This meta-analysis compared the outcomes of autologous auricle reconstruction using costal cartilage with those of alloplastic reconstruction using porous polyethylene implants. Methods: A literature review was conducted using the PubMed and Embase databases to retrieve articles published between January 2000 and June 2024. The outcomes analyzed included postoperative complications such as framework exposure, infection, skin necrosis, hematoma, and hypertrophic scars, as well as patient satisfaction. The proportions of reconstructive outcomes from each selected study were statistically analyzed using the "metaprop" function in R software. Results: Fourteen articles met our inclusion criteria. The group undergoing polyethylene implant reconstruction exhibited higher rates of framework exposure, infection, and skin necrosis, whereas the autologous reconstruction group experienced higher rates of hematoma and hypertrophic scars. Of all the complications, framework exposure was the only one to show a statistically significant difference between the two groups (p< 0.0001). In terms of patient satisfaction, those who underwent autologous cartilage reconstruction reported a higher rate of satisfaction, although this difference did not reach statistical significance in the meta-analysis (p= 0.076). Conclusion: There is no statistically significant difference in postoperative complications such as infection, hematoma, skin necrosis, and hypertrophic scars between auricle reconstructions using autologous costal cartilage and those using polyethylene implants. However, reconstructions with polyethylene implants show a significantly higher rate of framework exposure.