• Archives of Plastic Surgery
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• 제50권4호
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• pp.393-397
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• 2023

Constricted ear has a prevalence of 5.2 to 10% among ear abnormalities, and various surgical methods are suggested for treatment. We introduce a case of a constricted ear treated with a simple method using a novel concept cartilage graft and transposition flap, along with the well-known Mustardé suture, which is used for pediatric patients with mild to moderate constricted ears of Tanzer classification type IIA. A 10-year-old female patient visited the hospital complaining of an abnormality in the congenital right ear. Surgical approach was planned under the diagnosis of Tanzer classification type IIA constricted right ear. Posterior helix onlay graft and perichondrocutaneous transposition flap using excessive helical cartilage were performed along with the Mustardé suture. In the immediate postoperative period, ear contour was improved, and it was well-maintained without recurrence until 6 months' follow-up. In conclusion, the combination of Mustardé suture, and cartilage onlay graft and perichondrocutaneous transposition flap in the mild to moderate constricted ear would be a useful surgical option, producing aesthetically good results in a simple and effective method.

• 대한두개안면성형외과학회지
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• 제20권6호
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• pp.405-407
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• 2019

Due to the variety in the shape of dysmorphic cartilage, tragus reconstruction is one of the most challenging goals in otoplasty. The authors describe a method to reconstruct a prominent tragus in a simple way suitable for accounting for the size, shape, and location of the remaining ear. We present a case of tragus deformity in an 11-year-old female patient after a previous excision of pretragal skin tags. There was a small remnant of the deeply located dystopic cartilage in a horizontal orientation. The dystopic cartilage was used to reconstruct the tragus using a chondrocutaneous transposition flap. Only a small portion of the pre-existing cartilage was used to create a chondrocutaneous transposition flap that supplemented the portion of cartilage during tragus reconstruction. The result was a new tragus that showed acceptable improvement in shape, location, and projection. Patients with a small portion of pre-existing cartilage near the tragal wall may benefit from the use of this method for tragus reconstruction.

• 한국임상수의학회지
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• 제21권2호
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• pp.149-153
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• 2004

This study was to determine the procedure for ultrasonographic imaging of the canine external ear canal(ECC). By infusion of warm saline solution into the ear canal, a real-time B mode ultrasonographic examination of the ECC was performed in five healthy Beagle dogs and two dogs with severe otitis externa. The ultrasonography was very useful to detect the structures of the ECC and the tympanic membrane. An 11 NHz linear probe was permitted to assess an anechoic lumen of the ECC and a hyperechoic cartilage surrounding the ear canal. In two dogs with otitis externa, it could be assessed the ECC with ultrasonography without ear cleansing. A lumen of the ECC was irregular and a cerumen could be seen, but edematous inflammatory changes of the ECC could not be identified. The results suggest that ultrasonography of the ECC with an 11 NHz linear probe after infusing the saline solution into the ear canal may be an accurate, non-invasive, rapid, and widely available method for assessment of the ear canal diseases such as otitis externa, polyp, stenosis, hyperplasia, and foreign body in dogs.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제15권2호
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• pp.81-91
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• 1993

Arthrosis of the temporomandibular joint is defined as a disease of a joint with chief complaint of pain, clicking, limited jaw movements. Generally, most patients with the temporomandibular arthrosis can be treated conservatively with muscle relaxation therapy combined with mandibular repositioning prostheses, followed by occlusal equilibration, restorative dentistry and/or orthodontics, and many other forms of treatment. In case prior nonsurgical treatment proved to be ineffective or the disease is chronic and severe, surgical operation is recommended. For patients with arthrosis of the temporomandibular joint, only discectomy as therapeutic method of the surgical treatment should not be applied and the removed articular disc of the temporomandibular joint should be replaced. Allograft such as Proplast-Teflon, Silastic, etc have been used as replacements of removed articular disc. However, these allograft materials have caused complications such as inflammatory changes, foreign body reactions. As a result, a replacement material which is autogenous, space occupying, easy to harvest and less inflammatory change has been developed. Auricular cartilage with perichondrium satisfies many of these requirements. The apparent advantages of autogenous auricular cartilage as an interpositional graft after a discectomy are as follows, (1) the form of the external ear corresponds to joint morphology, (2) a graft of adequate size can be harvested, (3) the form of the external ear remains unchanged after surgery, (4) the graft can be obtained adjacent to the surgical site, (5) biologically acceptable material is used, (6) the additional expense of allogenic graft is avoided. Because we considered autogenous auricular cartilage as a good replacement material, removed articular disc has been replaced with fresh autogenous auricular cartilage in the case of three patients. The result of the treatment is favorable, and the cases being presented here.

• Journal of International Society for Simulation Surgery
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• 제1권2호
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• pp.80-82
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• 2014

Purpose Microtia is congenital anomaly of external ear and the reconstruction method for the external ear of microtia patient was based on autogenous costal cartilage framework. The application of 3D printing technique in medical science has made more possibility of human tissue restoration, and we tried to apply this technique in auricular reconstruction field. Materials and Methods As for unilateral microtia patient, the contralateral side ear is normal and reconstructive surgeon tried to mimic it for reconstruction of affected ear. So, we obtained facial CT scan of microtia patient and made mirror image of normal side ear. Moreover, to make the 3D scaffold based on the mirror image of normal ear and to apply this scaffold for the auricular reconstruction surgery, we included auriculocephalic sulcus and anterior fixation part. Results We could successfully obtain mirror image of normal ear, auriculocephalic sulcus and anterior fixation part for 3D scaffold printing. Conclusions Using this CT image processing and 3D printing technique, we will be able to make the scaffold for auricular reconstruction of unilateral microtia patient, and perform auricular reconstruction in near future.

• 대한두개안면성형외과학회지
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• 제10권2호
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• pp.109-113
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• 2009

Purpose: Materials for ear reconstruction are autogeneous cartilage and artificial implants. Despite their potential for donor site complications, autogeneous cartilage frameworks remain the accepted standard for external ear reconstruction. The purposes of this study were to investigate our ear reconstruction cases for 12 years. Methods: During twelve years from January 1996 to December 2008, 70 patients visited our hospital for ear reconstruction of microtia. Among them, 65 cases used autogenous cartilage frameworks, 3 cases used tissue expander and 2 cases used artificial implants. We investigated sex & age, common site, combined malformation, operation methods & their complications, donor site & their complications, anterior chest wall deformity and aesthetic evaluation. Results: Males were affected more often than females. Male to female ratio was 1.8 : 1. The common site of microtia was right ear (72%). And hemifacial microsomia was the most common associated congenital malformation. Surgical techniques included Tanzer-Ruecker method, Tissue-expander and Artificial framework ($Medpore^{(R)}$). Incidence of complication was higher with Tissue-expander & artificial framework than with Tanzer-Ruecker method. But There are few reports of using Tissue-expander & artificial framework and there was no acceptable statistical difference. And costal cartilage was harvested in ipsilateral side and anterior chest wall deformity reported only 2 cases under 10 year-old patients. Other minor complications reported such as, wound disruption and chest wall scar, but without any serious complications. Aesthetic result was evaluated by surgeons and patients for postoperative satisfaction and clinical evaluation. Conclusion: In ear reconstruction of microtia patient, delicate surgical strategy is important for natural shape and maintenance of postoperative contour. However, many methods were introduced for reconstrucion of microtia, the authors reconstructed an auricle in Tanzer-Ruecker method, Tissue-expander and Artificial famework ($Medpore^{(R)}$) for 70 patients. In our study, we generally chose Tanzer-Ruecker method and this treatment modality was satisfactory for patients and the postoperative result was acceptable for surgeons.

• 대한두경부종양학회지
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• 제38권1호
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• pp.69-74
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• 2022

Endochondral pseudocyst of the ear is a rare, benign, non-inflammatory cystic disease. It is known that there are a variety of treatment methods for pseudocyst, which is mainly common in the scaphoid or triangular fossa of the ear. Pseudocyst formation is prevalent in the residual cavity of the ear. So, to prevent a recurrence, a surgical approach is also required, but management through compression is necessary after surgery. Applying a cube magnet to the lesion to press provides patient convenience and facilitates continuous management.

• 한국임상수의학회지
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• 제15권2호
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• pp.263-266
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• 1998

외이도의 직경 및 길이와 외이도 질환과의 연관성을 알아보고자 73두 성견을 실 험에 이웅하였다. 임상중상, 배양 및 도말 검사를 통하여 외이 질환이 얼는 정상군 57개의 이 관과, 질환이 있는 비정상군 89개의 이관에 직경과 길이를 평가하기 위한 간접적인 방법으로 이관내 조영술을 실시하였다. 비정상군은 정상군에 비하여 윤상연골 및 귓바퀴 연골의 직경 이 더 넓었다. 수직외이도를 구성하는 귓바퀴 연골의 길이는 비정상군4(12.79{\pm} 3.08)이 정상 군(12.79{\pm}5.87 mm)$에서 보다 유의성 있게 길게 나타났다(p<0.001). 심한 외이도 협착증을 보이는 21개의 귀에서는 외이도 질환을 발견할 수 없었으며, 외이도 질환이 심한 귀에 있어 서 그 직경과 길이가 정상군에 비하여 넝고 길게 나타났다(p<0.05). 본 실험의 결과로 보아 외이도관의 협착증과 외이도 질환과는 연관성이 발견되지 않았으나, 환기와 귀내 분비물의 배출을 방해하는 긴 수직외이도를 갖는 귀가 외이도 질환과 밀접한 관계가 있는 것으로 생각 되었다.

• 한국임상수의학회지
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• 제36권5호
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• pp.266-270
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• 2019

A 13-year-old spayed female American cocker spaniel dog was submitted to an animal hospital with a mass from left ear canal and enlarged left parotid lymph node. Given one-year history of odorous exudates and chronic otitis externa, total ear canal ablation was performed. Grossly, because of the neoplastic mass in both inner and outside of annular cartilage in external ear, vertical ear canal was severely narrowed. Histologically, there were numerous proliferated glands in the ear canal mass. Many neoplastic glands contained secretory vesicles on the free margin and necrotic cellular debris. Severe multifocal necrosis and strong invasion were also observed throughout the mass. Massive metastatic foci of glandular structures originated from ceruminous gland were presented in the enlarged parotid lymph node. Neoplastic glandular epithelia contained PAS-positive diastase-resistant eosinophilic cytoplasmic granules. Immunohistochemically, the neoplastic cells showed positive reactions for cytokeratin (CK) 7 and negative for CK 5/6. Based on the clinical implication and gross findings, histopathology and immunohistochemistry, this case was diagnosed as metastatic ceruminous gland adenocarcinoma in the American cocker spaniel.

• 한국임상수의학회지
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• 제21권2호
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• pp.97-101
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• 2004

This study was aimed for ultrasonographic assessment of the tympanic membrane and the tympanic bulla in five healthy Beagle dogs. To improve an ultrasonographic image, the ear canal was filled with warm saline, and an 11 MHz linear probe and a 6.5 MHz convex probe were used. The structures of ear component such as ear canal, ear cartilage and tympanic membrane were easily identified. Especially, tympanic membrane was presented as a reflaction surface which was resulted from the different acoustic impedence between the fluid-filled anechoic ear canal and the gas-filled hyperechoic tympanic cavity in normal dogs. In five left-side ears, the saline was infused into the external ear canal after the tympanic membrane had been ruptured experimentally. Both anechoic fluid-filled ear canal and tympanic cavity were clearly identified. In five right-side ears, the surgically fluid-filled tympanic cavity was imaged as a hypoechoic oval shaped structure. When tympanic cavity and ear canal have been contained with fluid, it was difficult to identify whether the tympanic membrane was ruptured or not. For assessment of the ear structure with ultrasonography, the 11 MHz linear probe was considered as an optimal equipment for a serial assessment of ear canal, tympanic membrane and tympanic bulla whereas the 6.5 MHz convex probe was suitable to assess the tympanic cavity. The results suggest that ultrasonography with saline infusion into the ear canal can be used to find the intactness of the tympanic membrane and to assess the fluid- filld tympanic bulla.