Further Refinements in Otoplasty Surgery: A Modified Approach to Prevent Suture Extrusion in Cartilage-Suturing Otoplasty Using a Postauricular Dermofascial Flap

耳成形术 纤维接头 医学 外科 软骨 解剖
作者
Neil Bulstrode,Elsa M. Ronde,Ahmed S. Mazeed
出处
期刊:Plastic and Reconstructive Surgery [Ovid Technologies (Wolters Kluwer)]
卷期号:154 (6): 1191e-1199e
标识
DOI:10.1097/prs.0000000000011342
摘要

Background: Suture extrusion has been reported to be the most common complication after cartilage-sparing otoplasty. Several studies have described various designs of postauricular flaps to cover the cartilage sutures and reduce the incidence of suture extrusion. Methods: A total of 100 consecutive patients with prominent ears were operated on between January of 2018 and February of 2023 using a deepithelialized postauricular dermofascial flap that is performed as an adjunct to the authors’ cartilage-sparing otoplasty technique, which is essentially a combined modified Mustardé and Furnas technique. The flap is used to cover the cartilage-holding sutures with an extra layer of vascularized tissue to avoid the scar being directly over these sutures. Results: The median age of patients was 12 years (interquartile range, 9 to 15). One out of the 100 patients (1%) developed a postauricular skin infection requiring surgical removal of sutures. Primary suture extrusion did not occur; in an earlier study of cartilage-sparing technique without the postauricular flap, 17 out of 200 patients had suture extrusion ( P = 0.001). No hematoma occurred that necessitated return to the theater. Skin necrosis and wound dehiscence did not occur in any case. No patient developed cartilage deformities or relapse requiring surgical correction. Conclusions: Combining cartilage-sparing otoplasty using sutures and the described postauricular dermofascial flap is simple to perform and has significantly reduced the complication rate and improved the outcome compared with cartilage-sparing otoplasty alone. This flap is recommended for both primary and revisional otoplasty. CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, IV.
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