Ear Reconstruction (2nd Edition)

Description

This book comes to its second edition intending to broaden the discussion about the plastic surgical techniques for the reconstruction of the ear. It features a more in-depth discussion of the topics previously addressed, including chapters on microtia, anotia, the upper pole, auricular lobule and complications during and following ear surgery. Furthermore, it addresses a wide variety of deformities of the auricle and surgical topics that were not included in the previous edition, such as: Reconstruction of the tragus and creation of the external auditory canal – key considerations when planning or performing a reconstruction of the ear. New concepts on the surgical anatomy of the ear – essential knowledge for plastic surgeons when performing the operation. Traumatic amputation of the ear – a common and severe social and organic problem. Discussions are presented that address the cause of the problem, as well as guidelines for surgeons during first aid in order to provide adequate reconstruction. Ear reconstruction for reparation of deformities caused by piercing Reconstruction of the auricle secondarily to prominent ear surgery Reconstruction of the ear after human and animal bite Secondary reconstruction of the ear Reduction otoplasty – an important procedure whenever the size of the ear negatively impacts the patient’s wellbeing or self-esteem due to imbalanced facial contours. Features important notes on a procedure that leaves inconspicuous scars and creates a normal and natural appearance of the organ’s architecture. Post-operative care – special information on how to optimally avoid complications after surgery. Reconstruction of the ear is required in a variety of patients, especially in those with congenital anomalies and associated deformities or those suffering from accidents and trauma affecting the auricle. In this sense, this surgical approach has the ultimate goal of improving aesthetic and functional aspects of congenital and acquired anomalies of the ear. Throughout the book, the goal is to share the author’s experience, gathered in the course of 43 years dedicated to this challenging field. Descriptions and illustrative photos concerning correction and reconstruction of the auricle caused by prominent ear surgery are presented in detail. The didactic approach, supplemented by color illustrations and surgical photos, helps to demonstrate basic and advanced techniques alike. With forewords by Ivo Pitanguy and Jorge Psillakis.

Key Features

• Reconstruction of the tragus and creation of the external auditory canal – key considerations when planning or performing a reconstruction of the ear.
• New concepts on the surgical anatomy of the ear – essential knowledge for plastic surgeons when performing the operation.
• Traumatic amputation of the ear – a common and severe social and organic problem. Discussions are presented that address the cause of the problem, as well as guidelines for surgeons during first aid in order to provide adequate reconstruction.
• Ear reconstruction for reparation of deformities caused by piercing
• Reconstruction of the auricle secondarily to prominent ear surgery
• Reconstruction of the ear after human and animal bite
• Secondary reconstruction of the ear
• Reduction otoplasty – an important procedure whenever the size of the ear negatively impacts the patient’s wellbeing or self-esteem due to imbalanced facial contours. Features important notes on a procedure that leaves inconspicuous scars and creates a normal and natural appearance of the organ’s architecture.
• Post-operative care – special information on how to optimally avoid complications after surgery.
  Reconstruction of the ear is required in a variety of patients, especially in those with congenital anomalies and associated deformities or those suffering from accidents and trauma affecting the auricle. In this sense, this surgical approach has the ultimate goal of improving aesthetic and functional aspects of congenital and acquired anomalies of the ear. Throughout the book, the goal is to share the author’s experience, gathered in the course of 43 years dedicated to this challenging field. Descriptions and illustrative photos concerning correction and reconstruction of the auricle caused by prominent ear surgery are presented in detail. The didactic approach, supplemented by color illustrations and surgical photos, helps to demonstrate basic and advanced techniques alike. With forewords by Ivo Pitanguy and Jorge Psillakis.

Table of Contents

1. Surgical Anatomy with Regard to Ear Reconstruction
2. Introduction
3. Method
4. Auricular Skeleton
5. Cutaneous Covering
6. Anterior Surface
7. Posterior Surface
8. Vascularization
9. Lobule
10. Muscles
11. Auricular Muscles
12. Superior Muscle
13. Posterior Muscle
14. Anterior Muscle
15. Arterial Vascularization
16. Superficial
17. Deep Vascularization
18. Vascularization in Microtic Patients
19. Venous Circulation
20. Innervation
21. Discussion
22. Classification of Congenital Anomalies of the Ear
23. Introduction
24. Heredity
25. Classification of Congenital Anomalies of the Ear
26. Anotia
27. Agenesis of the Auricle
28. Microtia
29. Severe Microtia
30. Moderate Microtia
31. Moderate Eutopic Microtia
32. Moderate Ectopic Microtia
33. Macrotia
34. Cryptotia
35. Discussion
36. Anomalies Associated with Digenesis of the Ear
37. Introduction
38. Neighboring Anomalies
39. Lesions in Distant Structures
40. Anal Imperforation
41. Esophageal Atresia
42. Hearing Impairments
43. Discussion
44. Surgical Principles
45. Introduction
46. Method
47. Analyses of the Cutaneous Covering of the Mastoid Region
48. Creating the Missing Segment of the Future Auricular Framework
49. Creating the Cutaneous Covering of the New Auricle
50. Distention of Cutaneous Tissue During Surgery
51. Development of the New Layer of Perichondrium
52. The Segments of Rib Cartilage Do Not Heal Between Each Other
53. The Importance of the Dressing After the Operation
54. Discussion
55. The Importance of Surgical Planning Before an Operation
56. Introduction
57. Method
58. Discussion
59. Post-operative Care After Ear Reconstruction
60. Introduction
61. Method
62. Inorganic (Alloplastic) Materials
63. Organic Materials
64. Heterograft Materials
65. Homograft Materials
66. Autograft Materials
67. The Dressing after Total or Partial Ear Reconstruction
68. Dressing the Area of Donor Cartilage
69. Bandaging the Ear Region After the First Surgical Stage
70. Dressings on the Ear Region After the Second Stage of Surgery
71. Discussion
72. Reconstruction of the Tragus
73. Introduction
74. Definitions
75. Clinical and Anatomical Alterations
76. Method
77. Surgical Technique for Reconstruction
78. Reconstruction of the Tragus after Amputation during Rhytidoplasty
79. Discussion
80. Reconstruction of the External Auditory Canal
81. Introduction
82. Classification of Meatus Deformities
83. Congenital
84. Trauma
85. After Tumor Resection
86. Planning the Reconstruction
87. Personal Procedures
88. Reconstruction of the Auditory Canal in Congenital Deformities
89. Reconstruction of the External Canal After Traumatic Amputation
90. Reconstruction of the External Canal After Tumor Resection
91. Discussion
92. Reconstruction of the Ear Due to Congenital Anomalies
93. Introduction
94. Method
95. First Stage of Reconstruction
96. Surgical Planning
97. Analysis of Deformities
98. Spatial Projection of the Future Ear
99. Creation of the New Cartilaginous Framework
100. Creation of the Cutaneous Covering
101. The Tissue Expander During the Operation
102. Technique for Reconstruction
103. Severe Microtia
104. Discussion
105. Traumatic Amputation of the Ear: What to Do with the Amputated Segment?
106. Introduction
107. Method
108. What to Do with the Partially Amputated Segment of the Ear
109. What to Do with a Total Amputated Ear
110. Discussion
111. Reconstruction of the Ear after Traumatic Amputation
112. Introduction
113. Classification and Clinical Study of Acquired Ear Deformities
114. Burns
115. Iatrogenic
116. Bites
117. Human Bites
118. Car Accidents
119. Partial Reconstruction of the Ear
120. Composite Grafts
121. The Use of Local Flaps of the Ear
122. Neighboring Flaps for Reconstruction
123. Distant Flaps and Tubular Flaps
124. Total Reconstruction of the Ear
125. Discussion
126. Reconstruction of the Ear After Human or Animal Bites
127. Introduction
128. Surgical Considerations
129. Pathology
130. Disease Transmission
131. Method
132. Discussion
133. Late Follow-Up After Ear Reconstruction
134. Introduction
135. Technique of theTwo-Stage Method
136. Results
137. Discussion
138. Secondary Reconstruction of the Ear
139. Introduction
140. Method
141. Date of the Last Surgery
142. Type of Material Used to Fabricate the Framework
143. Cutaneous Scars
144. The Presence of Ear Cartilage Remnants from Dysgenesis or Surgical Graft
145. Quality of the Skin and Extension of the Hairless Area
146. Insufficiency of Auricular Framework
147. Distortion of the Framework
148. Reconstruction of the Ear
149. Discussion
150. Reconstruction of the Auricle Secondary to Prominent Ear Surgery
151. Introduction
152. Method
153. Planning the Operation
154. The Operation
155. Discussion
156. Complications After Ear Reconstruction: Treatment for and How to Avoid
157. Introduction
158. During Surgery
159. Immediate (Up to 7 Days After Surgery)
160. Medium-term
161. Long-term
162. Reabsorption of the Cartilaginous Framework
163. Displacement of the Framework
164. Fading of the Auricular Relief
165. How to Avoid Complications During and After Ear Reconstruction
166. Discussion
167. Reduction Otoplasty to Improve Facial Contour
168. Introduction
169. Method
170. Surgical Planning
171. The Operation
172. Demarcation
173. Incisions, Resection, and Rotation of the Flaps
174. Dressing
175. Discussion
176. Ear Reconstruction After Destruction Caused by Piercing
177. Introduction
178. Complications Resulting from Piercing
179. Reconstruction of Ear Deformities
180. Enlargement of Ear Lobule
181. Discussion