Journal of Otolaryngology and Ophthalmology of Shandong University ›› 2023, Vol. 37 ›› Issue (5): 1-5.doi: 10.6040/j.issn.1673-3770.0.2022.250

• Original Article •     Next Articles

Repairing skin defects 18 cases of the external auditory canal with retroauricular pedicled flaps

SHAO Yongliang, ZHOU Kunpeng, LI Guangsheng, ZHANG Xuemei, YANG Zeyin   

  1. Department of Otorhinolaryngology & Head and Neck Surgery, Shijiazhuang People's Hospital, Shijiazhuang 050030, Hebei, China
  • Published:2023-10-13

PDF (PC)

104

Abstract: Objective This study aimed to repair skin defects and enlarge the cavity of the external auditory canal with retroauricular pedicled flaps. Methods Sixteen patients with external auditory canal cholesteatoma and two patients with external auditory canal atresia were selected for this study. All surgical procedures were performed under general anesthesia through the retroauricular approach. Stenosis of the external auditory canal and annular granulation growth or atresia of the isthmus of the external auditory canal were observed during the operations. The bone canal of the external auditory canal was enlarged. Subsequently, the pedicled skin flap was removed at the retroauricular incision and transferred forward into the auditory canal to cover the skin defect of the posterior wall of the auditory canal and expand the cavity of the external auditory canal. Results The skin grafts of the auditory canal of all patients survived after the operation. The shape of the auditory canal of all patients recovered well 6 months after the operation, without stenosis or atresia. Conclusion The retroauricular pedicled skin flap is easy to obtain without new incisions. After skin grafting of the auditory canal, necrosis is unlikely to occur because of the blood supply to the skin grafts, which reduces the reoccurrence of auditory canal stenosis or atresia.

Key words: Pedicled flap, External auditory canal, Skin defect, Repair, Retroauricular approach

CLC Number: 

  • R764.1
[1] 邵永良, 周永青, 李晓明, 等. 耳屏软骨加颞肌筋膜在外耳道骨壁及皮肤缺损重建中的应用[J]. 临床耳鼻咽喉头颈外科杂志, 2014, 28(16): 1235-1237. doi:10.13201/j.issn.1001-1781.2014.16.015 SHAO Yongliang, ZHOU Yongqing, LI Xiaoming, et al. Canal wall reconstruction with Tragus cartilage and tempralis fascia graft[J]. Journal of Clinical Otorhinolaryngology Head and Neck Surgery, 2014, 28(16): 1235-1237. doi:10.13201/j.issn.1001-1781.2014.16.015
[2] 陈向红, 冯鑫利, 田从哲, 等. 异种脱细胞真皮基质修复外耳道皮肤缺损研究[J]. 中华耳科学杂志, 2021, 19(4): 587-591. doi: 10.3969/j.issn.1672-2922.2021.04.009 CHEN Xianghong, FENG Xinli, TIAN Congzhe, et al. Xenogeneic acellular dermal matrix for repair of skin defect in external auditory canal[J]. Chinese Journal of Otology, 2021, 19(4): 587-591. doi: 10.3969/j.issn.1672-2922.2021.04.009
[3] 曾薇, 陈美珍, 伍健辉. 脱细胞异体真皮与自体刃厚皮片修复外耳道皮肤缺损的比较[J]. 中国医药科学, 2021, 11(14): 213-216, 223. doi:10.3969/j.issn.2095-0616.2021.14.057 ZENG Wei, CHEN Meizhen, WU Jianhui. Comparative research of acellular allogeneic dermis and autologous split-thickness skin in repairing skin defect of external auditory canal[J]. China Medicine and Pharmacy, 2021, 11(14): 213-216, 223. doi:10.3969/j.issn.2095-0616.2021.14.057
[4] Narushima M, Yamasoba T, Iida T, et al. Supermicrosurgical reconstruction for congenital aural atresia using a pure skin perforator flap: concept and long-term results[J]. Plast Reconstr Surg, 2013, 131(6): 1359-1366. doi:10.1097/PRS.0b013e31828bd466
[5] Dessy LA, Figus A, Fioramonti P, et al. Reconstruction of anterior auricular conchal defect after malignancy excision: revolving-door flap versus full-thickness skin graft[J]. J Plast Reconstr Aesthet Surg, 2010, 63(5): 746-752. doi:10.1016/j.bjps.2009.01.073
[6] Kato H, Watanabe S, Nakamura M, et al. Reconstruction of the external auditory canal using the random flap technique and laser Doppler evaluation[J]. Dermatol Surg, 2014, 40(7): 739-742. doi:10.1111/dsu.0000000000000003
[7] Iida T, Mihara M, Yoshimatsu H, et al. Reconstruction of the external auditory canal using a super-thin superficial circumflex iliac perforator flap after tumour resection[J]. J Plast Reconstr Aesthet Surg, 2013, 66(3): 430-433. doi:10.1016/j.bjps.2012.08.005
[8] 屠晓明. 耳后皮瓣修复外伤性耳郭部分缺损15例分析报道[J]. 浙江创伤外科, 2015, 20(1): 36-37. doi: 10.3969/j.issn.1009-7147.2015.01.014
[9] Gómez Díaz OJ, Cruz Sánchez MD. Anatomical and clinical study of the posterior auricular artery angiosome: in search of a rescue tool for ear reconstruction[J]. Plast Reconstr Surg Glob Open, 2016, 4(12): 1165. doi:10.1097/GOX.0000000000001165
[10] Larcher L, Plötzeneder I, Tasch C, et al. Retroauricular pull-through island flap for defect closure of auricular Scapha defects: a safe one-stage technique[J]. J Plast Reconstr Aesthet Surg, 2011, 64(7): 934-936. doi:10.1016/j.bjps.2010.11.007
[11] Metselaar M, Dumans AG, van der Huls MP, et al. Osteoradionecrosis of tympanic bone: reconstruction of outer ear canal with pedicled skin flap, combined with hyperbaric oxygen therapy, in five patients[J]. J Laryngol Otol, 2009, 123(10): 1114-1119. doi:10.1017/S0022215109990612
[12] Motsch C, Ulrich J. The retroauricular subcutaneously pedicled island flap for reconstruction of auricular conchal defects[J]. J Ger Soc Dermatol JDDG, 2018, 16(4): 508-510. doi:10.1111/ddg.13477
[13] Zhu J, Zhao H, Wu K, et al. Reconstruction of auricular conchal defects with local flaps[J]. Medicine(Baltimore), 2016, 95(46): 5282. doi:10.1097/MD.0000000000005282
[14] Mehel DM, Özdemir D, Çelebi M, et al. Postauricular Island flap in reconstruction of Auricula tumor defects[J]. J Craniofac Surg, 2020, 31(7): 669-671. doi:10.1097/SCS.0000000000006508
[15] Anazawa U, Omura K, Nishijima Y, et al. External auditory canal reconstruction with inferior pedicled square screw flap from the preauricular area after resection of external auditory canal cancer[J]. Laryngoscope Investig Otolaryngol, 2021, 6(1): 77-80. doi:10.1002/lio2.505
[16] Shaari AL, Xing MH, Mundi N, et al. Reconstruction of the external auditory canal: the tragal flap revisited and review of contemporary reconstructive techniques[J]. Am J Otolaryngol, 2021, 42(6): 103094. doi:10.1016/j.amjoto.2021.103094
[17] Schellekens PP, Hage JJ, Paes EC, et al. Clinical application and outcome of the internal mammary artery perforator(IMAP)free flap for soft tissue reconstructions of the upper head and neck region in three patients[J]. Microsurgery, 2010, 30(8): 627-631. doi:10.1002/micr.20803
[18] Lassus P, de Leo A, Moussa IH, et al. Paraumbilical perforator flap for reconstruction of the external auditory meatus: a case report[J]. Microsurgery, 2015, 35(7): 573-575. doi:10.1002/micr.22491
[19] 邓建洪, 黄河, 彭利, 等. 带蒂岛状皮瓣修复外耳道肿物切除后耳周缺损[J]. 中国现代手术学杂志, 2015, 19(4): 312-314. doi:10.16260/j.cnki.1009-2188.2015.04.020 DENG Jianhong, HUANG He, PENG Li, et al. Clinical observation on pedicled island flap for repairing the skin defect associated with external auditory canal goiter resection[J]. Chinese Journal of Modern Operative Surgery, 2015, 19(4): 312-314. doi:10.16260/j.cnki.1009-2188.2015.04.020
[20] 罗静, 苏庚, 袁群芳. 带蒂皮瓣修复外耳道缺损疗效分析[J]. 中国美容医学, 2018, 27(1): 71-73. doi:10.15909/j.cnki.cn61-1347/r.002158 LUO Jing, SU Geng, YUAN Qunfang. Analysis of clinical effect in patients with external auditory canal defects by pedicled flaps repair[J]. Chinese Journal of Aesthetic Medicine, 2018, 27(1): 71-73. doi:10.15909/j.cnki.cn61-1347/r.002158
[21] 丁志琴, 何丕. 两种带蒂皮瓣修复耳郭、外耳道缺损的临床效果及手术方法分析[J]. 中国美容整形外科杂志, 2017, 28(8): 492-494. doi: 10.3969/j.issn.1673-7040.2017.08.015 DING Zhiqin, HE Pi. Analysis of the clinical results and surgical methods for two kinds of pedicled flaps in the repair of auricle and external auditory canal defects[J]. Chinese Journal of Aesthetic and Plastic Surgery, 2017, 28(8): 492-494. doi: 10.3969/j.issn.1673-7040.2017.08.015
[22] Chen JM, Liang HR, Wang YJ, et al. Applications of titanium mesh tubing in external ear canal reconstruction in congenital aural atresia[J]. Eur Arch Otorhinolaryngol, 2015, 272(4): 835-838. doi:10.1007/s00405-014-2888-7
[23] 韩浩伦, 吴玮, 王鸿南, 等. 个体化中空树酯支撑物预防小耳畸形术后外耳道狭窄[J]. 听力学及言语疾病杂志, 2018, 26(1): 40-42. doi: 10.3969/j.issn.1006-7299.2018.01.011 HAN Haolun, WU Wei, WANG Hongnan, et al. Application of individualized hollow resin plugs to prevente external auditory canal restenosis after canaloplasty of external auditory meatus for Microtia patients[J]. Journal of Audiology and Speech Pathology, 2018, 26(1): 40-42. doi: 10.3969/j.issn.1006-7299.2018.01.011
[24] 肖玲, 丁玲, 江英, 等. 先天性外耳道狭窄或闭锁的手术治疗[J]. 听力学及言语疾病杂志, 2022, 30(1): 74-76. doi:10.3969/j10.3969/j.issn.1006-7299.2022.01.017
[25] Manolidis S, Ratner D. External auditory canal defect management and reconstruction[J]. Dermatol Surg, 2014, 40(Suppl 9): S86-S95. doi:10.1097/DSS.0000000000000118
[26] Huang ZJ, Wei P, Gan LM, et al. Protective effects of different anti-inflammatory drugs on tracheal Stenosis following injury and potential mechanisms[J]. Mol Med Rep, 2021, 23(5): 314. doi:10.3892/mmr.2021.11953
[27] 王登元, 陈智斌, 陈若希, 等. 外耳道胆脂瘤的临床特征及疗效评估[J]. 山东大学耳鼻喉眼学报, 2017, 31(5): 62-66. doi: 10.6040/j.issn.1673-3770.0.2017.237 WANG Dengyuan, CHEN Zhibin, CHEN Ruoxi, et al. Clinical characteristics and treatment of external auditory canal cholesteatoma[J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2017, 31(5): 62-66. doi: 10.6040/j.issn.1673-3770.0.2017.237
[1] ZHANG Huaxiu, LIU Qin, LUO Wugen, YANG Jian, CHEN Lingyun. Clinical effect of new neck brace receiver in external auditory canal irrigation [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2023, 37(3): 7-10.
[2] WANG Yubing, ZHENG Yuebin, YANG Yirong, YAN Bincheng, PENG Shunlin. Metastatic Merkel cell carcinoma of the neck:A case report and literature review [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2023, 37(2): 51-55.
[3] JIN Xin, SHI Lei, JIN Mengyuan. Application of decellularized dermal matrix after benign tumor resection in the nasal sinus [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2021, 35(5): 17-22.
[4] LI Yanan，,HUANGFU Hui. Advancements in surgical repair after maxillectomy [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2021, 35(5): 113-117.
[5] WANG Yingying, ZHOU Han, DONG Weida, XING Guangqian, CHEN Zhibin, ZHANG Qingzhao, ZHANG Liqing. Analysis of distant metastasis and prognosis of adenoid cystic carcinoma of the external auditory canal [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2021, 35(1): 1-6.
[6] CHEN Kun, LI Lei, MENG Guozhen, YANG Jun, HOU Dongming. Diagnosis and nasal endoscopic surgery of congenital basal meningoencephaloceles in infants [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2021, 35(1): 77-81.
[7] GUO Fang, ZHANG Dejun, FU Zeming, GUO Yingyuan, WAN Yining, GUAN Guofang. Cholesteatoma of the external auditory canal complicated with suppurative parotitis: a case report and literature review [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2020, 34(6): 12-15.
[8] YUE Jianlin, LIN Yun, JIANG Zhen, LI Xuexin, SUN Ruijie, PAN Xinliang, LIU Dayu. Application of the hemi-tongue root flap for the repair of lateral defects in the pharyngeal cavity [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2020, 34(1): 63-66.
[9] XU Ling, SUN Yan. Advances in research on the trifoliate factor family in the middle ear respiratory mucosal epithelium [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2020, 34(1): 93-98.
[10] YUE Wenhui, LI Lianhe. Clinical application of posterior pharyngeal wall flap in the treatment of early posterior hypopharyngeal wall carcinoma [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2019, 33(6): 60-63.
[11] Yuzhu LIU,Yingkai GAO,Guiyun JIANG,Haoxu PEI,Xiaoxue YUE. Surgical repair of orbital floor fracture with content prolapse and inferior rectus incarceration through maxillary sinus approach [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2019, 33(5): 79-81.
[12] HE Jian, QIAN Liting, GAO Jin. A case of external auditory canal adenoid cystic carcinoma invading the middle ear and temporal lobe, with cervical lymph node metastasis [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2018, 32(6): 109-111.
[13] LI Guifen, YI Lina. Application of periorbital blood supply for repairing tissue defects in the orbital region [J]. J Otolaryngol Ophthalmol Shandong Univ, 2018, 32(4): 80-83.
[14] WANG Dengyuan, CHEN Zhibin, CHEN Ruoxi, ZHAO Xiaonian, LIU Cheng. Clinical characteristics and treatment of external auditory canal cholesteatoma. [J]. JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY), 2017, 31(5): 62-66.
[15] WANG Dengyuan, CHEN Zhibin, CHEN Ruoxi, ZHAO Xiaonian, CHENG Lei. Clinical efficacy of repairing auricular skin defects with posterior auricular flaps and their preparation with Gauze blotting. [J]. JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY), 2017, 31(3): 68-70.
Viewed
Full text


Abstract

Cited
  Shared   
  Discussed   
No Suggested Reading articles found!
Website Copyright: Editorial Office of Journal of Otolaryngology and Ophthalmology of Shandong University
Address: No.27 Shanda South Road, Jinan, Shandong, China. Post code: 250100 Tel: +86-0531-88366912 Email: ebhxb@sdu.edu.cn Supported by Beijing Magtech Co.Ltd