Microtia and Atresia - Combined Approach by Plastic and Otologic Surgery

Description

Remarkable progress in the development of new concepts and techniques used in reconstructive surgery of microtia/atresia of the external auditory canal (EAC) has been made since the beginning of the 21st century. Helical computed tomography has made a three-dimensional reconstruction of the soft tissue of the temporal bone surface and the cranium possible, and has laid the groundwork for a collaboration between plastic surgeons and otologists. This book presents the latest findings on reconstructive surgery performed jointly by plastic surgeons and otologists. Based on this concept, information on diagnosis, surgical procedures, outcomes, long-term results and psychology is discussed.
Collaborative surgery offers advantages not only in terms of a better reconstruction of morphology and function, but also in terms of the lower number of surgical procedures required which reduces the psychological pressure and economic burden on patients.

Informations

• Publié par: S. Karger AG
• Date de parution: 14 octobre 2013
• Nombre de lectures: 0
• EAN13: 9783318023862
• Langue: English
• Poids de l'ouvrage: 2 Mo

Extrait

Microtia and Atresia – Combined Approach by Plastic and Otologic Surgery
Advances in Oto-Rhino-Laryngology
Vol. 75
Series Editor
G. Randolph Boston, Mass.
Microtia and Atresia – Combined Approach by Plastic and Otologic Surgery
Volume Editors
Kimitaka Kaga Tokyo
Hirotaka Asato Tochigi
95 figures, 67 in color, and 8 tables, 2014
_______________________ Kimitaka Kaga National Institute of Sensory Organs National Tokyo Medical Center 2-5-1 Higashigaoka Meguro-ku Tokyo 152-8902 Japan
_______________________ Hirotaka Asato Department of Plastic Surgery Dokkyo Medical University 880 Kitakobayashi, Mibu-Machi Shimotsuga-gun, Tochigi 320-0293 Japan
Library of Congress Cataloging-in-Publication Data
Microtia and atresia: combined approach by plastic and otologic surgery /volume editors, Kimitaka Kaga, Hirotaka Asato.
p. ; cm. –– (Advances in oto-rhino-laryngology, ISSN 0065-3071 ; vol. 75)
Includes bibliographical references and indexes.
ISBN 978-3-318-02385-5 (hard cover: alk. paper) -- ISBN 978-3-318-02386-2 (electronic version)
I. Kaga, Kimitaka, 1944- editor of compilation. II. Asato, Hirotaka, 1958-editor of compilation. III. Series: Advances in oto-rhino-laryngology; v. 75.0065-3071
[DNLM: 1. Ear Auricle-abnormalities. 2. Ear Auricle-surgery. 3. Otologic Surgical Procedures-methods. 4. Reconstructive Surgical Procedures-methods. W1 AD701 v.75 2013/WV 220]
RF127 23
617.8’059-dc23
2013021357
Bibliographic Indices. This publication is listed in bibliographic services, including Current Contents ® .
Disclaimer. The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publisher and the editor(s). The appearance of advertisements in the book is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.
Drug Dosage. The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any change in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
© Copyright 2014 by S. Karger AG, P.O. Box, CH-4009 Basel (Switzerland)
www.karger.com
Printed in Germany on acid-free and non-aging paper (ISO 9706) by Kraft Druck, Ettlingen
ISSN 0065-3071
e-ISSN 1662-2847
ISBN 978-3-318-02385-5
e-ISBN 978-3-318-02386-2
Contents
Introduction
Kaga, K. (Tokyo); Asato, H. (Tochigi)
Etiology and Gene Mutation
Abstract
Etiology and Genes
Matsunaga, T. (Tokyo)
Diagnosis
Abstract
Classification of Shapes (Auricle/External Auditory Canal)
Suzuki, Y. (Tochigi)
Imaging Diagnosis
Takegoshi, H. (Tokyo)
Audiometry
Kaga, K. (Tokyo)
Bone-Conduction Auditory Brainstem Response and Bone-Conduction Auditory Steady-State Response
Sakata, H. (Saitama)
Development of the Auricle and External Auditory Canal
Ozeki, H. (Kobe)
Development of Rib Cartilage
Oki, M.; Asato, H. (Tochigi)
Deciding on the Position for Auricular Reconstruction
Umekawa, K. (Tochigi)
Anomalies of the Auditory Ossicles
Ishimoto, S. (Tokyo)
Follow-Up of Psychological Changes in Patients Prior to Surgery
Kaga, K. (Tokyo)
Otitis Media and Subcutaneous Abscess while Awaiting Surgery
Sakata, H. (Saitama)
Deciding on the Timing and Method of Surgery
Watanabe, M.; Asato, H. (Tochigi)
Surgical Methods
Abstract
Reconstruction of the Auricle with Autogenous Rib Cartilage Grafts
Kaji, N.; Asato, H. (Tochigi)
Joint Surgery for Elevation of the Auricle and Construction of the EAC. 1. Design of Auricle Elevation in a Joint Surgery
Imanishi, M.; Asato, H. (Tochigi)
Joint Surgery for Elevation of the Auricle and Construction of the EAC. 2. Construction of the External Auditory Canal/Middle Ear
Kaga, K. (Tokyo)
Elevation of the Auricle without Canal/Tympanoplasty
Fukuda, N.; Fukayama, Y. (Tochigi)
Complications
Abstract
Postoperative Infection of the External Auditory Canal
Shinjo, Y. (Tokyo)
Skin Necrosis
Tamura, R.; Mizuguchi, K.; Asato, H. (Tochigi)
Facial Nerve Palsy
Ushio, M.; Kaga, K. (Tokyo)
Chest Wall Deformity at the Site of Costal Cartilage Harvesting
Nomura, H. (Tochigi)
Management of Postoperative Wounds
Abstract
Management of the Auricle
Kurabayashi, T. (Tochigi)
Postoperative Management of the Reconstructed External Auditory Canal
Kaga, K. (Tokyo)
Hair Removal
Watanabe, T.; Onomura, M.; Asato, H. (Tochigi)
Postoperative Hearing
Abstract
Effect of Lateralization of the Reconstructed Eardrum on Postoperative Hearing
Kaga, K. (Tokyo)
Temporal Bone Computed Tomography of Patients with Poor Postoperative Hearing Improvement after Surgery for Atresia of the External Auditory Canal
Hayashi, Y.; Kaga, K. (Tokyo)
Author Index
Subject Index
Introduction
In Japan and overseas, plastic surgeons and otologic surgeons have performed reconstructive surgery for microtia/atresia of the external auditory canal (EAC) independently. Pinnaplasty alone has been performed by plastic surgeons, and it was not unusual for plastic surgeons to tell patients that otorrhea might persist lifelong or facial paralysis might even develop if an otologist reconstructed the EAC. Furthermore, otolaryngological surgeries were performed mainly to improve hearing through reconstruction of the EAC, eardrum and ossicular chain, but the cosmetic shape of the ear was not always given special attention. However, remarkable advances in the concepts and techniques for reconstructive surgery of this congenital malformation have been made since the beginning of the 21st century and, hence, this book contains the latest findings about joint reconstructive surgery performed cooperatively by plastic surgeons and otologists.
Previously, we, the editors, discussed reconstructive surgery for microtia/atresia of the EAC while working at the plastic surgery and otolaryngology departments of the University of Tokyo Hospital, and we wanted to realize our ideal of achieving a natural-looking auricle and improving hearing with a single surgery. Helical computed tomography has enabled three-dimensional reconstruction of the soft tissues of the temporal bone surface and the cranium, which serves as a plan for collaborative surgery connecting the two departments. In other words, it has become possible to determine the construction site for the EAC in the mastoid section as well as the site for pinnaplasty. With this concept of planning, the plastic surgery department creates an auricle framework using costal cartilage, which will be embedded subcutaneously in the temporal region during the first stage of surgery. The second stage is a joint procedure involving the plastic surgery and otolaryngology departments, where the auricle is elevated and the EAC, ossicular chains and eardrum are reconstructed. Finally, a costal cartilage block is placed at the posterior part of the auricle and covered with a free skin flap. This joint surgery takes approximately 6 h. If the surgery is performed separately, more surgeries are necessary from each department, and a patient would undergo a total of four to six surgeries. In cases of bilateral microtia, the number of surgical procedures would double. Joint surgery is therefore advantageous not only for better reconstruction of morphology and function, but also in terms of the lower number of surgical procedures required, which there by reduces the psychological pressure and economic burden on patients.
Based on our concept of joint surgery, information on diagnosis, surgical procedures, outcomes, long-term results and psychology is presented in this book. We hope that readers will also find information on the activities of the association of patients with microtia/atresia of the EAC called ‘Blue Sky Association’. This book is to be referenced by plastic surgery departments, otolaryngology departments, speech therapists, school teachers and patients’ families. We hope this book will serve as a clinical textbook for those involved in surgical and audiological specialties of microtia/atresia of the EAC in the clinical setting.
We would like to thank Ms. Kayoko Sekiguchi, the secretary of Dr. Kaga, for her unlimited contribution in publishing this book.
Kimitaka Kaga , Tokyo Hirotaka Asato , Tochigi
Etiology and Gene Mutation
______________________
Abstract
The external ear is composed of the auricle and the external auditory canal and develops from the first and second b