KEPÇE KULAK CERRAHİ TEDAVİSİ: 108 HASTADA 5 YILLIK KLİNİK DENEYİM PROMINENT EAR SURGICAL TREATMENT: 5 YEARS OF CLINICAL EXPERIENCE ON 108 PATIENTS

Erkan Yüce, Ali Can Gunenc, Ahmet Faruk Yücel, Memet Yazar, Semra Karşıdağ

Özet


KEPÇE KULAK CERRAHİ TEDAVİSİ: 108 HASTADA 5 YILLIK KLİNİK DENEYİM

PROMINENT EAR SURGICAL TREATMENT: 5 YEARS OF CLINICAL EXPERIENCE ON 108 PATIENTS

ÖZET

Giriş: Kepçe kulak toplumda sık görülen ve psikososyal etkikeri olan konjenital bir kulak deformitesidir. Kepçe kulak deformitesinin ortaya çıkmasında antihelikal foldun yetersiz gelişimi, konkal yapının fazla gelişmesi ve lobül deformitesi yer almaktadır.

Gereç ve Yöntem: Kasım 2010- Kasım 2015 tarihleri arasında kliniğimizde opere olmuş 108 otoplasti olgusu incelenmiştir. Bunların 63'ü kadın, 45'i erkek olmak üzere yaşları 5 ile 42 arasında (ortalama yaş 18.4) değişmekteydi. Hastaların 105 tanesi bilateral 3 tanesi unilateral kepçe kulak olarak değerlendirildi.

Bulgular: Hastaların operasyon öncesi sefaloaurikular açı ölçümleri 46 ile 57 derece arasında değişmekteydi. Medyan sefaloaurikular açı 51 derece olarak tespit edildi. Hastaların kaydedilen üst pol mastoid mesafesi 15mm ile 27 mm arasında değişmekteydi. Medyan üst pol mastoid mesafesi 20 mm olarak tespit edildi. Operasyon sonrasında medyan üst pol-mastoid uzaklığı 12 mm olarak tespit edildi. Medyan sefaloaurikular açı operasyon operasyon sonrasında 27 derece olarak ölçüldü. Hastaların ortalama takip süresi 18.4 aydı(3-24 ay). Hastaların ikisinde erken dönemde hematom görüldü. Geç dönemde bir hastada sutur ekspozisyonu, bir hastada rekürrens, altı hastada soğuk intoleransı, bir hastada kötü skar, bir hastada telefon kulak deformitesi gibi komplikasyonlar izlendi.

Sonuçlar: Otoplasti günümüzde en sık uygulanan estetik operasyonlardan birisidir. Mevcut anatomik problemlere yönelik uygun cerrahi yöntem seçimi ile yüz güldrücü sonuçlar alınmaktadır. Özellikle erken yaş hastalarda kozmetik açıdan sağladığı düzelmenin yanında ciddi psikolojik fayda sağladığı bilinmektedir

Anahtar Sözcükler: otoplasti, kepçe kulak, mustarde

ABSTRACT

Introduction: Prominent ear is a congenital ear deformity that is common in society and has psychosocial affects. Underdevelopment of antihelical fold, the overdevelopment of concave structure and lobule owergrowth take place in the development of prominet ear deformity.

Materials and Method: 108 autoplasthy cases that were operated in our clinic between October 2010 - October 2015 were evaluated resrospectively. These patients were 63 women and 45 men between the ages of 5 to 42 (average age of 18.4). 105 of these patients had bilateral, 3 of them had unilateral prominent ear.

Results: The cephaloauricular angle measurements of patients before operation ranged between 46 to 57 degrees. Median sefaloaricular angle was identified as 51 degrees. The recorded upper pole to mastoid distance ranged between 15 to 27 mms. Median upper pole to mastoid distance was recorded as 20 mms. After operation, the median upper pole to mastoid distance was recorded as 12 mms. Post operative median sefaloauricular angle was measured as 27 degrees. Average follow-up period of patients were 18.4 months (range, 3-24 months). Two of the patients developed hematoma in early postoperative period. In late postoperative period, one suture exposition, one recurrence, six cold intolerance, one bad scar and one telephone ear deformity were observed in the patients.

Conclusion: Nowadays, autoplasty is one of the most practiced aesthetic operations. With proper, problem based surgical treatment, positive results are obtained against present anatomical problems in these patients. Especially on early aged patients, it is known that not only good cosmetic results but also important psychological improvement is provided by these procedures.

Key Words: Autoplasty, Prominent ear, Mustarde

Tam Metin:

PDF

Referanslar


Kaynaklar

Ellis DAF, Keohane JD: A simplified approach to otoplasty. J Otolaryngol 1992;21:66–69

Altuntaş EE, Nur N, Cerrah YSS, Muderris S. A study of the prevalence of developmental anomalies of the external ear among preschool children in Sivas, Turkey. The Turkish Journal of Pediatrics 2011; 53: 528-531.

Adamson JE, Horton CE, Crawford HH. The growth pattern of the external ear. Plast Reconstr Surg. 1965;36:466–470.

Farkas L. Anthropometry of the Head and Face, 2nd ed. New York:Raven Press; 1994.

Macgregor FC. Ear deformities: Social and psychologicalimplications. Clin. Plast. Surg. 5: 347, 1978

Yotsuyanagi T, Yamauchi M, Yamashita K, Sugai A, Gonda A, Kitada A, Saito T, Urushidate S. Abnormality of AuricularMuscles in Congenital Auricular Deformities. Plast Reconstr Surg. 2015 Jul;136(1):78e-88e

Haworth R, Sobey S, Chorney JM, Bezuhly M, Hong P. measuring attentional bias in children with prominent ears: A prospective eye-tracking study. Journal of Plastic, Reconstructive & Aesthetic Surgery (2015) xx, 1-5,article in press

Lourenc o Gasques JA, Pereira de Godoy JM, Navarro Cruz EMT. Psychosocial Effects of Otoplasty in Children with Prominent Ear. Aesth Plast Surg 2008;32:910–914

Basat SO, Askeroğlu U, Aksan T, Alleyne B, Yazar M, Orman C, Usçetin I, Akan M. New otoplasty approach: a laterally based postauricular dermal flap as an addition to Mustarde and Furnas to prevent suture extrusion and recurrence, Aesthetic Plast Surg. 2014 Feb;38(1):83-9

Yazar M, Basat SO, Biçer A, Yazar SK, Güven E, Kuvat SV, Emekli U. Creating a neoconchal complex using the adjustable conchal sliding technique in prominent ear correction. J Craniofac Surg. 2012 Sep;23(5):1414-7

Dieffenbach JE. Die operative Chirurgie. Leipzig: F. A. Brockhause, 1845.

Ely ET. An operation for prominent auricles. Arch. Otolaryngol. 10: 97, 1881 (reprinted in Plast. Reconstr. Surg. 1968;42: 582

Luckett WH. A new operation for prominent ears based on the anatomy of the deformity. Surg. Gynecol.Obstet. 10: 635, 1910

Becker OJ. Correction of protruding deformed ear. Br. J. Plast. Surg. 5: 187, 1952

Mustardé JC. The correction of prominent ears using simple mattress sutures. Br. J. Plast. Surg. 16: 170, 1963.

Gibson T, Davis W. The distortion of autogenous cartilage grafts: Its cause and prevention. Br. J. Plast.Surg 1958;10: 267

Chongchet V. A method of antihelix reconstruction. Br. J. Plast. Surg 1963; 16: 268

Stenstrom SJ. A “natural” technique for correction of congenitally prominent ears. Plast. Reconstr. Surg. 1963;32: 50

Furnas DW. Correction of prominent ears by conchamastoid sutures. Plast. Reconstr. Surg 1968;42: 189

Spira M, McCrea R, Gerow FJ, Hardy, SB.Correction of the principal deformities causing protruding ears. Plast. Reconstr. Surg 1969; 44: 150

Mustarde´ JC. The treatment of prominent ears by buried mattress sutures: A ten-year survey. Plast Reconstr Surg. 1967; 39:382–386

McDowell AJ. Goals in otoplasty for protruding ears. Plast. Reconstr. Surg. 1968; 41: 17

Tan ST, Abramson DL, MacDonald DM, Mulliken JB. Molding therapy for infants with deformationalauricular anomalies. Ann. Plast. Surg. 1997;38:263

Rajanya S. Petersson , Chelsey A. Recker, Joscelyn R.K. Martin, Colin L.W. Driscoll, Oren Friedman. Identification of congenital auricular deformities during newborn hearing screening allows for non-surgical correction: A Mayo Clinic pilot study. International Journal of Pediatric Otorhinolaryngology 2012;76:1406–1412

Bhatti AZ, Donovan DO. Sutureless otoplasty by scoring of the cartilage: a study in 34 patients. Br J Oral Maxillofac Surg 2007;45:217-220

Elliott RAJ. Complications in the treatment of prominent ears. Clin Plast Surg 1978;5:479–490

Bauer BB, Marqulis A, Song DH. The importance of conchal resection in correcting the prominent ear. Aesthet Surg J 2005;25:72-79

Toplu Y, Toplu SA, Sapmaz E, Deliktas H. An unusual cause of conductive hearing loss: bilateral complete meatal obstruction following otoplasty. J Craniofac Surg 2014;25(2):e168-70

Beasley NJ, Jones NS. Otoplasty: The problem of the deep conchal bowl. J. Laryngol Otol 1996; 110: 864

Bauer BS, Song DH, Aitken ME. Combined otoplasty technique: chondrocutaneous resection as the cornerstone to correctionof the prominent ear. Plast Reconstr Surg 2002;110: 1033–1040)

Wood-Smith D. Otoplasty. In T. Rees (Ed.), Aesthetic Plastic Surgery. Philadelphia: Saunders, 1980. P. 833

Ozturan O, Dogan R, Eren SB, Aksoy F, Veyseller B. Percutaneous adjustable closed otoplasty for prominent ear deformity.J Craniofac Surg. 2013 Mar;24(2):398-404

Ozturan O, Dogan R, Eren SB, Aksoy F, Veyseller B. Cartilage-sparing techniques versus percutaneous adjustable closed otoplasty for prominent ear deformity. J Craniofac Surg. 2014 May;25(3):752-7

Weerda H, Siegert R. Complications in otoplastic surgery and their treatment. Facial Plast Surg 1994;10:287e97.

Limandjaja GC, Breugem CC, Mink AB. van der Molen, Kon M. Complications of otoplasty: a literature review. Journal of Plastic, Reconstructive & Aesthetic Surgery (2009) 62, 19e27

Vdgelin E and Jones.BM. Facial palsy following trauma to the external ear: 3 case reports. British Journal of Plastic Surgery(1997), 50, 646-648,

Kayabasoglu G, Nacar A. An Unexpected Otoplasty Complication: Temporal Nerve Paresis. Aesthetic Plast Surg. 2015 Feb;39(1):114-6




Online ISSN:2528-8644
Basılı ISSN:1300-6878 (önceki)

Türk Plastik Rekonstrüktif ve Estetik Cerrahi Dergisi (Turk J Plast Surg),
Türk Plastik Rekonstrüktif ve Estetik Cerrahi Derneği'nin, Estetik Plastik Cerrahi Derneği'nin, Türkiye Interplast Derneği'nin ve Çene Yüz Cerrahları Derneği'nin yayın organıdır.