{"title":"螺旋前进:珍珠和陷阱。","authors":"Aa Al-Shaham","doi":"","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Reconstruction of acquired auricular defects is a challenging procedure. Since its emergence, the helical advancement technique has proved to be an excellent method of repairing many auricle defects. This technique may occasionally result in an alteration in the dimensions of the neoauricle, with subsequent deformity. However, the advantages of this technique are well known, while the pitfalls are scarce.</p><p><strong>Objective: </strong>To critically review the selection criteria of patients with acquired auricular defects to determine which are eligible for helical advancement technique without subsequent deformity.</p><p><strong>Methods: </strong>From March 2004 to January 2006, 18 patients with three types of upper one-third auricle defects underwent the helical advancement procedure. All patients were male, with mean age of 33.5 years. The defects ranged from 1.2 cm to 4.3 cm in length. Two helical flaps (one on either side of the injury) were advanced along the helical margin to ensure closure. The vertical and horizontal auricular axes were measured before and after surgery, and the actual reduction in millimetres was calculated. Patients were followed up for three months postoperatively. Assessment of the surgical outcome was performed by surgeon (with patient feedback) in the final patient visit.</p><p><strong>Results: </strong>The principle pitfall in the form of small neoauricle with or without cupping was reported in five patients (27.77%). The defects in these cases were >2.8 cm and the mean resultant reduction in vertical axes was >5 mm. Statistical analysis resulted in χ(2)=4.24 and P=0.04.</p><p><strong>Conclusion: </strong>The three varieties of upper one-third auricle defects can best be corrected by the helical advancement technique when the defect is <2.8 cm. Furthermore, perioperative reduction in the vertical axis of the neoauricle >5 mm was an important predictive factor in the development of subsequent deformity.</p>","PeriodicalId":50714,"journal":{"name":"Plastic Surgery","volume":null,"pages":null},"PeriodicalIF":0.7000,"publicationDate":"2012-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3383560/pdf/cjps20e028.pdf","citationCount":"0","resultStr":"{\"title\":\"Helical advancement: Pearls and pitfalls.\",\"authors\":\"Aa Al-Shaham\",\"doi\":\"\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Reconstruction of acquired auricular defects is a challenging procedure. Since its emergence, the helical advancement technique has proved to be an excellent method of repairing many auricle defects. This technique may occasionally result in an alteration in the dimensions of the neoauricle, with subsequent deformity. However, the advantages of this technique are well known, while the pitfalls are scarce.</p><p><strong>Objective: </strong>To critically review the selection criteria of patients with acquired auricular defects to determine which are eligible for helical advancement technique without subsequent deformity.</p><p><strong>Methods: </strong>From March 2004 to January 2006, 18 patients with three types of upper one-third auricle defects underwent the helical advancement procedure. All patients were male, with mean age of 33.5 years. The defects ranged from 1.2 cm to 4.3 cm in length. Two helical flaps (one on either side of the injury) were advanced along the helical margin to ensure closure. The vertical and horizontal auricular axes were measured before and after surgery, and the actual reduction in millimetres was calculated. Patients were followed up for three months postoperatively. Assessment of the surgical outcome was performed by surgeon (with patient feedback) in the final patient visit.</p><p><strong>Results: </strong>The principle pitfall in the form of small neoauricle with or without cupping was reported in five patients (27.77%). The defects in these cases were >2.8 cm and the mean resultant reduction in vertical axes was >5 mm. Statistical analysis resulted in χ(2)=4.24 and P=0.04.</p><p><strong>Conclusion: </strong>The three varieties of upper one-third auricle defects can best be corrected by the helical advancement technique when the defect is <2.8 cm. Furthermore, perioperative reduction in the vertical axis of the neoauricle >5 mm was an important predictive factor in the development of subsequent deformity.</p>\",\"PeriodicalId\":50714,\"journal\":{\"name\":\"Plastic Surgery\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":0.7000,\"publicationDate\":\"2012-01-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3383560/pdf/cjps20e028.pdf\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Plastic Surgery\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q\",\"JCRName\":\"Medicine\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Plastic Surgery","FirstCategoryId":"3","ListUrlMain":"","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q","JCRName":"Medicine","Score":null,"Total":0}
Background: Reconstruction of acquired auricular defects is a challenging procedure. Since its emergence, the helical advancement technique has proved to be an excellent method of repairing many auricle defects. This technique may occasionally result in an alteration in the dimensions of the neoauricle, with subsequent deformity. However, the advantages of this technique are well known, while the pitfalls are scarce.
Objective: To critically review the selection criteria of patients with acquired auricular defects to determine which are eligible for helical advancement technique without subsequent deformity.
Methods: From March 2004 to January 2006, 18 patients with three types of upper one-third auricle defects underwent the helical advancement procedure. All patients were male, with mean age of 33.5 years. The defects ranged from 1.2 cm to 4.3 cm in length. Two helical flaps (one on either side of the injury) were advanced along the helical margin to ensure closure. The vertical and horizontal auricular axes were measured before and after surgery, and the actual reduction in millimetres was calculated. Patients were followed up for three months postoperatively. Assessment of the surgical outcome was performed by surgeon (with patient feedback) in the final patient visit.
Results: The principle pitfall in the form of small neoauricle with or without cupping was reported in five patients (27.77%). The defects in these cases were >2.8 cm and the mean resultant reduction in vertical axes was >5 mm. Statistical analysis resulted in χ(2)=4.24 and P=0.04.
Conclusion: The three varieties of upper one-third auricle defects can best be corrected by the helical advancement technique when the defect is <2.8 cm. Furthermore, perioperative reduction in the vertical axis of the neoauricle >5 mm was an important predictive factor in the development of subsequent deformity.
期刊介绍:
Plastic Surgery (Chirurgie Plastique) is the official journal of the Canadian Society of Plastic Surgeons, the Canadian Society for Aesthetic Plastic Surgery, Group for the Advancement of Microsurgery, and the Canadian Society for Surgery of the Hand. It serves as a major venue for Canadian research, society guidelines, and continuing medical education.