꽃봉오리 모양의 V-Y전진피판 및 이두개구 봉양술을 이용한 매몰이개의 교정

Abstract

In cryptotia the upper part of the auricle is buried beneath the temporal scalp, so the upper auriculocephalic sulcus is absent and auricular cartilage deformity is accompanied. The goals of surgical correction of cryptotia are to release the upper ear from temporal scalp to restore auriculocephalic sulcus, and to correct the cartilage deformity. Authors have experienced 23 auricles in 14 patients with cryptotia to correct cryptotia using lotus flower shaped V-Y advancement flap for the upper auricular skin deficiency and scoring for cartilage deformity. Lotus flower shaped flap is designed above superior pole of auricle. Designed flap has wider lower third than conventional V-Y flap. After complete exposure of upper auricular cartilage, cartilage deformity is corrected by scorings on lateral surface of the scapha and medial surface of the superior crus of antihelix. For construction of auriculocephalic sulcus, the flap is advanced inferiorly about 1 cm and 3 stab incisions on the flap are made at the expected auriculocephalic sulcus. The cinch suture is done between dermal layer of the stab incisions and auriculocephalic sulcus cartilage with 4-0 Prolene . Packing gauze is tied at corrected scapha for contour maintenance. A satisfactory contour of scapha and antihelical crus and deep auriculocephalic sulcus were maintained postoperatively. However, hypertrophic scar formation was found due to tension. Our method is similar to Ono's method in triangular flap shape. But the lotus flower shaped flap has wider lower 1/3 than Ono's triangular flap and provides sufficient skin for formation of auriculocephalic sulcus without additional rhomboid flap elevation in front of the ear.

저자들의 꽃봉우리 모양의 V-Y전진피판술을 이용한 매몰이개의 교정은 Ono법과 비교할 때 피판의 하부를 좀 더 넓게 작도함으로써 통상적인 삼각형의 V-Y 피판보다 피판 하부 1/3에 여유가 있어서 상부 이륜의 기형이 심하거나 수축이 심한 경우에 효과적으로 사용할 수 있었다. 그러나 피판의 하부가 더 넓어 공여부 봉합 때 긴장이 증가하여 이개 상부의 두피에 비후성반흔을 남길 수 있는 단점이 있으므로 주의가 요구된다.