小耳症に対する耳介形成手術の経験--肋軟骨フレ-ム法 (内藤儁教授退官記念論文集)

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The authors have experiences of surgical auricle formation for microtia by costocartilage frame method on 22 cases in the period covering 1968 to 1979, which we are reporting hereunder.The operation was done in Fukuda's procedure, which is presently done in three stages. The first stage operation consists of downward turning of the existing portion of lobule, formation of a subcutaneous pocket in the location for the auricle formation, removing of autocostocartilage from the patient's chest for transplant-use, formation of an auricle with the costocartilage and transplantation of the costocartilage auricle frame into the subcutaneous pocket, and thus the present operation method includes the external auditory meatus formation. The second stage operation consists of decollement of the lower two thirds of the transplanted costocartilage frame to raise it, the process of so-called "ear raising", as well as the full thickness skin grafting to cover the exposed raw surface. The third stage operation consists of decollement and fixing of the upper one third of the costocartilage frame and the full thickness skin grafting to cover the exposed raw surface.Besides the above, two or three times of trimming of various parts of the auricle are done.The above-method operation was completed on 17 cases. Both the patients and the surgeons were more than satisfied in 6 cases; the surgeons were extremely satisfied while the patients were fairly satisfied in 5 cases; both the patients and the surgeons were not quite satisfied in 2 cases, and both the surgeons and the patients were unsatisfied in 4 cases.Retrospectively from these experiences, we conclude that this operation method should be applied starting at the patient's age of 8 to 9 years; that the frame work should be done excellently, that decollement of the subcutaneal tissues should be sufficiently done; that subcutaneal tissue steel should be formed; that the frame should be covered with subcutaneal tissues; that the mattress suture should be relaxed; that the method of raising the auricle be improved, etc. in order to perform better and more satisfactory auricle formation.
耳鼻咽喉科臨床学会の論文

小耳症に対する耳介形成手術の経験--肋軟骨フレ-ム法 (内藤儁教授退官記念論文集)

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