Thermosensitivity in a reconstructed microtic ear

Becker

et al. 2013

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Ear reconstruction with autologous rib cartilage is performed in stages. Restitution of blood flow between the separate stages is crucial to obtain a good result. Laser Doppler perfusion imaging (LDPI) and local temperature were measured in reconstructed and normal ears in response to indirect heating. Ten persons who had had a unilateral ear reconstruction were included in the study. At a minimum, 157 days had passed since the last operation. LDPI showed no difference in blood flow between the reconstructed ear and the normal ear, neither before nor after indirect heating. The upper part of the normal ear was slightly cooler than the corresponding part in the reconstructed ear. Indirect heating caused an increase of LDPI-values and temperatures in the upper, middle, and lower part of the ear both in the reconstructed ear and the normal one. Skin blood flow recovers after 3-stage ear reconstruction and shows normal dynamic response upon indirect heating.

Section: Discussionsupporting

confidence: 92%

“…Nerves and vessels are necessarily bisected when incising and undermining the area. Despite this fact both thermo-sensitivity and tactile sensitivity recover to acceptable levels [4,5]. The nervous mechanisms regulating the blood supply could be restituted in analogy.…”

Section: Introductionmentioning

confidence: 99%

Blood flow dynamics in reconstructed auricles

Grayson

Becker

et al. 2013

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“…There are only a few reports about the skin sensitivity of a normal ear [12,13], and a MEDLINE search (key words: skin sensitivity, reconstructed auricle) gave no results about the reconstructed auricle, except for our own previous report on its thermosensitivity [14].…”

Section: Many Reports Have Been Published About the Different Surgicamentioning

confidence: 83%

“…The ears had been reconstructed from 1995-2008. The median age of the patients at the time of reconstruction was 10.5 years (range 6-19); median age 13 years (8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21) at the time of follow-up, and median time after the reconstruction 20 months (6-60).…”

Section: Patientsmentioning

confidence: 99%

Threshold of tactile perception in a reconstructed auricle

Svensson

Becker

et al. 2011

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There are more important outcome variables than the aesthetic when it comes to a successful result in reconstruction of the ear for microtia. The protective sensitivity, for example, is important to avoid damage to the skin covering the cartilaginous framework. We studied 39 patients with unilateral microtia and recorded their skin sensitivity more than six months after the last operation. The Semmes-Weinstein Monofilament Test (SWMT) was used to assess the threshold of protective sensitivity in three particular areas: the helix, the anthelix, and the lobule. The opposite ear served as control. A monofilament of 4.31 or less was regarded as acceptable protective sensitivity. Thirty-two patients had acceptable sensitivity in the whole ear, but the helix gave a poor result in seven patients and in one of them so did the anthelix.

“…porous polyethylene or autologous rib cartilage, respectively [2]. Benefits with an ear made of autologous rib cartilage are that it is sensitive for touch and temperature, and has a very good colour match [3,4]. The main disadvantage with porous polyethylene implant is the risk of extrusion, which does not exist for autologous rib cartilage.…”

Section: Introductionmentioning

confidence: 99%

Patients' satisfaction after ear reconstruction with autologous rib cartilage

Kristiansen

Wikström

2013

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Patients' satisfaction is an important outcome measure in reconstructive surgery and quality assurance is today central in the clinical practice. The aim of this study was to evaluate the patients' satisfaction with the process and final result after reconstruction for congenital microtia. A questionnaire was designed and sent to 78 patients who had undergone unilateral ear reconstruction with autologous rib cartilage during the period 2000-2010. For a multidimensional view the patients answered 42 questions about aesthetic, functional, psychosocial, and clinic-related outcomes. The response rate was 76% (59/78 patients). The patients were generally satisfied with the aesthetic result of the ear and had function gain in being able to wear glasses; however, some patients did report new different functional problems after the operation. Still, almost all patients felt that the ear was a part of them and would have chosen the same operative procedure if they could do it again. The patients were overall highly satisfied with the care process. This surgery-specific questionnaire is an important tool for quality assurance in this clinical practice. These findings can help to improve the preoperative information to meet the patients' notions, expectations, and fears.