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Surgical Atlas of pediatric otolaryngology - part 9

Sửa chữa khiếm khuyết liên quan đến môi commissure với nắp loại Estlander. Lip lỗi, trong trường hợp này do cắt bỏ khối u. Lưu ý nắp thiết kế (A). Kết quả sau khi chuyển vị nắp và tiến bộ niêm mạc (B). (In lại với sự cho phép từ Renner GJ Tái thiết của môi Trong | Soft Tissue Surgery 681 Figure 29 3 Repair of lip defect involving the commissure with Estlander type flap. Lip defect in this case due to neoplasm resection. Note flap design A . Result after flap transposition and mucosal advancement B . Reprinted with permission from Renner GJ. Reconstruction of the lip. In Baker SR Swanson NA editors. Local flaps in facial reconstruction. St. Louis Mosby 1995. p. 345-96. Figure 29-4 Repair of lip defect not involving the commissure using the Abbe flap. Lip defect showing flap design A . Result after flap transposition and mucosal advancement with pedicle intact B . Final result following pedicle division which is delayed C . Reprinted with permission from Renner GJ. Reconstruction of the lip. In Baker SR Swanson NA editors. Local flaps in facial reconstruction. St. Louis Mosby 1995. p. 345-96. 682 Surgical Atlas of Pediatric Otolaryngology AURICULAR REPAIR The pinna is particularly susceptible to injury and avulsion. The auricular contour has little role in terms of hearing so reconstruction is aimed at creating an inconspicuous unit. Fortunately both ears are rarely seen simultaneously. Consequently exact symmetry of the ears has a lesser priority than preserving general contour and definition. Auricular cartilage is elastic and covered by a thin layer of skin that allows the irregular contours to be apparent. This unique relationship is difficult to recreate and every effort is made to preserve as much native tissue as possible. Chondritis of the ear can destroy a meticulous repair and cause significant deformity. Consequently all open injuries to the ear require systemic antibiotics with adequate cartilage penetration. Quinolones are used frequently in adults but are inappropriate for pediatric use because of the potential for damage to structural cartilages. Auricular Hematomas Auricular hematomas should be incised and drained. The hematoma usually exists between the perichondrium and cartilage along the anterior and .