METHOD OF ONE-STAGE RECONSTRUCTION OF THE AURICLE Russian patent published in 2023 - IPC A61B17/00 

FIELD: medicine; maxillofacial; reconstructive; plastic surgery.

SUBSTANCE: invention is intended for use as a one-stage reconstruction of the auricle. The preparation of the bed in the projection of the future auricle is carried out simultaneously with the collection and formation of a cartilaginous rib autograft. After hydropreparation of the soft tissues of the appendage and the temporo-parietal region, an incision is made along the edge of the skin appendage on the right. The skin is mobilized over the anterior and posterior surfaces of the rudiment. The vestigial cartilage is isolated and removed. Next, in the temporo-parietal region and the scalp, the incision is extended in a Y-shape with a total length of up to 15 cm. After this, three triangular skin-fat flaps are mobilized, partly sharp, partly bluntly, and the wound is tamponed. A cartilaginous rib autograft is taken synchronously, a linear incision 4 cm long is made on the chest in the projection of the VII rib parallel to the costal arch, the cartilaginous part of the VIII rib is isolated using blunt and sharp dissection to its border with the bone tissue, the cartilaginous part of the VII–VI ribs is isolated in the same way with the obligatory inclusion of synchondrosis, dimensions corresponding to previously made templates, the wound is sutured in layers. Next, using the obtained fragments of the cartilaginous part of the ribs, with the help of carving technique, the base of the auricle frame is formed, which is positioned in a previously prepared bed, covered with flaps of the temporoparietal fascia on the inner and outer surfaces, the appendage is dissected and the auricle is formed. Next, using sharp and blunt dissection using electrocoagulation in cutting mode, a flap of temporoparietal fascia size 7 × 7 cm is mobilized, flipped onto the cartilaginous frame, the relief of the anterior surface of the auricle is formed and fixed to the inner surface of the skin appendage. After this, a skin strip up to 2 mm thick is taken from the anterior surface of the thigh or posterior surface of the buttocks, fixed over a flap of the temporoparietal fascia on the anterior-posterior surface of the auricle, and a drainage with active aspiration is installed along the edge of the skin appendage into the wound, which is removed on the 4–5th day after the surgery.

EFFECT: method allows to simultaneously restore the cartilaginous frame and soft tissue cover of the auricle, achieving a high aesthetic result by restoring all elements of the auricle in one stage.

1 cl, 4 dwg, 2 ex