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Yang Q, Qiang S, Fan X, Guo SZ, Yin Y, Li T, Dang H, Dong LW, Song BQ. Clinical Application of Long-Pulsed 800-Nm Diode Laser Depilation Technology on Microtia Reconstruction in 965 Patients. Aesthetic Plast Surg 2024; 48:2155-2161. [PMID: 38238570 DOI: 10.1007/s00266-023-03780-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2023] [Accepted: 11/28/2023] [Indexed: 06/06/2024]
Abstract
BACKGROUND The issue of hair growth on reconstructed ears has been a matter of concern for both patients and surgeons, despite the notable progress made in microtia reconstruction technology in recent times. OBJECTIVE This study aims to present the practical implementation of long-pulsed 800-nm diode laser depilation technology in the field of auricular reconstruction. Furthermore, it seeks to establish a comprehensive and standardized protocol for utilizing lasers in the reconstruction of microtia ears. METHODS A total of 965 patients (comprising 1021 ears) diagnosed with congenital microtia underwent treatment using 800-nm long-pulsed diode laser depilation. The participants received 1-3 treatment sessions with intervals of 25-30 days. To assess the effectiveness of the treatment, two independent observers compared photographs and measured the reduction in terminal hair count before and after the final session. Clinical outcomes were evaluated using VAS questionnaires, and any adverse events were diligently recorded. RESULTS The findings indicated that the utilization of the long-pulsed 800-nm diode laser was both safe and efficient in achieving hair removal during microtia ear reconstruction. As additional sessions were conducted, pain scores demonstrated a decline, while adverse reactions remained minimal. LIMITATIONS This is a retrospective single-institution study. CONCLUSION The application of a long-pulsed 800-nm diode laser has been proved to be a safe and effective method for removing hair during the process of microtia ear reconstruction, involving the use of a tissue expander and autologous costal cartilage. To achieve satisfactory results in hair removal, it was found necessary to repeat the shots procedure two to three times. LEVEL OF EVIDENCE IV This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
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Affiliation(s)
- Qing Yang
- Department of Plastic and Reconstructive Surgery, Xijing Hospital, Forth Military Medical University, No.127 Changle West Road, Xi'an, 710032, Shaanxi, China
| | - Shuai Qiang
- Department of Plastic and Reconstructive Surgery, Xijing Hospital, Forth Military Medical University, No.127 Changle West Road, Xi'an, 710032, Shaanxi, China
| | - Xing Fan
- Department of Plastic and Reconstructive Surgery, Xijing Hospital, Forth Military Medical University, No.127 Changle West Road, Xi'an, 710032, Shaanxi, China
| | - Shu Zhong Guo
- Department of Plastic and Reconstructive Surgery, Xijing Hospital, Forth Military Medical University, No.127 Changle West Road, Xi'an, 710032, Shaanxi, China
| | - Yue Yin
- Department of Plastic and Reconstructive Surgery, Xijing Hospital, Forth Military Medical University, No.127 Changle West Road, Xi'an, 710032, Shaanxi, China
| | - Tong Li
- Department of Plastic and Reconstructive Surgery, Xijing Hospital, Forth Military Medical University, No.127 Changle West Road, Xi'an, 710032, Shaanxi, China
| | - Hui Dang
- Department of Plastic and Reconstructive Surgery, Xijing Hospital, Forth Military Medical University, No.127 Changle West Road, Xi'an, 710032, Shaanxi, China
| | - Li Wei Dong
- Department of Plastic and Reconstructive Surgery, Xijing Hospital, Forth Military Medical University, No.127 Changle West Road, Xi'an, 710032, Shaanxi, China.
| | - Bao Qiang Song
- Department of Plastic and Reconstructive Surgery, Xijing Hospital, Forth Military Medical University, No.127 Changle West Road, Xi'an, 710032, Shaanxi, China.
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You P, Rosenberg TL, Liu YCC. Utilization of Alexandrite Laser for Hair Removal in Pediatric Auricular Reconstruction. Otolaryngol Head Neck Surg 2021; 167:203-205. [PMID: 34464219 DOI: 10.1177/01945998211041948] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Auricular reconstruction with autologous rib cartilage involves using a soft tissue envelope to cover the cartilage framework. In patients with a low hairline, hair-bearing skin may be incorporated on the reconstructed ear, creating a difficult and conspicuous aesthetic problem. A retrospective chart review was conducted to summarize and share the experience of using the Candela GentleMax Pro 755-nm alexandrite laser system (Candela Corp) in children following auricular reconstruction. Nine patients received laser hair removal via the alexandrite laser system with good results. The number of completed sessions ranged from 1 to 5. The procedures were completed without the need for premedication or procedural sedation. Laser hair removal with an alexandrite laser system was safe, fast, and effective. With multistage auricular reconstruction, it was feasible to incorporate laser hair removal between the stages.
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Affiliation(s)
- Peng You
- Department of Otolaryngology-Head and Neck Surgery, Baylor College of Medicine/Texas Children's Hospital, Houston, Texas, USA
| | - Tara L Rosenberg
- Department of Otolaryngology-Head and Neck Surgery, Baylor College of Medicine/Texas Children's Hospital, Houston, Texas, USA
| | - Yi-Chun Carol Liu
- Department of Otolaryngology-Head and Neck Surgery, Baylor College of Medicine/Texas Children's Hospital, Houston, Texas, USA
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Wang M, Wei Z, Zheng H, Lei C, Shan X, Ye J, Wang B. Comparison of Two Surgical Epilation Procedures Based on the Nagata Method in All Degrees of Low Hairline Microtia. Facial Plast Surg Aesthet Med 2020; 23:294-301. [PMID: 33259731 DOI: 10.1089/fpsam.2020.0324] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Background: Various methods exist to manage unwanted hair in low hairline microtia. We present our 10-year experience that compares the two procedures toward all degrees of low hairline microtia. Methods: The tongue-shaped split-thickness skin graft procedure (modified Chen's procedure) and the modified Nagata procedure were used for ear reconstruction in 42 microtia patients with three degrees of low hairlines from 2010 to 2020. Hair follicles in the low hairline area were removed free-hand, and the removed area was replaced with extended temporoparietal fascia (TPF) flap during the ear elevation. The satisfaction score and the clearance percentages of the hair were used as outcome measures. Results: There was no significant difference in satisfaction scores and the hair clearance percentages of hair between two procedures (p > 0.05) and among three degrees of low hairline (p > 0.05), respectively. Although the complication rate showed no significant difference, the major types of complication in modified Chen's procedure was fluid accumulation (9.52%), whereas in modified Nagata procedure was hypertrophic scar (4.76%). Conclusion: Patients with low hairlines can be treated using two different microtia reconstruction techniques to limit hair growth on the new ear. The rib graft construct is covered by a TPF flap, which is then grafted with an ultrathin skin graft and shows benefit in this review of our 10-year experience. Clinical Trial Registration Information Provided: Registration no. and date registered: ChiCTR2000030214.
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Affiliation(s)
- Meishui Wang
- Department of Plastic Surgery, the First Affiliated Hospital of Fujian Medical University, Fuzhou, P.R. China
| | - Zhenni Wei
- Department of Plastic Surgery, the First Affiliated Hospital of Fujian Medical University, Fuzhou, P.R. China
| | - Houbing Zheng
- Department of Plastic Surgery, the First Affiliated Hospital of Fujian Medical University, Fuzhou, P.R. China
| | - Chen Lei
- Department of Plastic Surgery, the First Affiliated Hospital of Fujian Medical University, Fuzhou, P.R. China
| | - Xiuying Shan
- Department of Plastic Surgery, the First Affiliated Hospital of Fujian Medical University, Fuzhou, P.R. China
| | - Jiong Ye
- Department of Plastic Surgery, the First Affiliated Hospital of Fujian Medical University, Fuzhou, P.R. China
| | - Biao Wang
- Department of Plastic Surgery, the First Affiliated Hospital of Fujian Medical University, Fuzhou, P.R. China
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Chen Q, Wang B, Wang Y, Hu J, Zhang Q. Using an expanded scalp flap without fascial flap harvest or skin grafting for total auricular reconstruction in hemifacial microsomia with low hairline. Int J Pediatr Otorhinolaryngol 2020; 128:109726. [PMID: 31639620 DOI: 10.1016/j.ijporl.2019.109726] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/06/2019] [Revised: 10/07/2019] [Accepted: 10/12/2019] [Indexed: 10/25/2022]
Abstract
BACKGROUND Total auricular reconstruction for hemifacial microsomia patients with extremely low hairline is a tough challenge in plastic surgery. In this work, a brand new technique using a singer expanded scalp flap without skin graft and combined with intense pulse light treatments (IPLT) for ear reconstruction is described in this special population. METHODS From January 2015 to April 2019, 41 hemifacial macrosomia (HFM) patients with 70-100% low hairline were enrolled in our study. Operative treatment was performed in 3 stages: 1. Expander insertion and inflation; 2. Expander removal, costal cartilage framework fabrication and auricular reconstruction; 3. Tragus reconstruction and reconstructed auricle refinement. Several IPLTs were performed every 45 days until local area become hairless during the whole course. The first IPLT could be executed either before all the operations or during the expansion period. The flap was treated with M22 system using a filter of 695-1200 nm. Follow up ranged from 10 months to 4 years. RESULTS During follow-up, 90.2% patients were surveyed as satisfied with the outcome, especially in the aspects of minimal scars, natural matched color and clear contour of the reconstructed ear. No serious complications happened. Patients starting the IPLT during the expansion period required less treatment times of depilation (p < 0.05). CONCLUSION Auricular reconstruction using a single expanded scalp flap combined with intense pulse light depilation is a safe, effective and less invasive technique for hemifacial microsomia with extremely low hairline, and providing highly satisfying results. Initialing the IPLD during the expansion period is recommended. CLINICAL QUESTION/LEVEL OF EVIDENCE Therapeutic, IV.
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Affiliation(s)
- Qi Chen
- From the Auricular Plastic and Reconstructive Surgery Center, Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College
| | - Bingqing Wang
- From the Auricular Plastic and Reconstructive Surgery Center, Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College
| | - Yue Wang
- From the Auricular Plastic and Reconstructive Surgery Center, Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College
| | - Jintian Hu
- From the Auricular Plastic and Reconstructive Surgery Center, Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College
| | - Qingguo Zhang
- From the Auricular Plastic and Reconstructive Surgery Center, Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College.
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Epidemiologic Assessment of Microtia in Over 23 Million Consecutive United States Births. J Craniofac Surg 2019; 30:342-346. [PMID: 30418290 DOI: 10.1097/scs.0000000000004885] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023] Open
Abstract
PURPOSE Conflicting data exist regarding the incidence, demographics, and abnormalities associated with microtia. Using a large national cohort database, a comprehensive evaluation of microtia in the United States was performed. METHODS The Kids' Inpatient Database was reviewed over a 15-year consecutive period. Information regarding patient demographics, comorbidities, postoperative complications, and hospital setting was collected. Statistical tests were analyzed using independent t tests and χ analysis. RESULTS A total of 23,479,792 births over 15 consecutive years from 1997 to 2012 were included in the study. Microtia was identified in 1563 births. Incidence of microtia was higher in males (P<0.01) and patients of Asian or Hispanic race (P<0.01). Patients with microtia had significantly more congenital anomalies relative to the rest of the population (P<0.01). Specifically, cardiac and genitourinary anomalies were 51 and 19 times, respectively, more likely in microtia patients. Risk of associated congenital anomalies with microtia was highest in female and Black patients. 12.6% of all microtia patients had an associated craniofacial syndrome with a comparable postsurgical course to the nonsyndromic population. CONCLUSION This study represents the largest national, longitudinal study of microtia allowing for demographic, socioeconomic, and comorbidity commentary. By quantifying relative risk of associated congenital anomalies, it can help inform the type and utility of screening modalities when evaluating microtia patients.
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Investigation of Microsurgical Technique Combined With Skin Flap Expansion for Ear Reconstruction in Treating Hunter Type III Congenital Microtia. Ann Plast Surg 2018; 78:680-683. [PMID: 27759585 DOI: 10.1097/sap.0000000000000908] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE This study aims to observe the efficacies of microsurgical technique combined with the Zhuang's skin soft tissue expander in treating Hunter type III congenital microtia. METHODS Fifty-eight patients (61 ears) were enrolled from 2003 to 2012; the skin tissue expander was embedded subepidermally in the first stage via the intrahairline longitudinal incision in the postauricular mastoid area, the diseased-side rib cartilage was then taken for preparing the ear bracket in the second stage, and the tragus was surgically reconstructed in the third stage. RESULTS The mean follow-up lasted 6 months to 10 years, the results were satisfactory for 54 ears and acceptable for 5 ears, and 2 ears (in two patients) appeared with complications, including 1 case of ear flap expansion rupture and 1 case of postoperative lateral helix flap necrosis. CONCLUSIONS The combination of microsurgical technique, Zhuang's skin soft tissue expander, and autogenous rib cartilage graft could achieve satisfactory results in treating Hunter type III congenital microtia, and the complications were less, so it was worthy of clinical applications.
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Nuri T, Ueda K, Yamada A. Application of free serratus anterior fascial flap for reconstruction of ear deformity due to hemifacial microsomia: A report of two cases. Microsurgery 2016; 37:436-441. [DOI: 10.1002/micr.30143] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2016] [Revised: 11/23/2016] [Accepted: 12/02/2016] [Indexed: 11/08/2022]
Affiliation(s)
- Takashi Nuri
- Department of Plastic and Reconstructive Surgery; Osaka Medical College; Osaka Japan
| | - Koichi Ueda
- Department of Plastic and Reconstructive Surgery; Osaka Medical College; Osaka Japan
| | - Akira Yamada
- Ann & Robert H. Lurie Children's Hospital Division of Plastic Surgery; Northwestern University; Chicago Illinois
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