1
|
Li Q, Chen Z, Jiang Z, Deng J, Cui W, Cai Z, Sheng Y. A Novel Conchal Cartilage Harvesting Technique. Aesthetic Plast Surg 2024; 48:2941-2950. [PMID: 38519571 DOI: 10.1007/s00266-024-03958-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2024] [Accepted: 02/21/2024] [Indexed: 03/25/2024]
Abstract
BACKGROUND Conchal cartilage is generally favored in rhinoplasty with a satisfied aesthetic outcome. However, patients may suffer from postoperative donor auricle deformities. OBJECTIVES This study introduced a novel conchal cartilage harvesting technique which can minimize the deformity of auricle and harvest the sufficient amounts of grafts. METHODS This study proposed preservation of the concha cymba and cavum support structures to minimize the deformity of auricle and harvest of cartilage hidden in the craniofacial region to obtain the sufficient amounts. The medical records of 60 patients who underwent the novel conchal cartilage harvesting were reviewed retrospectively. Postoperative aesthetic outcomes were assessed by comparing pre- and postoperative photographs according to the deformation extent of auricular subunits (cymba concha, cavum concha, antihelix, helix crus and intertragal notch) on a four-point Likert scale. Additionally, function and complications were analyzed. RESULTS 56 patients performed unilateral conchal cartilage harvesting (8 with right-side and 48 with left-side) and 4 performed bilateral harvesting. The average aesthetic score, rated on a four-point Likert scale (1 = significant deformation, 2 = moderated deformation, 3 = slight deformation, 4 = complete no deformation), were 3.83 ± 0.03 points, respectively. The functional scores, rated on a four-point Likert scale (1 = significant damage, 2 = moderated damage, 3 = slight damage, 4 = complete no damage), was 3.94±0.03. Complications included hematoma, delayed wound healing and hypopigmentated scar in six ears (9.4%). CONCLUSIONS This novel technique can minimize the deformity of auricle, as shown by the outcome scores, and allows for sufficient amount of grafting material acquired. 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 .
Collapse
Affiliation(s)
- Qingqing Li
- Department of Plastic Surgery, Sichuan Provincial People's Hospital, School of Medicine, University of Electronic Science and Technology of China, No. 32, Section 2, 1st Ring Road, Qingyang District, Chengdu City, Sichuan Province, China
| | - Zaihong Chen
- Department of Plastic Surgery, Sichuan Provincial People's Hospital, School of Medicine, University of Electronic Science and Technology of China, No. 32, Section 2, 1st Ring Road, Qingyang District, Chengdu City, Sichuan Province, China
| | - Zhiyuan Jiang
- Department of Plastic Surgery, Sichuan Provincial People's Hospital, School of Medicine, University of Electronic Science and Technology of China, No. 32, Section 2, 1st Ring Road, Qingyang District, Chengdu City, Sichuan Province, China
| | - Junnan Deng
- Department of Plastic Surgery, Sichuan Provincial People's Hospital, School of Medicine, University of Electronic Science and Technology of China, No. 32, Section 2, 1st Ring Road, Qingyang District, Chengdu City, Sichuan Province, China
| | - Wei Cui
- Department of Plastic Surgery, Sichuan Provincial People's Hospital, School of Medicine, University of Electronic Science and Technology of China, No. 32, Section 2, 1st Ring Road, Qingyang District, Chengdu City, Sichuan Province, China
| | - Zhen Cai
- Department of Plastic Surgery, Sichuan Provincial People's Hospital, School of Medicine, University of Electronic Science and Technology of China, No. 32, Section 2, 1st Ring Road, Qingyang District, Chengdu City, Sichuan Province, China.
| | - Yang Sheng
- Department of Plastic Surgery, Sichuan Provincial People's Hospital, School of Medicine, University of Electronic Science and Technology of China, No. 32, Section 2, 1st Ring Road, Qingyang District, Chengdu City, Sichuan Province, China.
| |
Collapse
|
2
|
Abukhder M, Onions E, Flaherty E, Tarassoli S, Hassan MR, Whelan R. A systematic literature review and narrative synthesis on the use of autologous cartilage in the repair of orbital fractures. Ann Med Surg (Lond) 2024; 86:968-974. [PMID: 38333240 PMCID: PMC10849358 DOI: 10.1097/ms9.0000000000001598] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Accepted: 11/27/2023] [Indexed: 02/10/2024] Open
Abstract
Introduction Fractures of the orbit are common injuries within the maxillofacial skeleton, and can often result in restrictions to ocular movement, diplopia, and enophthalmous if herniation of globe content occurs. Various studies have demonstrated the use of autologous cartilage grafts in the reconstruction of orbital fractures. Methods A systematic review protocol was registered with PROSPERO, and reported in accordance with the Preferred Reporting for Items for Systematic Reviews and Meta-Analyses. Comprehensive electronic search strategies of four databases were developed. Studies were screened according to the inclusion and exclusion criteria by two independent reviewers. Results Seven thousand one hundred seventy-one articles were identified following a comprehensive literature search. These articles were filtered for relevance and duplication, which reduced the number of articles to 16. A total of 259 patients underwent orbital reconstruction with the use of autologous cartilage. Conchal cartilage was harvested in 148 patients, auricular cartilage in 22 patients, nasoseptal cartilage in 72 patients, and costal cartilage in 17 patients. Thirty, seven, twelve, and four complications were observed in patients where cartilage was harvested from the concha, auricle, nasoseptum and rib, respectively. Most common complications included diplopia (n=23), infra-orbital para/anaesthesia (n=27), and enophthalmos (n=7). No failure of graft or donor site morbidity were observed in the studies. Conclusion Autogenous materials such as cartilage can be used as an alternative for orbital reconstruction. Cartilage was considered by the authors to provide adequate structural support to the orbital contents, and that it was easy to harvest, shape, and position.
Collapse
Affiliation(s)
| | | | - Erin Flaherty
- School of Medicine, Cardiff University, Neuadd Meirionnydd, Cardiff
| | - Sam Tarassoli
- Morriston Hospital, Heol Maes Eglwys, Morriston, Cwmrhydyceirw, Swansea
| | | | - Rhys Whelan
- Morriston Hospital, Heol Maes Eglwys, Morriston, Cwmrhydyceirw, Swansea
| |
Collapse
|
3
|
Zhou S, Jiang T, Zhong Y, Yu Z, Duan H, Li D, Xu L, Yuan J, Wei M. Efficacy and Safety of Expanded Polytetrafluoroethylene Implantation in the Correction of Long-Term Posttraumatic Enophthalmos. Plast Reconstr Surg 2023; 152:1313-1318. [PMID: 36940154 DOI: 10.1097/prs.0000000000010440] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/21/2023]
Abstract
SUMMARY Long-term enophthalmos is a common orbital fracture sequela. Various autografts and alloplastic materials have been studied in posttraumatic enophthalmos repair. However, expanded polytetrafluoroethylene (ePTFE) implantation in late enophthalmos repair has rarely been reported. The authors report novel use of ePTFE for late posttraumatic enophthalmos repair. This retrospective study included patients with posttraumatic long-term enophthalmos who underwent hand-carved ePTFE intraorbital implantation for enophthalmos correction. Computed tomography data were collected preoperatively and at follow-up. The volume of ePTFE, the degree of proptosis (DP), and enophthalmos were measured. Postoperative and preoperative DP and enophthalmos were compared using the paired t test. The correlation between ePTFE volume and DP increment was established using linear regression. Complications were identified by chart review. From 2014 to 2021, 32 patients were included, with a mean follow-up of 19.59 months. The mean volume of implanted ePTFE was 2.39 ± 0.89 mL. After surgery, the DP of the affected globe improved significantly, from 12.75 ± 2.12 mm to 15.06 ± 2.50 mm ( P < 0.0001). A significant linear correlation was found between ePTFE volume and DP increment ( P < 0.0001). Enophthalmos was substantially ameliorated from 3.35 ± 1.89 mm to 1.09 ± 2.07 mm ( P < 0.0001). Twenty-five patients (78.23%) had postoperative enophthalmos of less than 2 mm. Infection and implant dislocation were not observed. The authors concluded that ePTFE intraorbital implantation exhibited long-term efficacy and safety for late posttraumatic enophthalmos repair and represents an effective and predictable alternative. CLINICAL QUESTION/LEVEL OF EVIDENCE Therapeutic, IV.
Collapse
Affiliation(s)
- Sizheng Zhou
- From the Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine
| | - Taoran Jiang
- From the Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine
| | - Yehong Zhong
- From the Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine
- Department of Maxillofacial Surgery and Digital Plastic Center, Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College
| | - Zheyuan Yu
- From the Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine
| | - Huichuan Duan
- From the Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine
| | - Dong Li
- From the Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine
| | - Liang Xu
- From the Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine
| | - Jie Yuan
- From the Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine
| | - Min Wei
- From the Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine
| |
Collapse
|
4
|
Dabestani PJ, Massenburg BB, Aurit S, Dawson AJ, Susarla SM. Risk factors for inpatient hospital admission following isolated orbital floor fractures. Int J Oral Maxillofac Surg 2023; 52:1039-1048. [PMID: 37003906 DOI: 10.1016/j.ijom.2023.03.005] [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: 11/09/2022] [Revised: 03/11/2023] [Accepted: 03/15/2023] [Indexed: 04/03/2023]
Abstract
Orbital floor fractures are common injuries seen in the emergency department (ED). In this study, the National Trauma Data Bank (NTDB, 2016-2017) was used to identify patients presenting with isolated orbital floor trauma. Patient-specific factors were analyzed to determine associations with management. The sample comprised 912 patients; 285 (31.3%) of these patients were discharged from the ED, 541 (59.3%) were admitted to the hospital but did not undergo an operation, and 86 (9.4%) underwent operative treatment. Pediatric patients and older patients (<18 years and>55 years) were more likely to be admitted than those aged 18-55 years, and pediatric patients were more likely to undergo an urgent operative intervention than those in the other age groups (all P < 0.001). Patients with alcohol use disorder (P = 0.002) and hypertension (P = 0.004) had increased odds of admission. Private and Medicare insurance patients were more likely to be admitted, and self-pay patients less likely (P < 0.001). Older age and Medicaid payor status showed increased odds of a greater hospital length of stay. Biological sex, race/ethnicity, functionally dependent health status, myocardial infarction, steroid use, and substance use disorder were not associated with discharge disposition. There are non-injury related, patient-specific factors that may influence the management of orbital floor fractures.
Collapse
Affiliation(s)
- P J Dabestani
- Division of Plastic and Reconstructive Surgery, Loyola University Medical Center, Maywood, Illinois, USA
| | - B B Massenburg
- Department of Oral and Maxillofacial Surgery and Department of Surgery, Division of Plastic Surgery, University of Washington, Seattle, Washington, USA
| | - S Aurit
- Division of Plastic and Reconstructive Surgery, Creighton University, Omaha, Nebraska, USA
| | - A J Dawson
- Division of Plastic and Reconstructive Surgery, Creighton University, Omaha, Nebraska, USA
| | - S M Susarla
- Department of Oral and Maxillofacial Surgery and Department of Surgery, Division of Plastic Surgery, University of Washington, Seattle, Washington, USA.
| |
Collapse
|
5
|
Gu L, Huang R, Ni N, Gu P, Fan X. Advances and Prospects in Materials for Craniofacial Bone Reconstruction. ACS Biomater Sci Eng 2023; 9:4462-4496. [PMID: 37470754 DOI: 10.1021/acsbiomaterials.3c00399] [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] [Indexed: 07/21/2023]
Abstract
The craniofacial region is composed of 23 bones, which provide crucial function in keeping the normal position of brain and eyeballs, aesthetics of the craniofacial complex, facial movements, and visual function. Given the complex geometry and architecture, craniofacial bone defects not only affect the normal craniofacial structure but also may result in severe craniofacial dysfunction. Therefore, the exploration of rapid, precise, and effective reconstruction of craniofacial bone defects is urgent. Recently, developments in advanced bone tissue engineering bring new hope for the ideal reconstruction of the craniofacial bone defects. This report, presenting a first-time comprehensive review of recent advances of biomaterials in craniofacial bone tissue engineering, overviews the modification of traditional biomaterials and development of advanced biomaterials applying to craniofacial reconstruction. Challenges and perspectives of biomaterial development in craniofacial fields are discussed in the end.
Collapse
Affiliation(s)
- Li Gu
- Department of Ophthalmology, Shanghai Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, Shanghai 200011, China
- Shanghai Key Laboratory of Orbital Diseases and Ocular Oncology, Shanghai 200011, China
| | - Rui Huang
- Department of Ophthalmology, Shanghai Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, Shanghai 200011, China
- Shanghai Key Laboratory of Orbital Diseases and Ocular Oncology, Shanghai 200011, China
| | - Ni Ni
- Department of Ophthalmology, Shanghai Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, Shanghai 200011, China
- Shanghai Key Laboratory of Orbital Diseases and Ocular Oncology, Shanghai 200011, China
| | - Ping Gu
- Department of Ophthalmology, Shanghai Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, Shanghai 200011, China
- Shanghai Key Laboratory of Orbital Diseases and Ocular Oncology, Shanghai 200011, China
| | - Xianqun Fan
- Department of Ophthalmology, Shanghai Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, Shanghai 200011, China
- Shanghai Key Laboratory of Orbital Diseases and Ocular Oncology, Shanghai 200011, China
| |
Collapse
|
6
|
Singh AK, Khanal N, Chaulagain R, Sharma N, Thieringer FM. Is the Pre-Shaping of an Orbital Implant on a Patient-Specific 3D-Printed Model Advantageous Compared to Conventional Free-Hand Shaping? A Systematic Review and Meta-Analysis. J Clin Med 2023; 12:jcm12103426. [PMID: 37240532 DOI: 10.3390/jcm12103426] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2023] [Revised: 05/01/2023] [Accepted: 05/05/2023] [Indexed: 05/28/2023] Open
Abstract
This study aimed to perform a systematic review and meta-analysis to compare pre-shaped implants on a patient-specific 3D-printed (3DP) model to manual free-hand shaping (MFS) for orbital wall reconstruction. The PRISMA protocol was followed in this study, and the review was registered in the PROSPERO database (CRD42021261594). A search was conducted in MEDLINE (PubMed), Embase, Cochrane Library, Clinicaltrials.gov, Google Scholar, and the grey literature. Ten articles were included, and six outcomes were analyzed. In total, 281 patients were in the 3DP group and 283 were in the MFS group. The studies had an overall high risk of bias. 3DP models resulted in a better accuracy of fit, anatomical angle reproduction, and defect area coverage. The correction of orbital volume was also superior with statistical significance. There was a higher percentage of the correction of enophthalmos and diplopia in the 3DP group. Intraoperative bleeding and hospital stay were reduced in the 3DP group. The meta-analysis of operative time showed a reduction in the average operative time by 23.58 min (95% CI: -43.98 to -3.19), which was statistically significant (t(6) = -2.8299, p = 0.0300). The 3DP models appear advantageous for an accurate orbital wall reconstruction, with fewer complications than those for conventional free-hand-shaped implants.
Collapse
Affiliation(s)
- Ashutosh Kumar Singh
- Department of Oral and Maxillofacial Surgery, Tribhuvan University Teaching Hospital, Institute of Medicine, Kathmandu 44600, Nepal
| | - Nikita Khanal
- Department of Population Health Sciences, University of Bristol, Bristol BS8 1QU, UK
| | - Rajib Chaulagain
- Department of Oral Biology, Chitwan Medical College, Bharatpur 44200, Nepal
| | - Neha Sharma
- Clinic of Oral and Cranio-Maxillofacial Surgery, University Hospital Basel, CH-4031 Basel, Switzerland
- Medical Additive Manufacturing Research Group (Swiss MAM), Department of Biomedical Engineering, University of Basel, Hegenheimermattweg 167C, CH-4123 Allschwil, Switzerland
| | - Florian M Thieringer
- Clinic of Oral and Cranio-Maxillofacial Surgery, University Hospital Basel, CH-4031 Basel, Switzerland
- Medical Additive Manufacturing Research Group (Swiss MAM), Department of Biomedical Engineering, University of Basel, Hegenheimermattweg 167C, CH-4123 Allschwil, Switzerland
| |
Collapse
|
7
|
Vaanmugil J, Jimson S, Bhanumurthy L, Arunprakash M, Kandasamy R. Conchal Cartilage in Surgical Reconstruction of Orbital Floor Fracture. Cureus 2021; 13:e13223. [PMID: 33728173 PMCID: PMC7946607 DOI: 10.7759/cureus.13223] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
According to Kim and Jeong (2016), isolated orbital fractures are encountered in 4-16% of all facial fractures, and orbital fractures composed approximately 30--55% of the zygomaticomaxillary complex (ZMC) and naso-orbital-ethmoid (NOE) fractures. The ideal material for orbital floor fracture repair is one that is resorbable, osteoconductive, resistant to infection, minimally reactive, does not induce capsule formation, has a half-life that allows significant bone in-growth to occur, and is cheap and readily available. In this article, we report a case of a young female with an orbital floor fracture managed surgically using conchal cartilage and a review of literature.
Collapse
Affiliation(s)
- Jayapaul Vaanmugil
- Oral and Maxillofacial Surgery, Tagore Dental College & Hospital, Chennai, IND
| | - Samson Jimson
- Oral and Maxillofacial Surgery, Tagore Dental College & Hospital, Chennai, IND
| | - Lokesh Bhanumurthy
- Oral and Maxillofacial Surgery, Tagore Dental College & Hospital, Chennai, IND
| | - M Arunprakash
- Oral and Maxillofacial Surgery, Tagore Dental College & Hospital, Chennai, IND
| | | |
Collapse
|
8
|
Steinmassl O, Laimer J, Offermanns V, Wildauer M, Steinmassl PA, Grams AE, Kofler F, Rasse M, Bruckmoser E. Clinical Outcome Following Surgical Repair of Small Versus Large Orbital Floor Fractures Using Polyglactin 910/Polydioxanone (Ethisorb ®). MATERIALS (BASEL, SWITZERLAND) 2020; 13:E206. [PMID: 31947782 PMCID: PMC6982172 DOI: 10.3390/ma13010206] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/26/2019] [Revised: 12/29/2019] [Accepted: 12/31/2019] [Indexed: 11/16/2022]
Abstract
The aim of this retrospective study was to evaluate the clinical outcome of surgical management of small versus large, isolated orbital floor fractures (OFFs) using polyglactin 910/polydioxanone (Ethisorb®). Covering a four-year period (2010-2013), all records concerning midfacial fractures with involvement of the orbit were screened. Isolated fractures of the orbital floor as well as combined injuries of the orbital floor and medial wall that had been treated surgically using polyglactin 910/polydioxanone (Ethisorb®) were included. Patients underwent a preoperative, a postoperative, and a late ophthalmologic assessment. The clinical outcomes of surgically managed small OFFs up to 2 cm2 were statistically analyzed and compared to clinical results in larger defects. The final sample included 61 patients (25 women, 36 men). Fractures up to 2 cm2 were found in 33 patients (54.1%), whereas 28 patients (45.9%) suffered from OFFs larger than 2 cm2. The clinical outcomes did not significantly differ between both sample categories, and statistical analysis showed a power of 0.91 to detect a potentially existing difference. On final examination, 52 patients were free of any clinical symptoms, whereas minor issues were found in seven subjects, and two patients suffered from severe impairment. In conclusion, polyglactin 910/polydioxanone (Ethisorb®) seems to be a suitable material for surgical repair of both small and large OFFs.
Collapse
Affiliation(s)
- Otto Steinmassl
- University Hospital for Cranio-Maxillofacial and Oral Surgery, A-6020 Innsbruck, Austria
| | - Johannes Laimer
- University Hospital for Cranio-Maxillofacial and Oral Surgery, A-6020 Innsbruck, Austria
| | - Vincent Offermanns
- University Hospital for Cranio-Maxillofacial and Oral Surgery, A-6020 Innsbruck, Austria
| | - Matthias Wildauer
- University Hospital for Radiology, Medical University of Innsbruck, A-6020 Innsbruck, Austria
| | | | - Astrid E. Grams
- University Hospital for Neuroradiology, A-6020 Innsbruck, Austria
| | - Ferdinand Kofler
- University Hospital for Cranio-Maxillofacial and Oral Surgery, A-6020 Innsbruck, Austria
| | - Michael Rasse
- University Hospital for Cranio-Maxillofacial and Oral Surgery, A-6020 Innsbruck, Austria
| | - Emanuel Bruckmoser
- Private Practice for Oral and Maxillofacial Surgery, A-5020 Salzburg, Austria
| |
Collapse
|
9
|
Wilson C, Iwanaga J, Simonds E, Yilmaz E, Oskouian RJ, Tubbs RS. The Conchal Vascular Foramen of the Posterior Auricular Artery: Application to Conchal Cartilage Grafting. Kurume Med J 2018; 65:7-10. [PMID: 30158354 DOI: 10.2739/kurumemedj.ms651002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
The posterior auricular artery (PAA), a branch of the external carotid artery, gives rise to a conchal network formed by PAA perforators through the conchal floor of the auricle. However, this branch and its entrance (foramen) to the anterior concha, is rarely illustrated in the literature and has not been studied in detail. Therefore, we aimed to investigate the morphology of the perforating artery (PA) and its vascular foramen (VF). Ten sides from five formalin-fixed frozen Caucasian cadaveric heads were used. The number, diameter of the VF, diameter of the perforating artery (PA), shape of the VF (circular or oval), distance from the middle of the tragus and origin of the artery were documented. The number of VF ranged from 1 to 2; one was seen on 90% of the sides and two were seen on 10% of the sides. The VF was oval in 36% of the sides and circular in the remaining 64%. The mean diameter of the long and short axes of the VF, and PA was 2.0±1.4 mm, 1.3±0.9 mm, and 0.7±0.4 mm, respectively. Diameter of the PA was 1.0 mm or greater in 18% of the sides. The mean distance from the middle of the tragus to the VF was 10.7±2.6 mm. The perforating artery of the concha originated from the posterior auricular artery on all 11 sides.
Collapse
Affiliation(s)
| | - Joe Iwanaga
- Seattle Science Foundation
- Division of Gross and Clinical Anatomy, Department of Anatomy, Kurume University School of Medicine
| | | | - Emre Yilmaz
- Swedish Neuroscience Institute, Swedish Medical Center
| | - Rod J Oskouian
- Seattle Science Foundation
- Swedish Neuroscience Institute, Swedish Medical Center
| | - R Shane Tubbs
- Seattle Science Foundation
- Department of Anatomical Sciences, St. George's University
| |
Collapse
|