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Congenital pigmented nevi of the auricle: clinical experience and approach to treatment.
- Source :
-
Plastic and reconstructive surgery [Plast Reconstr Surg] 2009 Dec; Vol. 124 (6), pp. 1932-1939. - Publication Year :
- 2009
-
Abstract
- Background: Congenital pigmented nevi of the auricle are uncommon. The authors' approach is to excise these nevi and perform reconstruction because of the risk of malignant transformation and the aesthetic and psychological effects these nevi can have on the child. This study presents the authors' experience in treating congenital nevi of the ear and suggests treatment principles and guidelines for the reconstructive surgeon.<br />Methods: Fourteen patients with congenital nevus of the ear were treated from October of 1992 to September of 2008 by the senior surgeon (B.S.B.). Nevi involving the more stable areas such as the concha can be resected and grafted early; the antihelix, scapha, and triangular fossa area can be resected and grafted next; and the helical rim, having the most easily distorted cartilage, should be treated last. Lobule reconstruction requires combined flaps and a dermal fat graft or a postauricular fascial fat flap.<br />Results: Successful reconstruction was achieved in 10 patients. Three patients require final revision procedures (lobule reconstruction). One patient, early in our series, developed a deformed helical rim resulting from skin grafting at age 16 months, before the cartilage was firm enough to withstand the contraction forces of the skin graft. All subsequent patients with helical rim involvement had treatment delayed until the ear was at or near completion of its growth.<br />Conclusions: Congenital nevi of the ear present a challenging reconstruction surgeon. The authors developed a treatment plan that breaks the ear down to aesthetic units and considers the location of the nevus, patient age, and the firmness of the cartilage.
- Subjects :
- Adipose Tissue transplantation
Cartilage transplantation
Child
Child, Preschool
Cohort Studies
Esthetics
Female
Follow-Up Studies
Graft Rejection
Graft Survival
Humans
Male
Nevus, Pigmented pathology
Postoperative Complications physiopathology
Rare Diseases
Retrospective Studies
Risk Assessment
Skin Neoplasms pathology
Skin Transplantation methods
Treatment Outcome
Ear Auricle
Nevus, Pigmented congenital
Nevus, Pigmented surgery
Plastic Surgery Procedures methods
Skin Neoplasms congenital
Skin Neoplasms surgery
Surgical Flaps
Subjects
Details
- Language :
- English
- ISSN :
- 1529-4242
- Volume :
- 124
- Issue :
- 6
- Database :
- MEDLINE
- Journal :
- Plastic and reconstructive surgery
- Publication Type :
- Academic Journal
- Accession number :
- 19952648
- Full Text :
- https://doi.org/10.1097/PRS.0b013e3181bf823b