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Mouth, tongue, lips and ears
Published in Richard Ashton, Barbara Leppard, Differential Diagnosis in Dermatology, 2021
Richard Ashton, Barbara Leppard
Chronic eczema on the ear usually occurs in association with eczema elsewhere. Otitis externa, i.e. eczema of the external auditory canal and meatus, is usually due to seborrhoeic eczema (Fig. 6.41), and there will be other evidence of this, e.g. scaling in the scalp (see p. 62). Psoriasis is red rather than pink and there will be typical plaques elsewhere +/- thick scaly plaques in the scalp (see p. 62). Discoid lupus erythematosus (see p. 99) usually involves the antihelix but not the external auditory canal. A biopsy will be needed to confirm this diagnosis.
Head and neck
Published in Tor Wo Chiu, Stone’s Plastic Surgery Facts, 2018
ExcisionalCartilage – conchal reduction (Davis), antihelix (Luckett)Skin – postauricular skin – dumbbell, fishtail, etc.
Microtia and External Ear Abnormalities
Published in John C Watkinson, Raymond W Clarke, Christopher P Aldren, Doris-Eva Bamiou, Raymond W Clarke, Richard M Irving, Haytham Kubba, Shakeel R Saeed, Paediatrics, The Ear, Skull Base, 2018
The pinnae are paired structures with a cartilaginous framework. The inferior part of the pinna (lobule) does not have a cartilaginous framework and is only supported by a fibrofatty matrix. The helix is the outermost cartilaginous curvature of the pinna. The curve of the antihelix runs inside and parallel to the curve of the helix. The antihelix divides superiorly to forms two crura: the superior crus and the inferior crus. The depression between the two crura is called the triangular fossa. Anterior to the antihelix is the concave depression called the concha. The conchal bowl is subdivided into the cymba concha superiorly and the concha cavum inferiorly. The elevation of cartilage anterior to the entrance of the external ear canal is called the tragus. The antitragus is the inferior-most prominence of the antihelix curvature opposite the tragus, and the gap between the tragus and the antitragus is called the intertragal notch. The cartilage of the pinna is continuous with the cartilaginous ear canal, thereby fixing it to the temporal bone along with muscles and ligaments (anterior, posterior and superior ligaments). The intrinsic muscles of the pinna are poorly developed; the extrinsic muscles (anterior, posterior and superior) may be well developed in some individuals.
Auricular reconstruction after Mohs excision utilizing combination of pre-auricular transposition and chondrocutaneous advancement flaps
Published in Case Reports in Plastic Surgery and Hand Surgery, 2022
Annet S. Kuruvilla, Jared M. Gopman, Peter W. Henderson
Small defects of the helical rim in the upper third can be managed by the Antia-Buch chondrocutaneous helical advancement flap, and this can usually be completed in a single stage [13]. The creation of this flap involves an anterior incision along the helical to separate the helix and the scapha. A superficial dissection to the depth of the perichondrium is made in the posterior auricle in order to create the flaps that will converge at the wedge cut in the antihelix [21]. First described for helical rim defects up to 20 mm in size, larger defects have been repaired using modifications of this flap such as V-Y advancement of the helical root [7,14]. Larger defects repaired with an Antia-Buch flap can lead to a cup ear deformity, resulting in a superior helical rim that is folded over inferiorly. Modifications to the original methodology include the utilization of wedge cuts in the antihelix and chondra in order to avoid undesirable outcomes [21]. When larger defects extend beyond the helical rim of the upper third into the scapha and antihelix, single-stage pedicled chondrocutaneous transposition flaps based on the root of the helix or the caudal part of the helix have been described by Davis [15] and Orticochea [16], respectively.
Devastating effect of untreated facial squamous cell carcinoma
Published in Baylor University Medical Center Proceedings, 2021
Nasim Khalfe, Ya Xu, Elizabeth May Schuele, Doris Lin
On admission, the patient was started on doxycycline for a potential superimposed infection, as there was purulent discharge. Otolaryngology performed wide local excision of the right temple SCC, right parotidectomy, neck dissection with sacrifice of the frontal branch of the facial nerve, and graft reconstruction of the right lateral canthus. Histopathology results revealed well to moderately differentiated invasive SCC with a depth of invasion of 2.3 cm and presence of perineural invasion (Figure 2). Two of the intraparotid lymph nodes were also positive for metastatic carcinoma (Figure 2). In addition, the right ear antihelix lesion was resected and positive for SCC in situ arising in the background of actinic keratosis. The multidisciplinary tumor board concluded that adjuvant radiation was the next best step in treatment based on the degree of metastasis. The patient recovered well postoperatively and plans to start radiation treatment soon.
Second intention healing of nasal ala and dorsum defects in Asians
Published in Journal of Dermatological Treatment, 2021
Wenyan Jin, Shan Jin, Zhouna Li, Zhehu Jin, Chenglong Jin
There are some important factors in determining the method used in the reconstruction. Location is the most important predicting factor for the cosmetic outcome. In general, healed wounds are often imperceptible in NEET areas (concave surfaces of the nose, eye, ear, and temple). Wounds in FAIR areas (forehead, antihelix, eyelids, and remainder of the nose, lips, and cheeks) heal with satisfactory results accompanied by flat hypopigmented scars to many patients. However, wounds in NOCH areas (convex surfaces of the nose, oral lips, cheeks and chin, and helix of the ear) heal with more variable esthetic results. For instance, superficial wounds heal with acceptable appearance, but deep wounds heal with depressed or hypertrophic scars (12). As evidenced in this study, defects of anterior ala showed better cosmesis when compared to defects of the dorsum. Furthermore, we observed that although defects that extended from the alar groove to the cheek would develop slightly elevated scars after second intention healing, this was not obvious on frontal view. Indeed, the epithelialization and complete healing of these defects were achieved in a shorter time.