불완전 절단된 귀손상에서 단순봉합수술 및 거머리를 이용한 접합 치험례 (Survival of a Neartotally Amputated Auricle by Simple Closure and Medical Leech)

서지정보

· 발행기관 : 대한두개안면성형외과학회
· 수록지 정보 : Archives of Craniofacial Surgery / 10권 / 2호 / 127 ~ 130페이지
· 저자명 : 하기영, 김부영, 김한중, 김태연

초록

Purpose: In an amputated auricle, a microvascular anastomosis
is the best treatment of choice. But, the neartotally
amputated auricle which is connected by very narrow tissue
pedicle to the head, can survive by simple attachment without
a microvascular anastomosis owing to the rich vascular
network through the superficial temporal artery and posterior
auricular artery. In cases of venous congestion resulting from
a lack of vein anastomosis, medical leeches (Hirudo
medicinalis) can solve the problem. We are reporting the
case of a 6-year-old boy who had a neartotally amputated
auricle with successful results by simple closure and medical
leech treatment without a microvascular anastomosis.
Methods: A 6-year-old male patient had an left auricular
injury by an escalator accident. The left auricle was neartotally
amputated from the temporal head with connection
only by very narrow skin and subcutaneous pedicle (about
1 cm in width) at the helical root of upper and anterior part
of auricle. Marginal bleeding from the avulsed auricle was
noted and the arterial blood was supplied from a branch
of upper auricular branch of the superficial temporal artery.
The auricle was repaired by simple closure including
cartilage and skin without any vascular anastomosis. After
simple closure, the auricle showed good circulation with
pink color. But on the 2nd day after the operation, there
was a venous congestion with severe swelling, which
resulted in a purplish colored auricle. The venous congestion
disappeared after using medical leeches by the 5th day
after the operation.
Results: The repaired auricle showed aesthetically and
functionally satisfactory result with normal development at
the 9 months follow-up check after the operation.
Conclusion: In cases of neartotally amputated auricles of
children or crushing injury in which microsurgery is difficult,
we can try simple closure with the use of medical leeches
in treating a of venous congestion for a successful result.

영어초록

Purpose: In an amputated auricle, a microvascular anastomosis
is the best treatment of choice. But, the neartotally
amputated auricle which is connected by very narrow tissue
pedicle to the head, can survive by simple attachment without
a microvascular anastomosis owing to the rich vascular
network through the superficial temporal artery and posterior
auricular artery. In cases of venous congestion resulting from
a lack of vein anastomosis, medical leeches (Hirudo
medicinalis) can solve the problem. We are reporting the
case of a 6-year-old boy who had a neartotally amputated
auricle with successful results by simple closure and medical
leech treatment without a microvascular anastomosis.
Methods: A 6-year-old male patient had an left auricular
injury by an escalator accident. The left auricle was neartotally
amputated from the temporal head with connection
only by very narrow skin and subcutaneous pedicle (about
1 cm in width) at the helical root of upper and anterior part
of auricle. Marginal bleeding from the avulsed auricle was
noted and the arterial blood was supplied from a branch
of upper auricular branch of the superficial temporal artery.
The auricle was repaired by simple closure including
cartilage and skin without any vascular anastomosis. After
simple closure, the auricle showed good circulation with
pink color. But on the 2nd day after the operation, there
was a venous congestion with severe swelling, which
resulted in a purplish colored auricle. The venous congestion
disappeared after using medical leeches by the 5th day
after the operation.
Results: The repaired auricle showed aesthetically and
functionally satisfactory result with normal development at
the 9 months follow-up check after the operation.
Conclusion: In cases of neartotally amputated auricles of
children or crushing injury in which microsurgery is difficult,
we can try simple closure with the use of medical leeches
in treating a of venous congestion for a successful result.

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