RU2400173C2 - Method of laser correction of protruding ears - Google Patents

Abstract

FIELD: medicine.

SUBSTANCE: invention refers to medicine, namely to aesthetic surgery. A retroauricular incision is performed with a laser ray of power 10-20 Wt, focal length 1-1.5 cm, exposition 2-3 s, that is followed with evaporation of a cartilage with the laser ray of power 4-10 Wt, length 1.5-2 cm, exposition 3-5 s.

EFFECT: method enables reducing injuries associated with the correction of protruding ears.

3 ex

Description

The invention relates to medicine, namely to aesthetic surgery.

A known method for the correction of hearing loss implemented in the device. According to this technical solution, longitudinal and transverse incisions are applied to two-thirds of the depth of the ear cartilage in the region of its greatest tension, followed by the formation of an aesthetic anti-helix and elimination of lop-ears (RF patent 2170060). This method is taken as an analog.

A known method of surgical correction of congenital deafness (RF Patent 2130763, 1997 - prototype). The method is carried out from the posterior incision in the projection of the upper or lower legs of the antihelix after tunneling; in the necessary directions, multiple notches are applied along the inner surface of the auricle cartilage along the formed anti-helix. However, the method is relatively traumatic.

The aim of the invention is to reduce the invasiveness of the method.

The technical result is achieved by the fact that the posterior section is carried out with a 10-20 W laser beam, a focal length of 1-1.5 cm, an exposure of 2-3 seconds, followed by evaporation of cartilage with a 4-10 W laser beam, a distance of 1.5-2 cm exposure 3-5 s.

The method is implemented as follows.

Surgical correction of the shape and position of the ears refers to the aesthetic operations most often performed in children preparing to go to school. Heavily protruding ears are considered as a deviation in the development of the ears or as a mild congenital deformity with a clear hereditary component. An important condition for the success of the operation in children is their own desire for this intervention.

Parents of children suffering from deaf-eared note a reduced social adaptation of the child, as a result of which correction is required with minimal trauma of the intervention. Given that the ear is supplied abundantly from several arteries, surgical intervention may be accompanied by significant blood loss.

The degree of deviation of the patient’s ear from normal is found out at the consultation: protruding ears usually have a poorly developed antihelix, which makes the upper part of the ear protrudes sideways, increasing the angle between the processus mastoideus and the ear plane. The cartilaginous funnel leading to the auditory meatus can also be unusually deep; earlobes can be turned outward.

Under anesthesia performed by lidocaine (2%, 1-2 ml) or ubestezin (3%, 0.7-1.0 ml), a skin incision is made in the posterior region of the hairline. The posterior section is carried out with a 10-20 W laser beam, a focal length of 1-1.5 cm, an exposure of 2-3 s with a beam focusing of 0.1-0.5 mm. Bleeding is not observed due to coagulation of the vessels of the edges of the surgical incision.

Naked cartilage of the ear with a laser beam begin to process in the mode of evaporation with a power of 4-10 watts, a distance of 1.5-2 cm, exposure 3-5 s, repeating the exposure from 3 to 10 times depending on the degree of hearing loss.

After thinning of the cartilage, the skin incision is strengthened. The auricle is fixed to the scalp, reliably holding tissues in their new position for the duration of healing. After 1.5-2 weeks, the ear is freed from the profiled state and the patient is shown a new position of the auricle, which from an aesthetic point of view does not require additional correction.

The method is further explained by examples of its implementation.

Example 1

Parents of patient M., 6.5 years old, turned to the plastic surgery clinic with complaints of child's hearing loss, leading to reduced social adaptation in preparation for school.

Upon examination, the child is of the correct physique, low nutrition (height 1 m 48 cm, weight 30 kg). The skin is clean, the oral mucosa and sclera are clean. Rhythmic heart sounds, heart rate 76 min. Liver at the edge of the costal arch, elastic. Pasternatsky’s symptom is negative. There is no dysuria. Hemoglobin 120, red blood cells 3.3 · 1012, white blood cells 4.8 · 109, prothrombin - 90.

Assess the degree of deviation of the patient’s left ear from a normal position as I-II. The presence of a relatively poorly developed antihelix is established. In this case, the upper part of the ear protrudes to the side. The angle between the processus mastoideus and the plane of the auricle is increased.

Under anesthesia performed by lidocaine (2%, 1 ml), a skin incision is made in the posterior region of the hairline. The posterior section is carried out with a 10 W laser beam, a focal length of 1 cm, an exposure of 2 s with a beam diameter of 0.5 mm. Bleeding is not observed.

Then the exposed cartilage of the ear with a laser beam begin to process in the mode of evaporation with a power of 4 W, a distance of 1.5 cm, exposure 3 s, repeating the exposure 3 times.

After thinning of the cartilage, the skin incision is strengthened. The auricle is fixed to the scalp, reliably holding tissues in their new position for the duration of healing. After 1.5 weeks, the ear is freed from the prefixed state. Parents and the patient are shown a new position of the auricle, which, from an aesthetic point of view, does not require additional correction. A follow-up examination after a month showed the normal position of the left auricle. There are no traces of surgery. The social adaptation of the child among peers, according to parents, has improved.

Example 2

The parents of patient K., 7 years old, complained of a child’s hearing loss, reduced social adaptation in the first grade of the school, to the plastic surgery clinic.

When examined, the child is of the correct physique, low nutrition (height 1 m 42 cm, weight 32 kg). The skin, sclera and pharynx are clean. Rhythmic heart sounds, heart rate 80 per min. Liver at the edge of the costal arch, elastic. Symptom Pasternatsky negative Dysuria is not. Hemoglobin 110, red blood cells 3.5 · 10 ¹² , white blood cells 5.1 · 10 ⁹ , prothrombin - 95.

Assessment of the degree of deviation of both ears of the patient from the normal position - IV. The lobes are enlarged and deployed along with the auricle. The presence of a poorly developed contraceptive in both auricles is established. In this case, the auricles are deployed and sharply protrude laterally. The angle between the processus mastoideus and the plane of the auricle is increased to 90 °.

Under anesthesia carried out with ubestezin (3%, 1 ml), a skin incision is performed in the posterior region along the hairline with a laser. The posterior section is carried out with a 20 W laser beam, a focal length of 1.5 cm, an exposure of 3 s with a beam diameter of 0.1 mm. Bleeding is not observed.

Then the naked cartilage of the ear with a laser beam begin to process in the evaporation mode with a power of 10 W, a distance of 2 cm, exposure 5 s, repeating the exposure 10 times.

Correct a protruding lobe, removing part of the skin and fat from the back of the lobe.

After thinning of the cartilage, the skin incision is strengthened. Both auricles are fixed to the scalp, holding tissue in their new position for the duration of healing. After 2 weeks, the auricles are freed from the prefixed state. Parents and the patient are shown a new position of the auricles, which is aesthetically satisfactory. A follow-up examination after a month showed the normal position of the auricles. The social adaptation of the child among peers, according to parents, has improved

Example 3

A patient Z., 13 years old, came to the plastic surgery clinic with complaints of right-sided deafness, persecution and ridicule of his peers.

Upon examination, the child is of the correct physique, low nutrition (height 1 m 64 cm, weight 43 kg). Acne on the forehead, the skin of the ear area and temples are clean, the sclera is bluish, the pharynx is clean. Rhythmic heart sounds, heart rate 66 per min. The liver at the edge of the costal arch, soft, elastic. Pasternatsky’s symptom is negative. There is no dysuria. Hemoglobin 130, red blood cells 4.2 · 10 ¹² , white blood cells 5.0 · 10 ⁹ , prothrombin - 100.

The patient’s right auricle deviated from the normal position by 55-60 °, III degree of hearing loss. The antihelix is relatively poorly developed.

Under anesthesia carried out with ubestezin (3%, 0.7 ml), a skin incision is performed in the posterior region along the hairline with a laser. This section is carried out with a 15 W laser beam, 1.2 cm focal length, 2.5 s exposure with a beam diameter of 0.3 mm. No bleeding. Exposed cartilage of the ear with a laser beam is processed in an evaporation mode with a power of 6 W, a distance of 1.7 cm, an exposure of 4 s, repeating the exposure 6 times.

After thinning of the cartilage, the skin incision is strengthened. The auricle is fixed to the scalp, holding the tissue in their new position for the duration of healing. After 10 days, the auricle is freed from the prefixed state. Parents and the patient are shown the new position of the right auricle, which they assess as esthetically satisfactory. Control examination after 2 months showed the preservation of the normal position of the auricle. The social adaptation of the child among peers, according to parents, has improved.

According to the claimed method carried out 142 laser intervention correction of deafness with reduced trauma. Aesthetic effect is satisfactory, which allows patients to improve their social significance among their peers

Claims (1)

A method for laser correction of deafness, including a posterior section and exposure to the cartilage of the auricle, characterized in that the posterior section is performed with a 10-20 W laser beam, a focal length of 1-1.5 cm, an exposure of 2-3 seconds followed by cartilage evaporation with a laser beam power 4-10 W, distance 1.5-2 cm, exposure 3-5 s.