Ear Reconstruction

Front 1

What are the 3 main arteries supplying the ear?

Back 1

superficial temporal, posterior auricular, occipital

Front 2

What artery supplies the lateral surface of the auricle?

Back 2

superficial temporal

Front 3

The superficial temporal artery is a terminal branch of what major artery?

Back 3

external carotid

Front 4

What part(s) of the ear does the posterior auricular artery supply?

Back 4

posterior auricle, lobule, retroauricular skin

Front 5

The posterior auricular artery is a terminal branch of what major artery?

Back 5

external carotid

Front 6

What part(s) of the ear does the occipital artery supply?

Back 6

posterior auricle, lobule and retroauricular skin

Front 7

What 4 nerves innervate the ear?

Back 7

great auricular, auriculotemporal, lesser occipital, auricular branch of the vagus (Arnold's nerve)

Front 8

What part(s) of the ear does the great auricular nerve innervate?

Back 8

lower half of the lateral surface of the ear and posterior auricle

Front 9

What part(s) of the ear does the auriculotemporal nerve innervate?

Back 9

superolateral surface of the ear and anterior and superior external auditory canal

Front 10

What part(s) of the ear does the lesser occipital nerve innervate?

Back 10

superior cranial surface of the ear

Front 11

What part(s) of the ear does the auricular branch of the vagus nerve innervate?

Back 11

concha and posterior external auditory canal

Front 12

What is the normal size of the ear?

Back 12

6-6.5 cm high and 3.5 cm wide

Front 13

What is the normal ear projection?

Back 13

17-21 mm from the temporal scalp

Front 14

During what week of gestation does ear development begin?

Back 14

4th week

Front 15

The ear hillocks arise from which branchial arches?

Back 15

1st and 2nd

Front 16

What ear structures arise from the 1st branchial arch?

Back 16

malleus, incus and upper third of the ear

Front 17

What ear structures arise from the 2nd branchial arch?

Back 17

stapes and lower 2/3 of the ear

Front 18

What is the incidence of microtia?

Back 18

1 in 8000 births

Front 19

Which side is most commonly affected by microtia?

Back 19

right

Front 20

What other defect is commonly associated with microtia?

Back 20

Hemifacial microsomia

Front 21

Ear reconstruction of microtia is generally performed in how many stages?

Back 21

3

Front 22

What is the 1st stage of microtia repair?

Back 22

the cartilaginous framework is constructed from costal cartilage. A subcutaneous pocket is designed, and teh cartilage framework is inserted

Front 23

What is the 2nd stage of microtia repair?

Back 23

The cartilage framework is elevated off the head posteriorly, and a skin graft is used in the postauricular sulcus

Front 24

What is the 3rd stage of microtia repair?

Back 24

rotation of the lobule into its anatomic position

Front 25

What are the 2 deformities responsible for prominent ears?

Back 25

Lack of an antihelical fold and conchal hypertrophy

Front 26

How is conchal hypertrophy reduced in the correction of prominent ears?

Back 26

Conchomastoid (Mustarde) sutures pull concha toward the side of the head. A wedge of cartilage can also be excised.

Front 27

How is the antihelical fold recreated in the correction of prominent ears?

Back 27

conchoscaphal sutures

Front 28

When should crypotia be repaired?

Back 28

after age 5

Front 29

What is cryptotia?

Back 29

the upper pole of the ear is buried under skin with absecnce of the superior auriculocephalic sulcus

Front 30

What is Stahl's ear?

Back 30

presence of an abnormal 3rd crus that is oriented horizontally and extends from antihelix to the helical rim; superior crus is hypoplastic or absent; scaphoid fossa is malformed while the conchal fossa is normal

Front 31

what is the most common cutaneous malignancy of the ear?

Back 31

squamous cell

Front 32

What is a cauliflower ear?

Back 32

fluid and the hematoma accumulation between the perichondrium and the cartilage

Front 33

How do you manage frostbite of the ear?

Back 33

Rapid rewarming and application of a topical antimicrobial that penetrates cartilage (mafenide acetate)

Front 34

What is the size limit for wedge resection with direct closure?

Back 34

1.5 cm

Front 35

What technique is useful for correcting helical rim defects?

Back 35

Antia-Buch

Front 36

Describe the Antia-Buch technique.

Back 36

The rim is incised from the inferior portion of the defect to the upper part of the lobule, through the anterior skin, perichondrium, and cartilage. The posterior skin is left intact, is undermined, and is redraped following rim advancement and closure.

Front 37

What flap is useful for correction of helical defects larger than 3 cm?

Back 37

converse tunnel procedure

Front 38

What is the 1st stage of the converse tunnel procedure?

Back 38

A cartilage strut is harvested and placed in a tunnel beneath the retroauricual skin, to which the margins of the helical rim defect are sewed

Front 39

What is the 2nd stage of the converse tunnel procedure?

Back 39

The cartilage strut is elevated, along with the retroauricular skin that will be used to resurface the helical rim, and the reconstruction is completed

Front 40

What are the 4 procedures that can be used for helical and upper-third defect reconstruction?

Back 40

Wedge resection, Anti-Buch technique, converse tunnel procedure and tubed pedicle flap

Front 41

What is the first stage of the tubed pedicle flap?

Back 41

a thin tube of retroauricular skin is fashioned from a bipedicled skin flap, and athe long edge is sewn to the helical rim

Front 42

What is the 2nd stage of the tubed pedicle flap?

Back 42

one or both ends of the tube are elevated Sometimes the second end is elevated at a 3rd stage

Front 43

A Dieffenbach flap (postauricular flap) can be used to correct wha?t ear defects?

Back 43

Middle third defects

Front 44

What is a Dieffenbach (postauricular) flap

Back 44

a postauricular flap based on the edge of the hairline is planned with the width equal to the defect and the length sufficient to reconstruct the anterior surface, rim and posterior surface

Front 45

What flap can be used when a large portion of ear cartilage is exposed?

Back 45

temporoparietal fascia

Front 46

The use of what cartilage is the gold standard for total ouricular reconstruction?

Back 46

Costal cartilage

Front 47

Patients with oropharyngeal cancers may have referred ear pain through which nerve?

Back 47

Arnold's nerve (auricular branch of the vagus)

Front 48

What is the preferred topical antimicrobial for the burned ear and why?

Back 48

mafenide acetate beacuse of its superior cartilage penetration

Front 49

Prominent ears can be treated non-operatively with splints during what time period?

Back 49

The first week of life (malleable cartilage)

Front 50

Microsurgical replantation attmepts may sacrifice what artery?

Back 50

Superficial temporal