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50 Cards in this Set

  • Front
  • Back
What are the 3 main arteries supplying the ear?
superficial temporal, posterior auricular, occipital
What artery supplies the lateral surface of the auricle?
superficial temporal
The superficial temporal artery is a terminal branch of what major artery?
external carotid
What part(s) of the ear does the posterior auricular artery supply?
posterior auricle, lobule, retroauricular skin
The posterior auricular artery is a terminal branch of what major artery?
external carotid
What part(s) of the ear does the occipital artery supply?
posterior auricle, lobule and retroauricular skin
What 4 nerves innervate the ear?
great auricular, auriculotemporal, lesser occipital, auricular branch of the vagus (Arnold's nerve)
What part(s) of the ear does the great auricular nerve innervate?
lower half of the lateral surface of the ear and posterior auricle
What part(s) of the ear does the auriculotemporal nerve innervate?
superolateral surface of the ear and anterior and superior external auditory canal
What part(s) of the ear does the lesser occipital nerve innervate?
superior cranial surface of the ear
What part(s) of the ear does the auricular branch of the vagus nerve innervate?
concha and posterior external auditory canal
What is the normal size of the ear?
6-6.5 cm high and 3.5 cm wide
What is the normal ear projection?
17-21 mm from the temporal scalp
During what week of gestation does ear development begin?
4th week
The ear hillocks arise from which branchial arches?
1st and 2nd
What ear structures arise from the 1st branchial arch?
malleus, incus and upper third of the ear
What ear structures arise from the 2nd branchial arch?
stapes and lower 2/3 of the ear
What is the incidence of microtia?
1 in 8000 births
Which side is most commonly affected by microtia?
right
What other defect is commonly associated with microtia?
Hemifacial microsomia
Ear reconstruction of microtia is generally performed in how many stages?
3
What is the 1st stage of microtia repair?
the cartilaginous framework is constructed from costal cartilage. A subcutaneous pocket is designed, and teh cartilage framework is inserted
What is the 2nd stage of microtia repair?
The cartilage framework is elevated off the head posteriorly, and a skin graft is used in the postauricular sulcus
What is the 3rd stage of microtia repair?
rotation of the lobule into its anatomic position
What are the 2 deformities responsible for prominent ears?
Lack of an antihelical fold and conchal hypertrophy
How is conchal hypertrophy reduced in the correction of prominent ears?
Conchomastoid (Mustarde) sutures pull concha toward the side of the head. A wedge of cartilage can also be excised.
How is the antihelical fold recreated in the correction of prominent ears?
conchoscaphal sutures
When should crypotia be repaired?
after age 5
What is cryptotia?
the upper pole of the ear is buried under skin with absecnce of the superior auriculocephalic sulcus
What is Stahl's ear?
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
what is the most common cutaneous malignancy of the ear?
squamous cell
What is a cauliflower ear?
fluid and the hematoma accumulation between the perichondrium and the cartilage
How do you manage frostbite of the ear?
Rapid rewarming and application of a topical antimicrobial that penetrates cartilage (mafenide acetate)
What is the size limit for wedge resection with direct closure?
1.5 cm
What technique is useful for correcting helical rim defects?
Antia-Buch
Describe the Antia-Buch technique.
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.
What flap is useful for correction of helical defects larger than 3 cm?
converse tunnel procedure
What is the 1st stage of the converse tunnel procedure?
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
What is the 2nd stage of the converse tunnel procedure?
The cartilage strut is elevated, along with the retroauricular skin that will be used to resurface the helical rim, and the reconstruction is completed
What are the 4 procedures that can be used for helical and upper-third defect reconstruction?
Wedge resection, Anti-Buch technique, converse tunnel procedure and tubed pedicle flap
What is the first stage of the tubed pedicle flap?
a thin tube of retroauricular skin is fashioned from a bipedicled skin flap, and athe long edge is sewn to the helical rim
What is the 2nd stage of the tubed pedicle flap?
one or both ends of the tube are elevated Sometimes the second end is elevated at a 3rd stage
A Dieffenbach flap (postauricular flap) can be used to correct wha?t ear defects?
Middle third defects
What is a Dieffenbach (postauricular) flap
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
What flap can be used when a large portion of ear cartilage is exposed?
temporoparietal fascia
The use of what cartilage is the gold standard for total ouricular reconstruction?
Costal cartilage
Patients with oropharyngeal cancers may have referred ear pain through which nerve?
Arnold's nerve (auricular branch of the vagus)
What is the preferred topical antimicrobial for the burned ear and why?
mafenide acetate beacuse of its superior cartilage penetration
Prominent ears can be treated non-operatively with splints during what time period?
The first week of life (malleable cartilage)
Microsurgical replantation attmepts may sacrifice what artery?
Superficial temporal