Surgical importance of the posterior auricular ligament when harvesting ear cartilage in rhinoplasty
Background Ear cartilage is a preferred graft material in rhinoplasty. However, after harvest, instability of the auricular framework may arise as a form of donor site morbidity. In the harvest of ear cartilage, the posterior auricular ligament (PAL) is usually sacrificed in order to obtain as much...
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| Format: | Article |
| Language: | English |
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Korean Society for Aesthetic Plastic Surgery
2021-01-01
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| Series: | Archives of Aesthetic Plastic Surgery |
| Subjects: | |
| Online Access: | http://e-aaps.org/upload/pdf/aaps-2020-02313.pdf |
| _version_ | 1818947481802637312 |
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| author | Daekwan Chi Seokui Lee Jae-Hee Kim Taek-Kyun Kim Jae-Yong Jeong Sunje Kim Sang-Ha Oh |
| author_facet | Daekwan Chi Seokui Lee Jae-Hee Kim Taek-Kyun Kim Jae-Yong Jeong Sunje Kim Sang-Ha Oh |
| author_sort | Daekwan Chi |
| collection | DOAJ |
| description | Background Ear cartilage is a preferred graft material in rhinoplasty. However, after harvest, instability of the auricular framework may arise as a form of donor site morbidity. In the harvest of ear cartilage, the posterior auricular ligament (PAL) is usually sacrificed in order to obtain as much cartilage as possible. Since damage to the PAL may cause auricular instability, we studied the periauricular anatomy using cadavers and evaluated auricular stability during surgery. Methods Six ears from hemifacial cadavers were studied to clarify the exact anatomy of the PAL. Then, the recoil force of the auricle was serially measured to evaluate the stability of the auricular framework in 30 patients during surgery: before making the skin incision (M1), before and after cutting the PAL (M2, M3), and after harvesting the cymba concha (M4). The differences in force observed after cutting the PAL (ΔM2–M3) and after harvesting the cymba concha (ΔM3–M4) were statistically analyzed. Results In the cadaveric study, the PAL was identified between the superficial and deep mastoid fasciae and connected the caudal aspect of the cymba concha to the deep mastoid fascia. During surgery, the PAL accounted for 16.20% of the total auricular recoil force. The recoil force decreased by 13.61 N and 11.25 N after cutting the PAL and harvesting the cymba concha, respectively. These decreases were statistically significant (P<0.05). Conclusions The results suggest that the PAL is a supporting structure of the auricle. Therefore, to preserve auricular stability, minimizing damage to the PAL while harvesting the ear cartilage may be helpful. |
| first_indexed | 2024-12-20T08:31:36Z |
| format | Article |
| id | doaj.art-26f5c8482dd34792bec4e2cf17686a25 |
| institution | Directory Open Access Journal |
| issn | 2234-0831 2288-9337 |
| language | English |
| last_indexed | 2024-12-20T08:31:36Z |
| publishDate | 2021-01-01 |
| publisher | Korean Society for Aesthetic Plastic Surgery |
| record_format | Article |
| series | Archives of Aesthetic Plastic Surgery |
| spelling | doaj.art-26f5c8482dd34792bec4e2cf17686a252022-12-21T19:46:42ZengKorean Society for Aesthetic Plastic SurgeryArchives of Aesthetic Plastic Surgery2234-08312288-93372021-01-01271121710.14730/aaps.2020.02313724Surgical importance of the posterior auricular ligament when harvesting ear cartilage in rhinoplastyDaekwan Chi0Seokui Lee1Jae-Hee Kim2Taek-Kyun Kim3Jae-Yong Jeong4Sunje Kim5Sang-Ha Oh6 THE PLUS Plastic Surgery, Seoul, Korea Department of Plastic and Reconstructive Surgery, Chungnam National University College of Medicine, Daejeon, Korea THE PLUS Plastic Surgery, Seoul, Korea THE PLUS Plastic Surgery, Seoul, Korea THE PLUS Plastic Surgery, Seoul, Korea Department of Plastic and Reconstructive Surgery, Chungnam National University College of Medicine, Daejeon, Korea Department of Plastic and Reconstructive Surgery, Chungnam National University College of Medicine, Daejeon, KoreaBackground Ear cartilage is a preferred graft material in rhinoplasty. However, after harvest, instability of the auricular framework may arise as a form of donor site morbidity. In the harvest of ear cartilage, the posterior auricular ligament (PAL) is usually sacrificed in order to obtain as much cartilage as possible. Since damage to the PAL may cause auricular instability, we studied the periauricular anatomy using cadavers and evaluated auricular stability during surgery. Methods Six ears from hemifacial cadavers were studied to clarify the exact anatomy of the PAL. Then, the recoil force of the auricle was serially measured to evaluate the stability of the auricular framework in 30 patients during surgery: before making the skin incision (M1), before and after cutting the PAL (M2, M3), and after harvesting the cymba concha (M4). The differences in force observed after cutting the PAL (ΔM2–M3) and after harvesting the cymba concha (ΔM3–M4) were statistically analyzed. Results In the cadaveric study, the PAL was identified between the superficial and deep mastoid fasciae and connected the caudal aspect of the cymba concha to the deep mastoid fascia. During surgery, the PAL accounted for 16.20% of the total auricular recoil force. The recoil force decreased by 13.61 N and 11.25 N after cutting the PAL and harvesting the cymba concha, respectively. These decreases were statistically significant (P<0.05). Conclusions The results suggest that the PAL is a supporting structure of the auricle. Therefore, to preserve auricular stability, minimizing damage to the PAL while harvesting the ear cartilage may be helpful.http://e-aaps.org/upload/pdf/aaps-2020-02313.pdfcadaverinstabilityear cartilageligamentrhinoplasty |
| spellingShingle | Daekwan Chi Seokui Lee Jae-Hee Kim Taek-Kyun Kim Jae-Yong Jeong Sunje Kim Sang-Ha Oh Surgical importance of the posterior auricular ligament when harvesting ear cartilage in rhinoplasty Archives of Aesthetic Plastic Surgery cadaver instability ear cartilage ligament rhinoplasty |
| title | Surgical importance of the posterior auricular ligament when harvesting ear cartilage in rhinoplasty |
| title_full | Surgical importance of the posterior auricular ligament when harvesting ear cartilage in rhinoplasty |
| title_fullStr | Surgical importance of the posterior auricular ligament when harvesting ear cartilage in rhinoplasty |
| title_full_unstemmed | Surgical importance of the posterior auricular ligament when harvesting ear cartilage in rhinoplasty |
| title_short | Surgical importance of the posterior auricular ligament when harvesting ear cartilage in rhinoplasty |
| title_sort | surgical importance of the posterior auricular ligament when harvesting ear cartilage in rhinoplasty |
| topic | cadaver instability ear cartilage ligament rhinoplasty |
| url | http://e-aaps.org/upload/pdf/aaps-2020-02313.pdf |
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