Otapostasis. Modifikace otoplastiky Mustardé - Furnas CO2 laserem

Igor Janík

Disertační práce

Mustardé-Furnas Otoplasty. Modification with CO2 Laser Device

Anotace:

Otapostáza je bezesporu závažný estetický problém, který způsobuje celou řadu psychických potíží. Je stručně připomenuta anatomie boltce a anatomicko-estetické vztahy boltce a obličeje. Koncem devatenáctého a začátkem dvacátého století byla publikována řada operačních metod, které podle předpokládané příčiny otapostázy doporučovaly způsob otoplastiky a byly zařazeny do tří skupin-fixace boltce k processus mastoideus, zmenšení úhlu mezi konchou a processus mastoideus, plastiku anthelixu. U většiny našich pacientů se jednalo o kombinovanou vadu a to: nedostatečný vývin anthelixu se zvětšeným konchoskafálním úhlem a hypertrofií konchy se zvětšením úhlu cefaloaurikulárního

Abstract:

Otapostasis is on all accounts a serious aesthetic problem which can cause many mental troubles. The auricle anatomy as well as anatomical aesthetic relationship of auricle and face is described in short. A number of publications on surgery methods had been issued at the end of the nineteenth and at the beginning of the twentieth century. These methods recommended different ways of treatment (otoplasty) based on the assumed cause of otapostasis. They were classified into three groups-auricle fixation to processus mastoideus, angle reduction between conch and processus mastoideus and anthelix surgery. Most of our patients had suffered from a combination of the defect, especially from: insufficient development of anthelix with a enlarged conchscaphoid angle and conch hypertrophy with enlarged cephalo-auricular angle. We have been performing laser surgeries based on the technique Mustardé - Furnas CO2 laser. We also utilize its cutting beam features, preperation, coagulation as well as vaporization. We have focused on the way of anthelix formation above all. This consists in vaporization of auricle cartilage into 1/3 and 1/2 of the thickness into the form of channel of a 2-3 mm width and further in the stitches formation of the newly created anthelix with mattress stitches. We assume that the vaporized areas of the cartilage will heal together which enables the new anthelix formation to harden. This both-sided surgery has been performed with 68 people (43 women and 25 men) between 2002 and 2006. There have not been any serious postoperative complications and no keloid scars have developed. Re-surgery has been performed with 3,6 % of the patients (5 from 136 ears). Three patients, i.e. 4,41 % have complained about insufficient results. We have proved the way of vaporized cartilage healing in an experiment with ears of 8 rabbits. After the auricle cartilage

Keywords

Mustardé-Furnas otoplasty, modification with CO2 laser device

Jazyk práce: čeština

Datum vytvoření / odevzdání či podání práce: 9. 9. 2008

Obhajoba závěrečné práce

• Obhajoba proběhla 13. 2. 2009
• Vedoucí: Ivo Stárek
• Oponent: Vladimír Holibka, Jaroslav Slípka

Univerzita Palackého

Lékařská fakulta

Doktorský studijní program / obor:
Otorinolaryngologie a chirurgie hlavy a krku / Otorinolaryngologie a chirurgie hlavy a krku