Trauma to the auricle is common given its prominent position, and various methods for ear reconstruction exist. Herein, we present our experience of ear reconstruction using diced autogenous cartilage. A 72-year-old woman fell from a 1-m height, damaging her ear in the process. The ear helix, which was approximately 3.5×3 cm² in size, was amputated. The cartilage was diced into 1-mm pieces. The detached skin was made into a pocket and filled with the diced cartilage. Molding was performed with tie-over dressings on the anterior and posterior areas of the scaphoid fossa. Ten days post-surgery, the wound showed signs of successful recovery, and the contour of the ear helix was maintained. Ten months later, the cartilage in the damaged ear helix was intact. Conventional composite grafts on amputated ears have size limitations and exhibit significant resorption, and loss of anatomical structures and stability often occur. In this case, the operating time required to complete the composite graft was short, and molding the contour was not complex. The original ear structure was maintained over the long term and did not require an additional operation for aesthetic purposes. We believe that this is a useful method for the reconstruction of an amputated ear.
Aged ; Bandages ; Cartilage ; Ear ; Female ; Fungi ; Humans ; Methods ; Skin ; Transplants ; Wounds and Injuries

Adult ; Burns ; Epidemiology ; Humans ; Infant ; Medical Records ; Pediatrics ; Prospective Studies ; Retrospective Studies ; Steam

Background: The zygomaticomaxillary complex (ZMC) has a protruded, convex shape and plays a vital role in determining the contour by affecting the width of the middle face. This study aimed to evaluate the efficiency of ZMC fracture reduction and explore detailed directions for outcome improvement. Methods: We conducted a retrospective study of patients diagnosed with unilateral ZMC fracture who underwent ZMC reduction surgery at a single hospital between January 2015 and May 2020. The primary outcome variable was facial asymmetry using the difference in the bilateral malar eminence (ME) position measured by computed tomography scan. The 3-dimensional distance (IA, asymmetry index) and the distance in each dimension, Dx (anteroposterior distance), Dy (mediolateral distance), and Dz (superoinferior distance) were compared. Results: A total of 101 patients with ZMC fractures and 54 non-fracture patients were enrolled in the study. The mean age of the study sample was 43.49 years (control sample, 43.35 years), and the male-to-female ratio was 66.3:33.7 (control sample, 64.8:35.2). There were 53 and 48 patients with right and left ZMC fractures, respectively. The IA was not statistically different between the two groups. In terms of position in each dimension, only Dx was significantly different between the two groups. Conclusion The results show that overall facial asymmetry was recovered after ZMC reduction, but in certain dimension significant difference in ME position has still remained. For further improvement, treatment should be performed to relieve malar depression in the anteroposterior dimension.

Background: The zygomaticomaxillary complex (ZMC) has a protruded, convex shape and plays a vital role in determining the contour by affecting the width of the middle face. This study aimed to evaluate the efficiency of ZMC fracture reduction and explore detailed directions for outcome improvement. Methods: We conducted a retrospective study of patients diagnosed with unilateral ZMC fracture who underwent ZMC reduction surgery at a single hospital between January 2015 and May 2020. The primary outcome variable was facial asymmetry using the difference in the bilateral malar eminence (ME) position measured by computed tomography scan. The 3-dimensional distance (IA, asymmetry index) and the distance in each dimension, Dx (anteroposterior distance), Dy (mediolateral distance), and Dz (superoinferior distance) were compared. Results: A total of 101 patients with ZMC fractures and 54 non-fracture patients were enrolled in the study. The mean age of the study sample was 43.49 years (control sample, 43.35 years), and the male-to-female ratio was 66.3:33.7 (control sample, 64.8:35.2). There were 53 and 48 patients with right and left ZMC fractures, respectively. The IA was not statistically different between the two groups. In terms of position in each dimension, only Dx was significantly different between the two groups. Conclusion The results show that overall facial asymmetry was recovered after ZMC reduction, but in certain dimension significant difference in ME position has still remained. For further improvement, treatment should be performed to relieve malar depression in the anteroposterior dimension.

Background: The annual incidence of skin cancer has been increasing, and surgical ablation is presently the treatment of choice for skin cancer. However, it leaves soft tissue defects that require reconstruction. The methods for reconstruction include locoregional flaps (LRFs) and full-thickness skin grafts (FTSGs). We compared these two surgical methods for reconstruction of defects in the nose, which is prominently visible and the most common site of facial skin cancer, and assessed the cosmetic results by evaluating the scars. Methods: This retrospective study was conducted between July 2012 and January 2021. Patients were evaluated for scars after at least 6 months of follow-up. Patients were divided into LRF and FTSG groups. The scars were evaluated using the Vancouver Scar Scale. Results: In total, 27 patients were included in this study. Their mean age was 66.8 years. Eighteen patients underwent LRF, and nine patients underwent FTSG. The average defect size was 1.55 cm² in the LRF group, and 1.38 cm² in the FTSG group. The average scar score was 1.44 points in the LRF group and 3.67 points in the FTSG group. The LRF group showed significantly lower total scores than the FTSG group. Conclusions Although LRFs and FTSGs are useful reconstructive methods for nasal soft tissue defects, this study showed that LRFs are superior to FTSGs in terms of aesthetic results.

Rhabdomyosarcoma is the most common soft tissue sarcoma in children, accounting for 4.5% of all cases of cancer in childhood. Although the head and neck are the most common sites of rhabdomyosarcoma, oral lesions are relatively rare and account for only 10% to 12% of head and neck rhabdomyosarcoma cases. This is a case report of a girl aged 2 years and 1 month who initially presented with an upper lip mass that invaded the oral mucosa, oral skin, and nostril skin, causing narrowing of the airway. Through our case, we show that rapidly growing small round cell malignancies, especially rhabdomyosarcoma, can be effectively diagnosed and treated at the same time using primary resection with intraoperative frozen section biopsy and that the time spent waiting for the results of preoperative biopsy can be saved in this way, particularly when the patient’s symptoms are intensifying rapidly and require immediate operation.

Background: Rosenthal et al. classified female, habitual, non-suicidal wrist cutters as a group and introduced the concept of wrist-cutting syndrome. We investigated the characteristics of wrist-cutting patients at our institution in comparison with results reported previously. Methods: We conducted a retrospective study involving 115 patients who had cut their wrists and been examined at the emergency department of a single hospital in Seoul, Korea, between March 2014 and August 2018. Results: There were more women (73 patients; 63.5%) than men (42 patients; 36.5%), and the women (mean age, 34.42 years) were significantly younger than the men (mean age, 50.07 years). The patients who had cut their wrists repeatedly were mainly women (22 of 26 patients; 84.6%); however, men caused more severe damage than women. Substance use before a suicide attempt did not significantly increase the severity of wrist cutting. Our institution planned and implemented a suicide prevention intervention program to improve the continuity of outpatient care. The number of patients who continued psychiatric treatment increased significantly after program completion. Conclusions We confirmed that most patients were young women who were not suicidal in the true sense because their wounds were not severe. Our study showed a protective role of the barrier tendons (flexor carpi radialis, palmaris longus, flexor carpi ulnaris), and we suggest careful repair of the barrier tendons to protect neurovascular structures against subsequent cutting events. We found that it was possible to improve the continuity of patient counseling by managing patients through a psychiatric treatment program.

PURPOSE: Electric saw is widely used and patients involved with the tool are increasing. We made efforts to analyze data of saw-related hand injuries. METHODS: Electric saw-related hand injuries that required operation were analyzed retrospectively by reviewing medical charts, clinical photographs and X-ray films from 2009 through 2013. Additionally, we interviewed patients regarding the type of electric saw involved (hand-held/table-mounted) and how the hand was injured. RESULTS: There were 16 male patients with 19 injured fingers and 22 injured tendons. Due to the damaging mechanism of the electric saw, injuries were severe and complex such as tendon, bone defects, fractures and amputations. 4 fingers had open fractures. Separately, 4 were amputated. Non-dominant hands were injured more by hand-held saw, while, dominant hands were damaged more by table-mounted saw. The thumb and index fingers were injured mostly by electric saw. Probability of dominant and non-dominant hand injury depends on the types of electric saw because of the working position when using this tool. CONCLUSION: Hand injuries can be classified according to the type of electronic saw used. Complete understanding of a specific trauma mechanism and the resulting injury patterns is important especially for hand surgeons. Surgeons should take into account the type of electric saw when examining patients. However, the most important step to prevent these types of injuries is to provide all workers with appropriate training and precautions before using the electric saw.
Amputation ; Finger Injuries ; Fingers ; Fractures, Open ; Hand Injuries* ; Hand* ; Humans ; Korea* ; Male ; Retrospective Studies ; Rupture ; Tendon Injuries ; Tendons ; Thumb ; X-Ray Film

BACKGROUND: The epidemiology of nasal fractures varies according to factors such as the era and area of the study, as well as the age of the patient. We compared the characteristics and causes of pediatric nasal fractures. METHODS: A total of 2,321 patients with nasal fractures from 2010 to 2017 were examined. The patients were divided into age groups using the Korean school system of age classification. The causes of injury were divided into five groups: violence, fall or slip down, sports, road traffic accidents, and others. Fractures were classified using the Stranc and Robertson standard: vector of force and plane of fracture. RESULTS: Violence was the most common cause of nasal fracture in patients older than 12 years. Violence was a significantly less frequent cause among patients younger than 12 years old than among adolescent and adult patients. Nasal fractures due to violence were not observed in patients younger than 10 years. Plane 2 and lateral force fractures were the most common; however, in patients younger than 12 years, frontal force fractures were significantly more frequent than were lateral force fractures. CONCLUSION: As children may simply be injured due to a fall or slip down, it is important for the parents and guardians to ensure their safety. As they become older, children should abstain from violence and be monitored. It is therefore very important to ensure that the environment is free of violence in order to prevent such injuries.
Accidents, Traffic ; Adolescent ; Adult ; Child ; Classification ; Epidemiology ; Fractures, Bone ; Humans ; Nasal Bone ; Parents ; Pediatrics ; Sports ; Violence

Keloid scars may cause a range of symptoms and aesthetic problems. The ear is one of the most frequent sites of keloids, and the earlobe and ear helix account for more than 80% of ear keloids. There are various surgical methods for removing keloids in the ear. Standard keloidectomy and core excision can be effective surgical methods compared to wedge resection since they preserve normal tissue surrounding the keloid. However, ears often show various types of asymmetry by default, which can be relatively difficult to detect, so wedge resection continues to be a useful surgical method for ear keloids. Here, we report four cases of keloids in the earlobe and ear helix that were successfully treated by wedge resection without a postoperative deformity or recurrence.