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Buchan 1975

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Ear lobe repair
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  British Journal of Plastic Surgery x975), 28, 296498 THE CLEFT EAR LOBE: A METHOD OF REPAIR WITH PRESERVATION OF THE EARRING CANAL By N. G. BUCHAN, .R.C.S. Ed.) Department of Plastic Surgery Queen Mary’s Hospital Roehampton London Sw15 5PN CLEFTS of the ear lobe are usually due to sudden traction on an earring McLaren, 1954). The laceration may be sutured initially but more commonly is allowed to heal spontaneously. Secondary repair by excision of the cleft edges and resuture has been advocated by some McLaren, 1954; Converse, 1964) while others have devised methods to preserve the earring canal. Boo-Chai 1961) described retention of the apical epithe- lium in the cleft and suturing the freshened edges below it. The floor of the canal carrying the weight of the earring, however, is a scar. Pardue 1973) used a small skin flap from one side of the cleft near the apex to form the floor of the canal but this flap is composed of thin scarred skin and thus less suitable than the unscarred skin in the following technique. METHOD Figs. I to 7) A flap of skin 2 mm wide is fashioned from the posterior aspect of one side of the cleft and is drawn through to form the floor of the canal. The remainder of the cleft is sutured with a Z-plasty or lap joint if desired. RESULTS Twelve patients with complete clefts and I with an uncomplete cleft have been operated on with this technique. There has been no recurrence of the cleft. Depression FIG. I. Dotted lines indicate areas of excision of the cleft edges FIG 2. Posterior view The solid line outlines the skin flap 296  THE CLEFT EAR LOBE 97 of the scar sometimes seen with simple secondary suture of the ear lobe has not been found using this technique which involves a tightening of the skin envelope of the lobe. Figure 8 shows a typical cleft. The postoperative result 3 months later is shown in Figure g. I do not recommend the wearing of large earrings after operation but this lady insisted on doing so. The author wishes to thiank Mr P. K. B. Davis for advice and encouragement Mr E. Ferrill for the photographs and Mrs A. Christie for the illustrations. FIG 3 The cleft edges have been excised leaving apical epithelium and the flap has been raised FIG 4 The flap is turned on its axis and drawn through the cleft FIG 5 The flap in position ready for suturing FIG 6 Back of the lobe after suturing FIG 7 Suturing completed and gold sleeper in position   98 BRITISH JOURN L OF PL STIC SURGERY FIG. 8. A photograph of a cleft ear lobe. FIG. 9. A photograph of the same lobe 3 months after operation with earring in position. A Z-plasty has been used at the base of the lobe. REFERENCES BOO-CHAI, K. 1961). The cleft ear lobe. Plastic and Reconstructive Surgery 28 681. Co=;aJ;lyM. 1964). “Reconstructive Plastic Surgery.” Philadelphia: W. B. Saunders MCLAREN, L. R. 1954). Cleft ear lobe: a hazard of wearing ear-rings. British Journal of Plastic Surgery, 7, 162. PARDUE, A. M. 1973). Repair of the torn ear lobe with preservation of the perforation for an earring. Plastic and Reconstructive Surgery 51, 472.
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