Plastic surgery; its principles and practice . th of thecrescent should be about two-thirds of the width of the gap in the helix, AA, which is ends of the helix should be sutured first, and then the crescentic incision. Parkhill, Kolle, Gersuny, Joseph, and others, for the correction of thisdeformity. Good results may be obtained. 4IO PLASTIC SURGERY The objection to Kolles second method, and to both of Gersunysoperations, is that the blood supply of the flap of helix is endangeredon account of its length and narrow pedicle (Fig. 404-413). Microtia (Absence of the Ear), Congenital o
Plastic surgery; its principles and practice . th of thecrescent should be about two-thirds of the width of the gap in the helix, AA, which is ends of the helix should be sutured first, and then the crescentic incision. Parkhill, Kolle, Gersuny, Joseph, and others, for the correction of thisdeformity. Good results may be obtained. 4IO PLASTIC SURGERY The objection to Kolles second method, and to both of Gersunysoperations, is that the blood supply of the flap of helix is endangeredon account of its length and narrow pedicle (Fig. 404-413). Microtia (Absence of the Ear), Congenital or Acquired When the entire ear or a large part of it is missing, the possibilityof successful plastic reconstruction is doubtful, and at best the cosmeticresults are only fair. Nevertheless, some of my patients have preferredto undergo the necessary discomforts in order to have an ear made oftheir own tissues. Many years ago Szymanowski proposed a procedure which has beentried from time to time, and as far as the incision goes, it seems to be. Fig. 413.—Schwartzs operation for macrotia (Kolle).—i and 2. A long crescenticshaped piece of tissue DBDC is removed from the full thickness of the auricle in the fossaof the helix. A triangle of tissue AEA is then excised, its base corresponding to theouter border of the helix, and its apex well within the concha. 3. The edges are closed asindicated. the best method of raising a flap from adjacent tissue for the purposeof forming an auricle. Szymanowskis Operation for Reconstructing the Auricle.—An incision is made on the scalp, as shown in the diagrams, back of therudimentary ear or external auditory meatus. This flap should beplanned at least one-third larger than the auricle which it is proposedto make and should consist of skin and subcutaneous tissue. Theflap is dissected up, and is folded on itself at the constricted portionso that raw surface is in apposition to raw surface. The margins aresutured above and below. Close the
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