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Bridging phenomenon — Simplifying complex ear reconstructions
Author(s) -
Wingerden Jan J.,
Lapid Oren,
Horst Chantal M. A. M.
Publication year - 2014
Publication title -
head and neck
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.012
H-Index - 127
eISSN - 1097-0347
pISSN - 1043-3074
DOI - 10.1002/hed.23458
Subject(s) - bridging (networking) , microtia , medicine , surgery , anatomy , cartilage , computer science , computer network
Background Extirpation of noninvasive skin tumors of the anterior ear may create large defects. Various flaps, described to cover these defects, demand special knowledge without which a loss of the fine detail of the ear may result. Methods Healthy, exposed cartilage is deliberately excised leaving a basic framework for support, thus preserving contours and a well‐vascularized recipient bed for full‐thickness skin grafting. The grafts heal by revascularization and “bridging,” a phenomenon whereby grafts on avascular beds (such as denuded cartilage) are revascularized. Results By marrying clinical experience gained during microtia reconstruction with insights regarding the bridging phenomenon derived from the laboratory, our 17 reconstructed ears healed without serious complications and kept their normal contours and shape, and there was no recurrence of the carcinoma. Conclusion Satisfactory patient‐centered outcome can be obtained in reconstructing defects of one‐third to two‐thirds of the total anterior surface of the ear relying on the bridging phenomenon. © 2013 Wiley Periodicals, Inc. Head Neck 36 : 735–738, 2014