Background: Prominent ears are a common congenital deformity of the head and neck. Correcting concha hypertrophy is an important step in otoplasty. Despite the risk of postoperative deformity due to the sharp edges created by excision, removing a section of cartilage is sometimes the only method to obtain a satisfying and long-lasting result. Multiple conchal excision techniques have been reported in the literature, with significant differences in approach, outcome evaluation, and complication classification. The objective was to review cartilage excision-based otoplasty procedures to offer plastic surgeons’ insights into current data on outcomes and complications of conchal excision techniques. Methods: We conducted a literature search through the MEDLINE, EMBASE, Scopus, and Cochrane databases. Prospective and retrospective studies on otoplasty, including revision surgeries and conchal excision techniques involving concha cartilage resection, were included. Articles with no outcomes data, review articles, case reports, expert opinion or comment, and nonclinical studies were excluded. Results: There were a total of four manuscripts that fulfilled our criteria. Three out of four authors preferred posterior access that separates the skin excision from the cartilage excision. Following resection, cartilage edges can be approximated by placing cartilage sutures, or they can be allowed to collapse spontaneously. Although only two authors employed a systematic classification for complications, all the articles reviewed indicated a low complication rate and excellent postoperative cosmetic outcomes. Conclusion: Although the techniques and principles stated in the literature varied to some extent, the outcomes of all studies reviewed were comparable.
Morton's neuroma (MN) was first documented in 1876 by Thomas George Morton, an American surgeon. 1 It is a type of degenerative neuropathy featuring fibrosis that usually affects the common interdigital nerve of the foot, mostly affecting middle-aged women. 2 The predominant symptom is localized pain, described as burning, stabbing, or tingling with electric sensations. 3 CASE REPORTA 30-year-old male patient working as a carpenter with active tobacco use and no relevant comorbidities presented in our plastic surgery outpatient clinic with persistent pain in his left little finger. Three years prior, the patient suffered a traumatic fingertip amputation distal the DIP joint using an electric planer. Primary care was carried out in a peripheral hospital, where the fingertip was initially simply sutured in the emergency room. Furthermore, because of persistent pain and the suspect of remaining nail matrix the finger was re-operated in the operating theater 1 month later. Due to persistent burning sensations, residual nail growth, as well as neuromalike pain of the ulnar and radial proper digital nerve of the fifth finger, the patient underwent his second revision surgery, again in the operating theater, 27 months after primary trauma. To achieve optimal healing, and because the insertion of the flexor digitorum, profundus tendon was no longer given, the distal phalanx was removed, the neuromas excised, and the nerve stumps shortened. Yet again, uneventful healing was followed by progressive neuropathic pain in the entire little finger and ever-present Hoffmann-Tinel-sign. Due to the number of previous surgeries, a conservative approach was taken, but it was unsuccessful. Therefore, 44 months after the initial trauma, because of extreme pain at the slightest touch, as well as Hoffmann-Tinel-sign and burning sensations
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