Artikel
Vascular mapping of the retroauricular skin – proposal for an ideal surgical incision method with possible benefits
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Veröffentlicht: | 14. April 2014 |
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Gliederung
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Introduction: Nowadays, a wide variety of implantable hearing aids are used for the correction of impaired hearing. Most of these methods use a smaller or larger incision in the retroauricular region for an appropriate approach. Vitality of the surrounding skin has utmost importance as insufficient circulation may lead to skin necrosis, which requires further therapy, e.g. more thorough wound care, repeated surgical intervention, or even removal of the implanted device.
Methods: The authors examined the vascular pattern and blood flow of the retroauricular skin with dissection (10 cases), CT angiography of the carotid arteries (10 cases) and in vivo Doppler ultrasound (10 cases). The vessels were categorized by size.
Results: The authors were able to detect the external carotid artery branches (the posterior auricular artery, the parietal and posterior temporal branches of the superficial temporal artery and the occipital artery) which are responsible for the blood supply of the retroauricular area.
Conclusion: They concluded that the classical retroauricular incision affects the integrity of the important arterial branches which supply the retroauricular skin and puts considerable hazards on the survival of the retroauricular skin flap. A more posterior incision parallel to the major arterial branches potentially spares the normal or near normal blood supply, thus the chance of survival of the skin flap increases considerably. As the vascular pattern may have individual variations, a preoperative ultrasound investigation is recommended.
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