Kirurško liječenje odstojećih uški

master's thesis

• Title (english): Surgical treatment of prominent ears
• Author: Tamara Zadravec
• Mentor: Srećko Branica (mentor)
• Committee member: Mario Bilić (predsjednik povjerenstva)
• Committee member: Mirko Ivkić (član povjerenstva)
• Committee member: Srećko Branica (član povjerenstva)
• Granter: University of Zagreb; School of Medicine; (Department of Othorhinolaryngology and Head and Neck Surgery); Zagreb
• Defense date and country: 2014-07-15, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Otorhinolaryngology

Abstract

Normalna ušna školjka ima prepoznatljivu konfiguraciju udubina i izbočina. Iako su moguće brojne varijacije, značajne devijacije od „normale“ su odmah uočljive. Upravo iz tog razloga odstojeće uške su čest razlog zabrinutosti pacijenata. Ispravljanje odstojećih uški zahtijeva pažljivu analizu anatomije uške kako bi se utvrdio točan uzrok. To će omogućiti prikladnu preoperativnu pripremu i odabir ispravne metode otoplastike. Pri odabiru najprikladnije tehnike među mnogim ponuđenima, operater treba izabrati onu pomoću koje će postići prirodan izgled. U pravilu, daje se prednost repoziciji nad resekcijom hrskavice. Uške se zbog iznimne elastičnosti hrskavice postoperativno uvijek u manjoj mjeri vrate prema početnom položaju. Stoga se prilikom operacije radi manja hiperkorekcija položaja, tj. korigira se više od željenog položaja. Cilj operacije je ne samo pozicionirati ušku u odgovarajućem položaju u odnosu na lubanju, nego i formirati normalne anatomske strukture uške.
Krajem 19. i tijekom 20. stoljeća, opisani su brojni postupci kirurškog ispravljanja odstojećih uški. Začeci otoplastike sežu u davnu 1845. godinu. Upravo široka paleta mogućnosti otežava kirurgu odabir ispravne tehnike koja najbolje odgovara pojedinom pacijentu.
U većini slučajeva, pojava odstojećih uški nije značajno povezana s drugim anatomskim ili fiziološkim abnormalnostima. Međutim, društvene i psihološke manifestacije ostavljaju trag na većini pacijenata, što objašnjava velik broj kirurških tehnika koje su prezentirane u literaturi tijekom posljednja dva stoljeća.
U ovom diplomskom radu dan je pregled kroz povijest otoplastike odstojećih uški i opisana su neka od otkrića u postupku. Nadalje, prikazane su ključne mjere koje treba imati na umu u preoperativnom i intraoperacijskom tijeku. Također su detaljnije opisane neke od najčešćih metoda za ispravljanje odstojećih uški, kao i postoperativni postupci i zajedničke komplikacije koje mogu nastupiti nakon operacije.

Abstract (english)

The normal auricle has a well-recognized configuration of depressions and projections. Although there are many variations, significant deviations from ˝normal˝ are immediately evident. Because of that reason, prominent ears are a relatively frequent cause of patient concern. Correction of the outstanding ear requires a careful anatomic analysis to determine the precise cause. That will allow appropriate preoperative planning and selection of the appropriate technique. In selecting appropriate techniques from the many that are described in the literature, the surgeon's priority must be the achievement of a natural-looking improvement. In general, techniques that reposition rather than resect cartilage are preferred. The auricles regularly, due to exceptional elasticity of cartilage, postoperatively partially return to the starting position. Therefore, during operation a smaller hypercorrection is made, which means the auricles are placed tighter than the finally desired position. The aim of the operation is not only to position the auricle in a proper position towards the skull, but also to form normal anatomical structures of the auricle.
In the late 19th and throughout the 20th century, numerous surgical procedures have been described for the correction of protruding ears. Otoplasty origins date back to ancient 1845. Precisely that wide range of options makes it difficult for the surgeon to select the correct technique that suits best for individual patients. In most cases, the appearance of protruding ears is not significantly associated with other anatomical or physiological abnormalities. However, social and psychological manifestations leave their mark on most patients, which explains the large number of surgical techniques that have been presented in literature over the last two centuries.
This paper gives an overview through the history of otoplasty of protruding ears is given as well as significant discoveries in that field. Furthermore, key measures that should be kept in mind in the preoperative and intraoperative course are presented. Also, the most common methods for correcting protruding ears are described in detail, as well as postoperative procedures and common complications that can occur after surgery.

• Keywords: ispravljanje odstojećih uški; anatomija uške; začeci otoplastike
• Keywords (english): correction of the outstanding ear; anatomy of the auricle; otoplasty origins
• Language: croatian
• URN:NBN: urn:nbn:hr:105:558556
• Study programme: Title: Medicine; Study programme type: university; Study level: integrated undergraduate and graduate; Academic / professional title: doktor/doktorica medicine (doktor/doktorica medicine)
• Type of resource: Text
• File origin: Born digital
• Access conditions: Open access
• Created on: 2015-09-22 06:17:31