Timea Madaras

Background/Objectives: Prominent ears, affecting approximately 5% of the population, can cause significant psychosocial distress without functional impairment. Methods: This retrospective single-center study evaluated a cartilage-cutting otoplasty technique augmented by three triangular fascioperichondrial flaps in 40 patients (80 ears), aged 6–37 years (mean age: 13 years), treated between 2022 and 2024 at Târgu Mureș County Emergency Hospital. Results: Preoperative helical–mastoid distances (HMD) were elevated, superior: 21 mm, middle: 22 mm, inferior: 21 mm; concho-mastoid angle (CMA) averaged ~50°. Surgery involved postauricular skin excision, selective conchal cartilage resection, and flap fixation to the mastoid periosteum for stabilization. Measurements at immediate postoperative and 6-week follow-up showed significant reductions: superior HMD by 10 mm (immediate) and 9 mm (6 weeks), middle by 9 mm and 8 mm, inferior by 4 mm and 4 mm, CMA by 27° and 26° (all p < 0.001). Stability between postoperative and 6-week intervals was confirmed by ANOVA (no significant differences). Patient satisfaction was excellent: 75% very satisfied and 22% satisfied (97% overall positive), with no correlation with age or sex. Conclusions: This hybrid approach offers reliable correction, natural contours, and low postoperative complications, representing a feasible option in otoplasty. Longer-term prospective trials are recommended.

Background: Non-anastomotic pseudoaneurysm formation due to very late prosthetic graft failure after femoropopliteal bypass is exceptionally rare. Case Presentation: We describe a 73-year-old blind man who presented with rapid enlargement of a mid-thigh mass on the left side, associated with skin necrosis. His history included advanced atherosclerosis with bilateral superficial femoral artery occlusion and prior femoropopliteal bypasses: a right-sided great saphenous vein graft (2006) and a left-sided Dacron^® graft (2008). Computed tomography angiography revealed a giant pseudoaneurysm originating from the mid-portion of the left bypass graft (13.8 × 16.5 cm) with active contrast extravasation and distal popliteal artery occlusion, as well as a large, well-defined lateral thigh lipoma. Open surgery revealed structural graft disruption within the prosthetic body and a large chronic pseudoaneurysm sac containing organized thrombus. En bloc pseudoaneurysm excision and graft exclusion without reconstruction were performed, followed by soft-tissue reconstruction. The postoperative course was uneventful, with complete wound healing by four weeks and no ischemic symptoms during 18 months of follow-up. This exceptionally late prosthetic graft complication underscores the need for long-term surveillance in patients with lower-limb bypass grafts. Conclusions: This case highlights that prosthetic graft failure may occur very late and present insidiously. Recognition of this rare complication is essential for timely diagnosis and individualized surgical management.