We describe a three staged method of reconstruction for partial helical rim defects using a thin post auricular tube pedicle. The technique is illustrated by three case reports.

An electrode system was developed consisting of two 8 mm long 0.2 mm diameter silver-coated copper wires arranged parallel to each other 8 mm apart and held in contact with the skin by means of an acoustically transparent plastic adhesive tape. This system was attached to the upper arms of young adult volunteers who increased the voltage of the rectangular electrical pulses supplied to the electrodes until a reproducible sharp prickling pain sensation was perceived. A one inch diameter physiotherapy transducer was positioned over the electrode site so that ultrasound could be administered throughout the measurement period. The experiments were performed single blind to eliminate any subjective bias on the part of the volunteers. Preliminary experiments established that highly reproducible (+/- 3 to 4%) pain threshold perception values could be obtained, and that these values were not affected by changes in (a) the duration of the "on" time of the electrical pulses between 1.5 and 48 ms, (b) the contact pressure between the transducer and the electrode site, (c) the time interval between successive threshold measurements (providing that an unacceptable level of oedema was not produced around the electrodes), and (d) whether or not a test measurement was preceded by a control. Ultrasound exposure via a direct contact technique consistently produced a statistically significant (p less than 0.05) decrease in the perception threshold for electrical pain. This effect usually developed within 30-60 s and its magnitude increased both with increasing intensity (rising to 20.7 +/- 0.57% at an SATA intensity of 0.43 W/cm2 at 1.1 MHz) and with increasing frequency at the same ultrasonic intensity. Delivering the same amount of ultrasonic energy in the form of 2 ms bursts at several different peak intensities produced exactly the same reduction in pain threshold perception. These results indicate a thermal interaction mechanism, and similar threshold changes could be obtained by heating or cooling the electrode site by nonacoustic means. The inclusion of a thermocouple junction between the electrode wires showed that temperature increases of up to 10 degrees C could be produced when the transducer was in direct contact with the tape over the electrodes. The volunteers were not aware of these temperature increases which were primarily caused by heating of the transducer face. If the temperature of the skin surface is kept constant by interposing a thermostatted water path between the transducer and the electrode system, then similar ultrasound exposures had no detectable effects upon the electrical pain perception threshold.(ABSTRACT TRUNCATED AT 400 WORDS)