Objective To investigate the method and effectiveness of two-stage operation of auricular reconstruction in treating lobule-type microtia. Methods Between March 2007 and April 2010, 19 patients (19 ears) of lobule-type microtia were treated. There were 13 males and 6 females, aged 5 to 27 years (mean, 12.6 years). Of 19 patients, 11 were less than or equalto 14 years old. The locations were left ear in 9 cases and right ear in 10 cases. Two-stage operation for auricular reconstruction of lobule-type microtia included fabrication and grafting of the costal cartilage framework at the first-stage operation and the ear elevation operation at the second-stage operation. Results Pseudomonas aeruginosa infection occurred in 1 patient after the first-stage operation, who was not given the second-stage operation. Skin necrosis occurred in 1 patient 8 days after the secondstage operation and healed after symptomatic treatment. Eighteen patients were followed up 6 months to 2 years (mean，14 months). Retraction of cranioauricular angle and thoracic deformity occurred in 1 patient. The surgical results were satisfactory in the other 17 patients whose reconstructive ear had verisimilar shape and suitable cranioauricular angle. Conclusion Twostage operation of auricular reconstruction is considered to be an ideal method for lobule-type microtia.
Objective To investigate the cl inical outcome of a surgical strategy by soft tissue expansion in treating acquired auricular defect. Methods Between January 2007 and December 2009, 136 patients with acquired auricular defect were treated with a surgical strategy by putting autoallergic costal framework after soft tissue expansion. There were 93 males and 43 females, aged 8-60 years (median, 20 years). Defects were caused by burn in 82 cases, by trauma in 47 cases, and by bite in 7 cases. Defect involved in almost the whole auricle and earlobe in 50 patients, 2/3 superior part of auricle in 35 patients, 1/3 superior part of auricle in 31 patients, 1/3 middle part of auricle in 9 patients, and 1/3 inferior part of auricle and earlobe in 11 patients. Results All the flaps had good blood supply, skin grafts all survived, and all the wounds healed by first intention after operation. All patients were followed up 6-24 months with an average of 14 months. All reconstructive auricle survived with good color, soft texture, and normal sensory function; the appearance had no enlargement and attrition, and the grafted costal cartilage framework had no malacosis, absorption, and deformation. The reconstructed ear had the same position, size, shape, and oto-cranium angle as normal ear. The curative effect was good according to ZHUANG Hongxing’s evaluation standard of auricular reconstruction. Conclusion To reconstruct auricle by soft tissue expansion is an effective method. The position of putting expander and the number of expanders are different in different patients.
Objective To investigate the clinical effect of intensepulsed light depilation combined with bigger skin expander in auricular reconstruction. Methods From January 2000 to January 2006, seventythree patients suffering congenital microtia of one side were treated. Among them, 32 patients were reconstructedby the intense pulsed light depilation combining with bigger skin expander(new method group), and 41 patients were reconstructed by traditional auricular reconstruction method(traditional method group). In the new method group, there were12 males and 20 females, aging 6-45 years. The typing of congenital microtia weredegree Ⅰ in 6 cases, degree Ⅱ in 20 cases and degree Ⅲ in 6 cases. The size of flap ranged from 9 cm×5 cm to 11 cm×6 cm. And the size of fascial flap ranged from 7 cm×5 cm to 9 cm×6 cm.In the traditional method group, there were 13 males and 28 females, aging 6-42 years. The typing of congenital microtia were degree Ⅰ in 8 cases, degree Ⅱ in 27 casesand degree Ⅲ in 6 cases. The size of flap ranged from 8 cm×5 cm to 10 cm×6 cm. And the size of fascial flap ranged from 7 cm×5 cm to 9 cm×6 cm. The skin sizeand scar size were measured. The complications and the satisfactory rate were compared between two groups after operation to assess the value of these methods. Results After 6-12 months of second operation, all patients were given thirdstage auricular reconstruction and followed up. In the new method group, the flap and skin grafting survived and the wound healed by the first intension. The crus of helix, helix,concha and scapha could be found clearly. There was no hair on the surface of helix. In the traditional method group, the framework exposure occured in one patients because of local flap necrosis. The wound cured by the temporal superficial fascia flaps combined with split skin grafts transplantation. The other flap and skin grafting survived and the wound healed by the first intension. The helix, concha and scapha could be found, but there was some hair on the surface of 35 patients’ helix. There were significant differences in the skin graft, scar size and the satisfactory rate between two groups (Plt;0.05). There was no significant difference in the complications(Pgt;0.05). Conclusion There is less scar and skin grafts in this new method. And the hair can be depilated in the reconstructed auricle completely. So it can achieve more satisfactory appearance.
ObjectiveTo investigate the application and effectiveness of split-thickness scalp graft and temporoparietal fascia flap in the low hairline auricle reconstruction in microtia patients. MethodsBetween July 2010 and April 2015, 23 patients with low hairline microtia (23 ears) underwent low hairline auricle reconstruction. There were 16 males and 7 females with the mean age of 12 years (range, 6-34 years). The left ear was involved in 10 cases, and the right ear in 13 cases. There were 18 cases of lobule-type, 4 cases of concha-type, and 1 case of small conchatype. Referring to Nagata's two-stage auricular reconstruction method, the first stage operation included fabrication and grafting of autogenous costal cartilage framework; after 6 months, second stage operation of depilation and formation of cranioauricular sulcus was performed. The split-thickness scalp was taken from the part of the reconstructive ear above hairline. The hair follicles and subcutaneous tissue layers in hair area were cut off during operation. The area of depilation and auriculocephalic sulcus were covered with temporoparietal fascia flap. Then split-thickness skin was implanted on the surface of temporoparieta fascia flap. ResultsAll operations were successfully completed. Healing of incision by first intention was obtained, without related complication. The patients were followed up 6-20 months (mean, 12 months). The reconstructed ear had satisfactory appearance and had no hair growth. ConclusionThe application of splitthickness scalp graft and temporoparietal fascia flap in low hairline auricle reconstruction in microtia patients can achieve satisfactory results.