Auricular reconstruction using an expanded postauricular flap with double pedicle
10.3760/cma.j.cn114453-20210608-00254
- VernacularTitle:耳后双蒂扩张皮瓣法耳廓再造术
- Author:
Shuang WANG
1
;
Leren HE
;
Jinxiu YANG
;
Chen YANG
;
Qinhao GU
Author Information
1. 中国医学科学院北京协和医学院整形外科医院整形七科，北京 100144
- Keywords:
Congenital microtia;
Reconstruction of auricle;
Surgical flaps;
Soft tissue expansion
- From:
Chinese Journal of Plastic Surgery
2022;38(1):58-63
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the clinical effect of auricle reconstruction using an expanded postauricular flap with double pedicle in the ear reconstruction.Methods:From September 2016 to August 2017, the clinical data of all patients with congenital microtia treated in the Department of Plastic Surgery, Plastic Surgery Hospital, Chinese Academy of Medical Sciences were analyzed retrospectively. The surgical procedures: The expander was implanted in the first stage. The ear framework was covered by the retroauricular double-pedicled expanded flap with free skin grafting at the retroauricular superior margin in the second stage, and the helix was wrapped by the retroauricular fascia. The patients were followed up at 1, 6 months after operation and before the third stage operation, and the appearance of the reconstructed auricle was evaluated by two junior doctors before the third stage of the operations. If there were any differences, the final evaluation would be carried out by a senior doctor. The evaluation results were good, medium and poor.Results:A total of 46 patients (49 ears) with congenital microtia were included, including 36 males (39 ears) and 10 females (10 ears), with the age range of 6-23 years. After operation, the blood supply was good, and the skin grafts survived completely. Three ears had postoperative hematomas under the double-pedicled expanded skin flap when the drainage was removed 5 days after operation. The hematomas recovered well after the negative pressure suction and dressing changed. During the follow-up of 6 months and 18 months, 43 cases (46 ears) were evaluated well with symmetrical and clear three-dimensional structure of reconstructed auricles, uniformed color, and hidden scar behind the ear. Three cases (3 ears) were evaluated as medium. There was hematoma when the drainage tube was removed 5 days after operation, which survived completely after negative suction and dressing change. No cartilage framework infection and exposure were found.Conclusions:The double-pedicled expanded flap has many advantages, such as reliable blood supply, natural auricle appearance, concealed scar, and less skin color difference. It is a good choice for soft tissue wrapping and covering during auricle reconstruction.
