Ear reconstruction with Ba Da Chu Method——Ten-year experiences of our team
10.3760/cma.j.issn.1009-4598.2017.s1.007
- VernacularTitle:小耳畸形八大处法耳廓再造术——团队10年经验
- Author:
Leren HE
1
;
Qinghua YANG
;
Haiyue JIANG
;
Hongxing ZHUANG
;
Qingguo ZHANG
;
Yongzhen WANG
;
Jinxiu YANG
;
Yanyong ZHAO
;
Bo PAN
;
Lin LIN
;
Hengyun SUN
;
Ye ZHANG
;
Jin QIAN
Author Information
1. 中国医学科学院北京协和医学院整形外科医院七科
- Keywords:
Microtia;
Ear reconstruction with Ba Da Chu method;
Otoplasty;
Soft tissue expander;
Costal cartilage;
Framework
- From:
Chinese Journal of Plastic Surgery
2017;33(z1):28-33
- CountryChina
- Language:Chinese
-
Abstract:
Objective To introduce our experiences in ear reconstruction with Ba Da Chu Method during the past 10 years, and to summarize the operative skills and key points .Methods Generally, Ba Da Chu Method for ear reconstruction includes 3 stages:Stage 1, skin expansion in mastoid region .Stage 2, auricular reconstruction), consisting of tissue expander removal, earlobe transposition, expanded skin flap and temporal fascia flap formation , autologous costal cartilage harvest , framework fabrication and transplantation , and the wound closure .Stage 3: tragus formation , conchoplasty , and refinement of the reconstructed ear.Results From January, 2006 to December, 2015, we performed 5628 reconstructed ears for 5267 patients with congenital microtia .Follow-up period ranged from 1 to 10 years.Complications in stage 1 included hematoma , infection and expander exposure sporadically arising , which were treated properly and stage2 operations were carried out on time or delayed .5202 (92.4％) reconstructed ears were demonstrated with fine substructure landmarks .236(4.2％) reconstructed ears with poor blood circulation at the margin of skin flap , were cured completely and ended up with acceptable outcomes;108 ( 1.9％) reconstructed ears , manifestedwith mild cartilage framework exposure due to partial necrosis of skin graft , were repaired in stage 3.61 (1.1％) of them with severe exposure , needed additional operations to cover the framework with axial fascial flap immediately .21 ( 0.3％) reconstructed ears lost the normal contour because of cartilage infection , which a secondary operation was needed to repair .The complications of stage 3 occurred rarely , which could be cured in the end .Conclusions Ba Da Chu Method is well adapted to treat congenital microtia , and it is flexible to adjust surgical skills when microtia was combined with other complicated soft tissue deformities or craniofacial bone defects;Satisfactory result were achieved in 92.4％reconstructed ears in this study with fine substructures;During approximate 2-month skin expansion , great attention must be paid to ensure successful expansion , which is based on extensive clinical experiences from doctors, appropriate nursing management from nurses , and careful observation from patients or their families.
