Application of different auricular reconstruction methods in congenital microtia with low hairline
10.3760/cma.j.cn114453-20200319-00166
- VernacularTitle:极低发际线小耳畸形耳廓再造方案
- Author:
Yue WANG
1
;
Qi CHEN
;
Jin QIAN
;
Bingqing WANG
;
Qingguo ZHANG
Author Information
1. 中国医学科学院北京协和医学院整形外科医院耳再造二中心 100144
- Keywords:
Congenital microtia;
Ear auricle;
Reconstructive surgical procedures;
Tissue expansion;
Surgical flaps;
Costal cartilage;
Tissue scaffolds;
Lasers, gas;
Hair
- From:
Chinese Journal of Plastic Surgery
2021;37(7):784-789
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the effect of different strategies on auricle reconstruction in microtia with very low hairline according to the skin condition of retroauricular mastoid region and the degree of temporal bone development.Methods:The clinical data of patients with very low hairline congenital microtia admitted to the Plastic Surgery Hospital, Chinese Academy of Medical Sciences from January 2014 to June 2019 were retrospectively analyzed. Surgical plan: the patients with moderate temporal bone development and thin and poor elasticity skin were treated with retroauricular skin expansion combined with laser hair removal; the patients with moderate temporal bone development and thick and loose skin were treated with fasciocutaneous flap expansion combined with laser hair removal; the patients with poor temporal bone development were treated with temporal superficial fascia combined with Medpor frame for one-time reconstruction. All patients were followed up to investigate their satisfaction with the three-dimensional structure and subunit morphology of the reconstructed ear, and the complications were recorded.Results:A total of 68 patients, 55 males and 13 females, aged from 5 to 22 years old, with an average of 10.4 years old, were included in this study. Among them, 22 patients were treated with retroauricular skin expansion combined with laser hair removal, 41 patients were treated with retroauricular fasciocutaneous flap expansion combined with laser hair removal, and 5 patients were treated with temporoparietal superficial fascia combined with Medpor frame for one-stage reconstruction. The follow-up ranged from 10 to 24 months (average 13 months). The three-dimensional structure and local subunits of 66 cases of reconstructed ears were in good shape, and the operation area recovered well without obvious scar hyperplasia and chest deformity. Among them, 6 patients remained a small amount of hair after laser hair removal treatment, and the satisfactory effect was achieved after re-hair removal treatment. The satisfaction rate of patients was 97.1% (66/68). Two cases of auricle reconstruction by retroauricular skin expansion combined with laser hair removal showed cartilage exposure after operation, and recovered with temporoparietal fascial flap after. No subcutaneous hematoma, poor skin graft survival, cartilage absorption, deformation and other complications occurred in all cases.Conclusions:According to the skin condition and temporal bone development degree of patients with very low hairline, different treatment schemes can obtain better auricle shape, improve postoperative patient satisfaction and reduce complications.
