OBJECTIVETo investigate a method of auricular reconstruction by soft tissue expansion techniques without skin grafting.

METHODSTwo tissue expanders (50 ml and 70 ml) were implanted under the skin of mastoid in 15 patients with grade II or III microtia. One big expander (100 ml) were implanted under the skin of mastoid in 13 patients with grade I microtia and 3 patients with grade II or III microtia. After skin expansion, the expanders were taken out. The autologous rib cartilage or Medpor scaffolds were implanted. The superior expanded skin flap was used to cover the frontal surface and the upper part of the back surface of the framework. The inferior expanded skin flap was transplanted to cover the lower part of the back surface of the framework. The remained expanded skin flap was transplanted to cover the wound in the lateral of head.

RESULTSNo skin graft was needed in all the patients. Epidermis blister occurred at the distal part of flap in one case. No other complication was happened. A follow-up of 6 to 12 months (mean 10.9 months) was carried out in all patients with good cosmetic result when the reconstructed ear underwent second-stage operation. The scar size on the dornor site was (5.2 +/- 0.6) cm2 The satisfactory rate was 90% (28/31).

CONCLUSIONSThe expanded skin with this new method is enough for auricular reconstruction without skin grafting, leaving less complication and less scar at donor site.