Three-stage functional ear reconstruction for microtia with congenital aural stenosis
10.3760/cma.j.issn.1009-4598.2018.03.005
- VernacularTitle: 三期法功能及耳再造技术在先天性小耳畸形伴耳道狭窄患者中的应用
- Author:
Chenlong LI
1
;
Youzhou XIE
;
Yaying ZHU
;
Tianyu ZHANG
Author Information
1. Ear Nose and Throat Institute and Department of Facial Plastic and Reconstructive Surgery, Eye & Ear Nose and Throat Hospital, Fudan University, Shanghai 200031, China
- Publication Type:Clinical Trail
- Keywords:
Microtia;
Stricture of external auditory canal;
Reconstruction
- From:
Chinese Journal of Plastic Surgery
2018;34(3):183-187
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To discuss the clinical results of three-stage functional ear reconstruction for microtia with congenital aural stenosis (CAS).
Methods:From September 2007 to June 2017, 53 cases of microtia with CAS underwent all three-stage functional ear reconstruction, and 445 cases of microtia underwent two stage ear reconstruction without meatoplasty at the same periods. First-stage of three-stage functional ear reconstruction: it was similar to Nagata technique. The crus of helix could not be too long, since we needed the space for the next meatoplasty. Second-stage: it was a modified meatoplasty with endoaural-conchal incision, in which two local rotation flaps and a transposition split-thickness scalp flap were used to widen the stenotic external auditory canal (EAC) and reconstructed the tympanic membrane. Third-stage: it was a modified technique for firm elevation of the reconstructed auricle by using the retro-auricular fascial flap wrapping a porous polyethylene (Medpor) wedge or stored cartilage as the strut. If the patient showed EAC cholesteatoma or infection, we could do the meatoplasty at the first stage. If the patient had completed ear reconstruction, meatoplasty could be done at the third stage.
Results:53 cases underwent all three-stage functional ear reconstruction. There were 41 cases (77.4%) obtaining serviceable hearing. The complication rate of meatoplasty was 1.89% and the complication rate of ear reconstruction was 5.66%. Among the 445 cases of microtia treated with two stage ear reconstruction without meatoplasty, the complication rate of ear reconstruction was 9.43%. There was no significant difference between the two groups (P>0.05).
Conclusions:Our novel three-stage functional ear reconstruction is a feasible strategy for microtia with CAS. The patients can obtain satisfactory auricle and serviceable hearing. The results are stable and can improve the life quality in both aesthetics and hearing function.
