OBJECTIVEPrevious literatures have reported favorable results in ear reconstruction. Many details in fabricating cartilage framework have been paid much attention. Whereas, many patients still complain about unnatural contours. This article is to provide a new technique to solve some of the problems.

METHODSA total of 253 patients underwent reconstruction using the modified technique from 2011 to 2014. In fabricating the complex of antihelix, the authors modified the prior method. Instead of sculpting a sharp Y-shaped cartilage graft for projecting the prominent structures, the authors increased the width of the superior crura, sculpted a gentle slope in the both sides of superior crura, simultaneously carved a groove in the base frame to join with the carved attachment smoothly. The width of inferior crura was about one third of the superior crura width, and the inferior crura was narrow and prominent. A gentle slope was carved on the antihelix and a groove was carved on the base frame for the antihelix to sit on.

RESULTSFour cases have been selected to illustrate the favorable results of this technique. Due to the modified details, the superior crura, inferior crura, antihelix and the structures around them, in these cases, show natural contours, and provide a coordinated figure to the integrity of reconstructed ear.

CONCLUSIONSAntihelix complex is one of the most important structures for creating a natural auricle. The natural superior and inferior crura and antihelix can enhance the impression of a harmonious shape, and acquire an increased satisfaction for both patients and surgeons.

Malignant lesions of external ear are most commonly excised with histologic margin control. But each ear defect is unique and the surgeon often faces a reconstructive challenge after tumor excision. Recently, we experienced a case of auricle cancer developed in 80 year old man with ulcerated lesion on conchal bowl, which was reconstructed with postauricular pull-through flap. We report this case with a review of the literature.
Ear ; Ear Auricle ; Ear, External ; Ulcer

BACKGROUND AND OBJECTIVES: External ear resonance (EER) can normally increase the sound pressure level at the tympanic membrane by as much as 20 dB at the frequency between 2 and 4 kHz. Perforation of tympanic membrane (TMP) may alter the resonance characteristics. Surgical modifications of the external auditory canal by tympanoplasty may also change the EER features. We aimed to analyze the EER of patients with the TMP before and after surgery. MATERIALS AND MEHTOD: This study comprised of 130 patients (135 ears) with chronic otitis media. We checked EERs before and after the surgery. The preoperative group was divided into two groups according to perforation size. Postoperatively, the EER was checked at 3, 6, 9, 12 months or after 15 months. We compared these data with the control group which comprised of 96 adult ears. RESULTS: In the preoperative group, the peak resonant gain and the frequency were not different from the control's and the peculiar negative peaks appeared around 1500 Hz in half of the cases. No significant differences were found in the first peak gains according to the perforation size. The negative peaks appeared deeper in the larger perforation group. After tympanoplasty, the gain markedly increased. As time passed, the gain tended to decrease, but did not equalize with the control's data. CONCLUSION: Additional gain should be considered in the frequency of around 1 kHz for hearing aid users with the TMP. We could expect alterations of EER after tympanoplasty, suggesting that these changes should be considered at the time of fitting hearing aids.
Adult ; Ear ; Ear Canal ; Ear, External* ; Hearing Aids ; Humans ; Otitis Media* ; Otitis* ; Thymidine Monophosphate ; Tympanic Membrane ; Tympanic Membrane Perforation ; Tympanoplasty

Helical rim defects of the auricle are usually the result of injury or tumor excision. Acquired helical rim defects are eye-catching and cosmetically unacceptable. We experienced a case of squamous cell carcinoma at the helical rim. The lesion was resected with clear margin and the defect was successfully reconstructed with a helical rim chondrocutaneous advancement flap.
Carcinoma, Squamous Cell ; Ear Auricle ; Ear, External

BACKGROUND AND OBJECTIVES: Middle ear effusion (MEE) is common in children, so the effects of the ventilation tube (VT) should be taken into account in prescribing hearing aids. With the ventilation tube, the external auditory canal communicates with the middle ear space, hence changing the impedance in the middle ear. This change, in turn, will have an effect on the external ear resonance (EER, real ear unaided response (REUR)). The aim of this study is to observe the effects of the tympanic membrane perforations caused by the ventilation tube on EER. MATERIAL AND METHODS:We selected 30 ears with MEE and measured EER before and after the ventilation tube insertion. We compared the EERs of the control group with the MEE group and two types of VT groups. RESULTS: In the subjects who had middle ear effusion, the average gain of the peak resonance was larger than that of the control group. After the VT insertion, the amplitude of the gain decreased to the level of control groups, although negative gain appeared in some cases characteristically around 1000 Hz. This negative gain was observed more frequently in the VT with larger diameter. CONCLUSION: The external ear resonance gain can be changed according to disease status or by VT insertion in patients with MEE. These changes should be considered especially in the low frequencies around 1000 Hz when prescribing the hearing aids for patients.
Child ; Ear ; Ear Canal ; Ear, External* ; Ear, Middle* ; Electric Impedance ; Hearing Aids ; Humans ; Otitis Media with Effusion* ; Tympanic Membrane ; Ventilation*

BACKGROUND AND OBJECTIVES: High-resolution computed tomography provides an excellent method for examination of the middle ear, inner ear anatomy and pathologic changes in the temporal bones. The purpose of this study was to get various measurements of the external auditory canal and temporal bones, and to compare the changes with age and sex. MATERIALS AND METHOD: The various measurements by CT of the external ear canal of normal 50 ears were done. RESULTS: The obtained results were as follows: 1) In both male and female group, the distance from the medial end of EAC to bony-cartilage junction, the distance from medial end of EAC to the lateral end of cartilage, the distance from the superior wall to the inferior wall (coronal EAC isthmus) and the distance from anterior wall to the posterior wall (axial EAC isthmus) increased significantly with age (p<0.05). 2) Compared with the female group, the male group had longer distance from the posterior tympanic plate to the sinus tympani with age (p<0.05). 3) Compared with male group, the female group had longer distance from the posterior EAC wall to the Sigmoid sinus and from the EAC superior wall to the tegmen tympani with age (p<0.05). 4) In both male and female groups, the anterior and inferior angles increased and the posterior and superior angles decreased with age (p<0.05). CONCLUSION: Computed tomographic evaluation can give us to information to operate external ear, middle ear, and inner ear surgery.
Cartilage ; Colon, Sigmoid ; Ear ; Ear Canal* ; Ear, External ; Ear, Inner ; Ear, Middle ; Female ; Humans ; Male ; Temporal Bone*

Ear Auricle ; Ear, External ; Humans ; Lymphohistiocytosis, Hemophagocytic/complications*

Dermatofibrosarcoma/surgery* ; Ear Auricle ; Ear, External ; Humans ; Skin Neoplasms/surgery*

OBJECTIVE: To Study the clinical features of congenital microtia and atresia . To evaluate the methods and results of the same microtia surgery, ear canal and middle ear reconstruction. METHOD: Statistically analysis of the data of the hospitalization microtia 62 ears of 58 cases of patient in our department from January 2005 to October 2010 waw conducted. These patients with congenital ear malformations are associated with aural atresia, ossicular chain abnormalities, severe conduction Deafness. All patients received preoperative temporal bone CT examination and reconstruction, hearing examination. Operation was given in two phases, first operation aim to form a line of ear, ear canal reconstruction, ear reconstruction, the second one aim to line of ear skin graft, cranial angle of the ear reconstruction. The preoperative and postoperative data were retrospectively analyzed. RESULT: The auricle plus external auditory canal, middle ear reconstruction came out with a good shape of the ear and the ear canal in close proximity to the normal population. Most patients' hearing were improved after surgery. CONCLUSION Surgeries of patients with congenital ear malformations and aural atresia should be carefully designed according to the three-dimensional reconstruction of multislice spiral CT reconstruction, which can provide information about surgery approach and middle ear abnormality. The whole ear shape and hearing ear after reconstruction are improved after the surgery.
Adolescent ; Angioplasty ; Congenital Microtia ; surgery ; Ear ; Ear Auricle ; abnormalities ; surgery ; Ear Canal ; abnormalities ; surgery ; Ear, External ; abnormalities ; surgery ; Hearing ; Hearing Loss ; surgery ; Humans ; Reconstructive Surgical Procedures ; methods ; Retrospective Studies ; Skin Transplantation ; Tomography, X-Ray Computed

OBJECTIVE: To investigate the reconstruction method of lateral attic wall with tragal cartilage and temporalis fascia graft. And analyze the postoperative result of its clinical application. METHOD: From Jan 2005 to Jul 2014, 45 patients whose middle ear disease were limited to attic received this surgery in our department. Among 31 cases of cholesteatoma otitis media and 14 cases of external auditory canal cholesteatoma were included. In order to expose the attic fully, we operated epitympanotomy through retroauricular incision and then removed the scutum and lateral attic bone wall. After eliminating the lesions, we reconstructed the lateral attic bone wall with tragal cartilage, covered the cartilage with temporalis fascia and then repaired the tympanic membrane and external ear canal skin. After surgery, all patients were followed up at 10 days, 1 month, 2 months, 6 months and 1 year. RESULT: Two months after surgery, 45 patients' achieved one-stage wound healing. Six months later, all of the patients' operation area had epithelized completely. After 1 year, 37 patients had recovered the normal shapes and stable audition; 7 cases patients have different level tympanic membrane retraction; 1 patient suffered from tympanic membrane retraction and recurrent cholesteatoma. CONCLUSION With regard to the lesion limited to the attic, we can remove it by operating epitympanotomy through retroauricular incision, and then reconstruct the lateral attic wall with tragal cartilage and temporalis fascia. By the support of the cartilage, we can keep the epitympanic aeration, reduce the retraction of pars flaccida membrana tympani, and maintain the fundamental shape of lateral attic wall.
Cartilage ; transplantation ; Cholesteatoma ; surgery ; Ear Auricle ; Ear Canal ; Ear Diseases ; surgery ; Ear, Middle ; pathology ; Fascia ; transplantation ; Humans ; Mastoid ; Otitis Media ; surgery ; Tympanic Membrane ; surgery ; Tympanic Membrane Perforation ; surgery