BACKGROUND: The ear is composed of elastic cartilage as its framework, and is covered with a thin layer of skin. Auricular reconstruction using autogenous cartilage in microtia patients requires delicacy. This paper reports clinical experiences related to elevation of reconstructed ear in the last 11 years. METHODS: This study was based on 68 congenital microtia patients who underwent auricular elevation in our hospital. Among these 68 patients, 47 patients were recruited. We compared the differences in the ear size, auriculocephalic angle, and conchal depth with those in the opposite ear, and the patients' satisfaction levels were investigated using a survey. RESULTS: The difference in the sizes of the two ears was less than or equal to 5 mm in 32 patients, 5 to 10 mm in 10 patients, and greater than or equal to 10 mm in 5 patients. The difference in the auriculocephalic angles of the two ears was less than or equal to 10 degrees in 14 patients, 10 to 20 degrees in 26 patients, and greater than or equal to 20 degrees in 7 patients. The difference in the conchal depths of the two ears was less than or equal to 5 mm in 24 patients, 5 to 10 mm in 19 patients, and greater than or equal to 10 mm in 4 patients. The average grade of 3.9 points out of 5 points was obtained by the patients with satisfactory surveys. CONCLUSION: We could make enough protrusion and maintain the three-dimensional shape for a long time to satisfy our patients.
Cartilage ; Ear ; Ear Auricle ; Elastic Cartilage ; Humans ; Skin ; Transplantation

Cartilage ; transplantation ; Ear, Middle ; surgery ; Humans ; Otologic Surgical Procedures ; methods

The short nose is characterized by decreased distance from the starting point of nose, sellion to tip defining point and increased nasolabial angle with excessively increased nostril show. In Orientals there are many people who have short nose due to low caudal level sellion and small nasofrontal angle with low dorsum of nose, reduced tip projection and acute nasolabial angle although it is not a typical short nose. In this study we defined this nose as atypical short nose. Lengthening short nose is arguably the most difficult operation in aesthetic rhinoplasty. We have described here a simple and easy technique that correct atypical short nose by using L-type silastic nasal implant and shield-shape cartilage graft. From January 2002 to March 2004, the author attempted to lengthen nasal root by cephalic upward repositioning of sellion with L-type silastic nasal implant with open rhinoplasty approach and improve tip projection and cephalic rotation by using columellar srtut formation with L-type silastic nasal implant, interdomal suture and shield-shape cartilage graft which is harvested from concha in 18 cases. We have got the satisfactory results on aesthetic aspects in all patients without any complications. The change of nasal length was from 44.8mm to 45.7mm and nasal tip projection and cephalic rotation were successfully improved. Especially the patients were very satisfied with one's lateral nasal profile because of smooth curvature of nasal root and natural nasofrontal angle due to cephalic nasal lengthening by upward repositioning of sellion. In conclusion I think this procedure is an effective and simple method in correcting atypical short nose which is characterized by low caudal level sellion, low dorsum of nose and reduced tip projection in Orientals.
Cartilage* ; Ear Cartilage ; Humans ; Nose Diseases ; Nose* ; Rhinoplasty ; Sutures ; Transplantation ; Transplants*

OBJECTIVETo explore the curative effect of Z-plasty without skin grafting for correction of cryptotia.

METHODSTwenty-five cases (29 ears) with cryototia were corrected by Z-plasty without skin grafting in our department from June 2009 to January 2014. A Z-shaped incision with one arm on the back of antihelix and the other arm on the edge of hair was made on the back of ear and scalp. The adhesion on the back of antihelix cartilage was dissected and the cartilage framework was lifted and re-positioned. The postauricular flap was transferred to cover the wound on the back of antihelix. The other flap was transferred to cover the remnant wound and correct the malformation of cryptotia.

RESULTSAll the patients were followed up from 6 months to 1 year with stable and symmetric appearance.

CONCLUSIONSThe shape of auricle is natural after operation without skin grafting. It is a simple and ideal method for the treatment of cryptotia.

Ear Cartilage ; abnormalities ; surgery ; Ear, External ; abnormalities ; surgery ; Humans ; Skin Transplantation

OBJECTIVES: Rhinoplasty is one of the most common cosmetic surgeries in China. Septal extension grafts (SEG) have been widely used in rhinoplasty, but there are few reports on SEG derived from ear cartilage. This study aims to explore the effectiveness and stability of auricular cartilage nasal SEG transplantation in Chinese rhinoplasty. METHODS: A retrospective analysis of 35 rhinoplasty patients admitted from September 2019 to March 2022 has been conducted. Among them, 29 patients underwent rhinoplasty for the first time and 6 patients underwent rhinoplasty with the age of 18-32 (average 22.4) years old. The postoperative follow-up was 3-28 (average 18.5) months. The improvement of the nose shape was observed. The changes of the nose tip angle, nasolabial angle, and nasofrontal angle were compared between before and after the operation, and the complications were recorded. RESULTS: All patients who underwent rhinoplasty with a septal extension grafts constructed from the concha cavity and concha cartilage showed significant improvement in nasal contour. The preoperative nasal tip angle, nasolabial angle, and nasofrontal angle were significantly improved compared with 3 months after operation (all P<0.001), and there was no significant difference between 3 months and 14 months after operation (all P>0.05). The appearance of nasal cavity was satisfactory in 32 patients after operation. Columella deviation occurred in 2 patients and 1 patient complained of downward rotation of the nasal tip, which was satisfied after readjustment of the graft. CONCLUSIONS The simplified SEG derived from auricular cartilage can provide stable support for the nasal tip, the nasal shape is natural after operation, and minimal trauma of unilateral auricle cartilage transplantation remains.
Humans ; Young Adult ; Adult ; Rhinoplasty ; Ear Cartilage/transplantation* ; Retrospective Studies ; Nasal Septum/transplantation* ; Plastic Surgery Procedures

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

OBJECTIVETo investigate the method for creation of auriculocephalic sulcus.

METHODSThe reconstruction was performed 4-12 months after the first surgery. Skin incision was made 5mm posterior to the outer margin of the auricle. The ear framework was elevated with a thick fascia at the deep surface. The costal cartilage banked at the first operation was shaved and transplanted to the deep surface of the concha with sutures. The position and angle of the ear framework was adjusted to be familiar to the healthy ear. The auriculocephalic angle was slightly larger than that in the contralateral ear. Two flaps were designed at the upper and lower area of reconstructed ear and rotated to cover the cartilage. The wound at the donor site was closed with skin graft.

RESULTSA total of 72 patients were treated. All the flaps survived completely. 51 patients were followed up for 3-24 months with satisfactory results. The auriculocephalic sulcus maintained at about 20-30 degree.

CONCLUSIONSIt is a simple, safe and reliable method to create a auriculocephalic sulcus with two random skin flaps from mastoid area combined with skin graft.

Adolescent ; Cartilage ; transplantation ; Dermatologic Surgical Procedures ; methods ; Ear ; Ear Auricle ; surgery ; Ear Deformities, Acquired ; surgery ; Fascia ; Humans ; Mastoid ; Ribs ; Skin Transplantation ; methods ; Surgical Flaps ; transplantation

OBJECTIVETo investigate the application of medpor and split-thickness skin graft in formation of cranioauricular sulcus during auricular reconstruction with Nagata method.

METHODSThe first stage operation was fulfilled according to the Nagata two-stage method which involves fabrication and grafting of the costal cartilage framework. The second-stage ear elevation operation was undertaken 6 months later to form the cranioauricular sulcus. Split-thickness skin was taken from temporal and accipital area. After releasing the auricular framework and transplanting C shaped medpor at the rear side of framework, the temporaparietal fascia flap was transferred to cover postauricular medpor and framework. Then the split-thickness skin graft was implant on the fascia surface.

RESULTSFrom July 2010 to August 2012, 20 cases (22 ears) were treated. Partial necrosis of temporaparietal fascia flap and framework exposure happened in 1 case. Successful ear reconstruction was achieved in other cases with satisfactory cranioauricular sulcus during the follow-up period of 6-18 months (average, 13 months).

CONCLUSIONSThe application of medpor and split-thickness skin graft in the ear elevation of Nagata method for auricular reconstruction for microtia can achieve satisfactory results. It not only avoids the obvious scar in the donor site due to harvesting full-thickness and intermediate-thickness skin, but also reduces chest trauma due to harvesting costal cartilage.

Costal Cartilage ; transplantation ; Dermatologic Surgical Procedures ; methods ; Ear Auricle ; surgery ; Fascia ; Humans ; Polyethylenes ; therapeutic use ; Skin Transplantation ; Surgical Flaps ; transplantation

OBJECTIVETo investigate the emergency treatment for large amputated ear defect.

METHODSFrom Feb. 2010 to Oct. 2013, 5 cases with large unilateral amputated ear defects were treated. The amputated auricular cartilage was replanted subcutaneously in mastoid area at the first stage. Cranioauricular sulcus was reconstructed and skin grafting was performed at the second stage.

RESULTSAll cases were followed up for 3-6 months with satisfactory result. The reconstructed helix, scapha and cavity of auricular concha had similar color and elasticity as the ear at healthy side. Scar at donor sites, such as inguinal region and armpit, was inconspicuous.

CONCLUSIONSThe method of auricular cartilage replantation is an effective way for emergency treatment of large amputated auricular defect with less morbidity at donor site.

Adolescent ; Adult ; Ear Cartilage ; transplantation ; Ear, External ; injuries ; surgery ; Female ; Follow-Up Studies ; Humans ; Male ; Replantation ; Treatment Outcome ; Young Adult

OBJECTIVETo explore the therapeutic effect of the temporal rotation flap combined with cartilage plasty for cryptotia correction.

METHODSFrom January 2009 to June 2012, 8 cases with cryptotia (10 ears) were treated. After complete dissection of the cartilage adhesion, the cartilage was reshaped by suture to restore its appearance. Then the temporal triangular rotation flap was transferred to cover the wound.

RESULTSNo hematoma, infection or flap necrosis happened. The follow-up period ranged from 3 months to 1 year, with an average of (6.88 +/- 2.85) months. The ear appearance kept stable with no recurrence and inconspicuous scar. Satisfactory result was achieved.

CONCLUSIONTemporal rotation flap combined with cartilage plasty is a good option for correction of mild or moderate cryptotia.

Adolescent ; Child ; Ear Cartilage ; surgery ; Ear, External ; abnormalities ; Female ; Humans ; Male ; Reconstructive Surgical Procedures ; methods ; Rotation ; Skin Transplantation ; Surgical Flaps