1.The application of porous polyethylene biological scaffolds combined with temporoparietal fascial flaps in auricular reconstruction.
Ken LIN ; Yulin DU ; Rui HUANG ; Xia LI ; Hangying ZHANG ; Yuhui HUA ; Dong SU ; Jing MA
Journal of Clinical Otorhinolaryngology Head and Neck Surgery 2025;39(2):147-157
Objective:To analyze the application efficacy of employing high-density porous polyethylene (Su-por) in combination with temporoparietal fascial flaps via a minimally invasive scalp incision in auricular reconstruction. Methods:This study carried out a retrospective analysis of 50 patients (50 ears in total) who underwentprimary auricular reconstruction with a Su-por scaffold in our hospital from June 2022 to January 2024. All patients underwent primary auricular reconstruction using a minimally invasive scalp incision with high-density porous polyethylene (Su-por) and temporoparietal fascial flaps. The postoperative treatment effects and complications were statistically analyzed. Results:The reconstructed ears of all patients survived. After 6 months of follow-up, the scar hyperplasia of the scalp minimally invasive incision was not obvious in any patient, and no significant hair loss was observed. The reconstructed auricle of 48 patients had a realistic shape and strong three-dimensional sense. With the extension of follow-up time, the three-dimensional structure of the auricle became clearer, and patient satisfaction increased. Among the remaining two patients, one case of flap necrosis survived after skin grafting and dressing changes. One patient had scar hyperplasia at the incision of the reconstructed ear due to a scar-prone constitution, and the shape of the auricle was not ideal, but the scar hyperplasia at the scalp incision was not obvious. Conclusion:One-stage ear reconstruction with high-density porous polyethylene (Su-por) combined with superficial temporal fascia flap through a minimally invasive scalp incision can better show the fine structure of the reconstructed ear. The minimally invasive scalp incision can effectively reduce the occurrence of scar hyperplasia and postoperative alopecia at the scalp incision.
Humans
;
Plastic Surgery Procedures/methods*
;
Retrospective Studies
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Surgical Flaps
;
Tissue Scaffolds
;
Polyethylene
;
Ear Auricle/surgery*
;
Male
;
Scalp/surgery*
;
Female
;
Skin Transplantation
;
Fascia/transplantation*
;
Porosity
;
Adult
;
Middle Aged
2.Summary and analysis of total auricle reconstruction in adult microtia patients.
Xiu WANG ; Zhen Po ZHANG ; Xu Lun GUO ; Zhuo Fan YANG ; Teng Xiao MA ; Zheng Wen ZHANG
Chinese Journal of Otorhinolaryngology Head and Neck Surgery 2023;58(5):476-480
Objective: To observe the clinical effect of auricle reconstruction in adult patients with microtia and summarize the experience. Methods: Clinical data of adult patients with microtia who underwent total auricle reconstruction using the modified Nagata's two stage for microtia reconstruction from June 2016 to June 2021 were analyzed. A total of 41 adult patients (42 ears) with microtia were enrolled, including 30 males and 11 females, with the median age at the time of surgery of 37 years. Autogenous costal cartilage was used as the auricular framework for all patients in this group. The first stage surgery was performed according to the modified Nagata's two stage for microtia reconstruction procedure,cartilage auricular framework carving was performed by different methods according to the ossification state of adult costal cartilage. Six months following the primary operation, ear elevation and cranioauricular angle formation, retroauricular facial flap transfer and medium-thick skin grafting were performed in the second stage. Results: All patients successfully completed two stage operation. During the follow-up of 3 months and 24 months, all the 41 patients were satisfied with the morphology of reconstructed auricle. Conclusion: According to the costal cartilage status of adult patients, different costal cartilage carving techniques can be used for total auricle reconstruction to obtain ideal surgical results.
Male
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Female
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Humans
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Adult
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Surgical Flaps
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Congenital Microtia/surgery*
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Plastic Surgery Procedures
;
Ear, External/surgery*
;
Ear Auricle/surgery*
4.Correction of severe cup ears using postauricular tongue-shaped flap combined with deep fascial suspension.
Ying GUO ; Chen Long LI ; Yao Yao FU ; Tian Yu ZHANG
Chinese Journal of Otorhinolaryngology Head and Neck Surgery 2021;56(4):323-328
Objective: To investigate the effect and satisfaction of using the postauricular tongue-shaped flap combined with deep fascia suspension in correcting severe cup ear malformation. Methods: Between August 2018 and November 2019, nine cases (10 ears) of Tanzer type Ⅲ severe cup ear malformation were treated with postauricular tongue-shaped flap combined with deep fascia suspension in this study. Results: Nine cases primary healed without hematoma, infection or skin necrosis, except one case with postoperative incision dehiscence. The cup ear deformity was significantly improved after the operation, the helix was intact, and the anti-helix was visible. The length, width, and circumference of the auricle were significantly enlarged three months following surgeries. There were no other complications except 1 patient recurrence 12 months after surgery. The patients were highly satisfied with the results of the surgery. Conclusions: Although the aesthctic of the reconstructed auricle is insufficient, this new technology makes full use of the autologous auricle tissue to correct severe cup ear malformation with good results.
Ear Auricle/surgery*
;
Ear, External/surgery*
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Humans
;
Reconstructive Surgical Procedures
;
Surgical Flaps
;
Tongue
5.Treatment effect of hemifacial dysplasia by injecting transplantation of autologous tissue in the second stage surgery for total auricle reconstruction.
Dong Yi ZHANG ; Lu Lu ZHANG ; Zhi Peng WANG ; Ying Wei XU ; Qing Liang LIU ; Shang Hua ZHAO ; Shen Song KANG
Chinese Journal of Otorhinolaryngology Head and Neck Surgery 2021;56(6):643-647
Objective: To observe the treatment effect of hemifacial dysplasia by injecting transplantation of autologous dermis and fat granules in the second stage surgery for total auricle reconstruction. Methods: From March 2013 to March 2018, 57 patients with unilateral microtia and mild-to-moderate hemifacial dysplasia were divided into concurrent treatment group (32 cases, including 13 females and 19 males and aged 6-33 years old with an average age of 12.5 years) and traditional treatment group (25 cases, including 10 females and 15 males and aged 6-21 years old with an average age of 11.3 years) according to the different surgical methods. Modified Nagata method of auricular reconstruction was chosen, in the second stage surgery (cranial ear angle plasty), patients in concurrent treatment group received the treatment of hemifacial dysplasia with autologous dermal and fat injection transplantation at the same time; Patients in traditional treatment group only received cranial ear angle plasty. Statistical analysis of the two groups of patients was carried out for the average operation time, the average length of hospital stay, the incidence of common complications and postoperative satisfaction rate. SPSS 21.0 software was used for statistical analysis. Results: The mean operation time of the concurrent treatment group (282.0±3.4)min was longer than that of the traditional treatment group (243.0±3.1)min, and the difference was statistically significant (t=9.884, P<0.05). There were no statistically significant differences in the average length of stay between the the concurrent treatment group (9.4±0.3)d and the traditional treatment group(9.5±0.2)d, t=0.256, P>0.05. There were no statistically significant differences in the incidence of common surgical complications between the concurrent treatment group (12.5%, 4/32) and the traditional treatment group(12.0%, 3/25), χ2=0, P>0.05. Postoperative satisfaction rate of the concurrent treatment group(90.6%, 29/32) was significantly higher than that of the traditional treatment group(56.0%, 14/25), the difference was statistically significant (χ2=9.081, P<0.05). Conclusions: Auricular reconstruction with treatment of hemifacial dysplasia should not significantly increase the average length of stay and the incidence of common complications compared with auricular reconstruction alone. Although the operation time is slightly extended, the scheme of concurrent treatment can reduce the times of operations, save medical resources and increase the satisfaction rate of patients.
Adolescent
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Adult
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Child
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Congenital Microtia/surgery*
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Ear Auricle/surgery*
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Ear, External/surgery*
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Female
;
Humans
;
Male
;
Operative Time
;
Reconstructive Surgical Procedures
;
Treatment Outcome
;
Young Adult
7.Analyses of the factors relevant to revision tympanomastoid surgery.
Li LI ; Zhaomin FAN ; Yuechen HAN ; Lei XU ; Dong CHEN ; Haibo WANG
Chinese Journal of Otorhinolaryngology Head and Neck Surgery 2016;51(5):333-337
OBJECTIVETo analyze factors relevant to revisional tympanomastoid surgery for chronic otitis media(COM).
METHODSThe clinical data of 159 patients (159 ears), who exhibited either wet ear or relapsed after the initial operation, and were subjected to revisional tympanomastoid surgery, were retrospectively analyzed in this study. Of those 159 consecutive patients, 85 were males and 74 were females, aged 11-64 years, with a median age of 36 years old. The situations in terms of intra-operative findings, surgical procedures, change dressing post-operation, dry ear time, and the improvement of aural ability during the second operation, were recorded and analyzed.
RESULTSThe second surgery found that, of those 159 patients underwent the re-operation, 67 presented with cholesteatoma and 92 had no cholesteatoma. In addition, the inadequate skeletonization and insufficient opening for mastoid cavity accounted for 70.4% (112/159) of all previous operations, the external auditory canal stenosis for 98.7% (157/159), the high facial ridge leading to insufficient drainage for 61.0% (97/159), the lesion in tympanic ostium of Eustachian tube for 34.6% (55/159), the insufficient drainage due to inappropriate post-operating dressing for 5.0% (8/159), the postauricular incision for 30.8% (49/159), and the endaural incision for 69.2% (110/159). As for the re-operation of the canal wall down mastoidectomy, tympanoplasty plus plastic repairing of cavity of concha were performed in 94 cases, the modified Bondy plus plastic repairing of cavity of concha in four cases, the radical mastoidectomy plus plastic repairing of cavity of concha in 59 cases, and the simple cleaning for mastoid cavity in two cases. Since one to two weeks after the revisional operations, the post-operating dressing was performed with aid of microscopy once a week on average. The average dry ear time ranged from 2 to 6 weeks (median=3 weeks). During a period of 6-93 months for the follow-up, all patients presented with dry ears. The epithelialization of the operating cavity was well and the tympanic membranes were integrity. Neither granulation tissue nor cholesteatoma was found to reoccur. Both pure tone hearing thresholds and air-bone gap decreased in 87 cases after the revisional operation, with statistically significant different in comparison to those two parameters before the operation (P<0.05).
CONCLUSIONThe primary causes responsible for the wet ear or reoccurrent cholesteatoma after tympanomastoid surgery may be related to the improper operation procedures and selection of incision, the non-standard operation, inexhaustive removal of pathological tissues, as well as the irregular postoperation change dressing, and other factors.
Adolescent ; Adult ; Child ; Cholesteatoma, Middle Ear ; surgery ; Chronic Disease ; Ear Auricle ; surgery ; Eustachian Tube ; pathology ; Female ; Humans ; Male ; Mastoid ; surgery ; Middle Aged ; Otitis Media ; surgery ; Postoperative Period ; Reconstructive Surgical Procedures ; Reoperation ; Retrospective Studies ; Treatment Outcome ; Tympanic Membrane ; pathology ; surgery ; Tympanoplasty ; Young Adult
8.Therapeutic efficacy of a modified method with splints in correction of cryptotia.
Zhu HUIDONG ; Huang WEIGUANG ; Lan FUJIN
Chinese Journal of Plastic Surgery 2015;31(5):335-336
OBJECTIVETo explore the therapeutic efficacy of a modified method with splints in correction of cryptotia.
METHODSFrom Oct. 2012 to Jan. 2014, 3 cases with unilateral cryptotia were treated with the modified method with splints. The muscles attached to the periosteum of cartilage were dissected. The muscles between the ear and temper were cut off. Then one silicon tube was put around the ear through cranioauricular sulcus. The other tube was placed within the cavum conchae and fixed with the tube around the ear.
RESULTSNo flap necrosis happened. The patients were followed up for six months to one year with satisfied and stable results.
CONCLUSIONSThe modified method is easy to perform with less morbidity. It is one of the ideal correction for cryptotia.
Ear Auricle ; abnormalities ; surgery ; Ear Cartilage ; abnormalities ; surgery ; Humans ; Reconstructive Surgical Procedures ; instrumentation ; methods ; Splints
9.Application of double pedicle sliding skin flap in cryptotia correction.
Chinese Journal of Plastic Surgery 2015;31(5):332-334
OBJECTIVETo explor the curative effect of double pedicle sliding skin flap for correction of cryptotia.
METHODSFrom January 2011 to October 2014, 7 cases with cryptotia (12 ears) were treated. We designed a double pedicle sliding skin flap above the helix. The flap was slided downward to form a new auriculocephalic sulcus. The other wound was covered by skin graft.
RESULTSAll wounds healed very well with no complication. The follow-up period ranged from 3 months to 1 year, with an average of (5.67 ± 3.38) months. The ear had stable appearance with no recurrence. The result was satisfactory.
CONCLUSIONSThe method is simple with reliable flap survival rates. The new auriculocephalic sulcus is stable and resistant. It's a good choice for correction of cryptotia.
Ear Auricle ; abnormalities ; surgery ; Ear Cartilage ; abnormalities ; surgery ; Follow-Up Studies ; Graft Survival ; Humans ; Reconstructive Surgical Procedures ; methods ; Surgical Flaps ; transplantation ; Time Factors ; Wound Healing
10.The clinical application of rectangle window method treating pseudocyst of auricle.
Wenli TU ; Weihai SONG ; Niangen WANG ; Youlin DONG ; Jieyi WANG ; Juanfang SHI
Journal of Clinical Otorhinolaryngology Head and Neck Surgery 2015;29(23):2076-2077
OBJECTIVE:
To summarize pseudocyst of auricle governor square included surgical curative effect, the advantages of the analysis of the operation.
METHOD:
The governor of the central square in auricle pseudocyst incision, 56 cases were retrospectively analyzed clinical data, surgical curative effect and advantages were summarized.
RESULT:
Adopt the auricle pseudocyst governor of the central square of incision, postoperative follow-up of 6 months did not relapse.
CONCLUSION
Rectangle window method effective method of treating pseudocyst of auricle, able to cure pseudocyst of auricle, is a kind of simple, practical, and value in the basic-level hospital surgical method.
Cysts
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surgery
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Ear Auricle
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pathology
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Ear Diseases
;
surgery
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Humans
;
Otologic Surgical Procedures
;
methods
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Postoperative Period
;
Retrospective Studies

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