ZHANG Zhenyu , LIU Ruiqi , WANG Ru , TANG Jun , LIU Chuanqi , CHEN Xinghan , CEN Ying , LI Zhengyong
  • Department of Aesthetic Plastic and Burn Surgery, West China Hospital, Sichuan University, Chengdu Sichuan, 610041, P.R.China;
LI Zhengyong, Email: lizydd@sina.com
Microtia; auricular reconstruction; cartilage scaffold; mechanical equilibrium
10.7507/1002-1892.201807137
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Objective To summarize clinical experience and curative effect in applying three-dimensional mechanical equilibrium concept to cartilage scaffold construction in total auricular reconstruction.Methods Between June 2015 and June 2017, ninety-seven microtia patients (102 ears) were treated with total ear reconstruction by using tissue expanders. The patients included 43 males and 54 females and their age ranged from 7 to 45 years with an average of 14 years. There were 92 unilateral cases (45 in left side and 47 in right side) and 5 bilateral ones. There were 89 congenital cases and 8 secondary cases. According to microtia classification criteria, there were 21 cases of type Ⅱ, 67 cases of type Ⅲ, and 9 cases of type Ⅳ. Tissue expander was implanted in the first stage. In the second stage, autogenous cartilage was used to construct scaffolds which were covered by enlarged flap. According to the three-dimensional mechanical equilibrium concept, the stable ear scaffold was supported by the scaffolds base, the junction of helix and inferior crura of antihelix, and helix rim. The reconstructed ears were repaired in the third stage operation.Results All patients had undergone ear reconstruction successfully and all incisions healed well. No infection, subcutaneous effusion, or hemorrhage occurred after operation. All skin flaps, grafts, and ear scaffolds survived completely. All patients received 5- to 17-month follow-up time (mean, 11.3 months) and follow-up time was more than 12 months in 61 cases (64 ears). All reconstructed ears stood upright, and subunits structure and sensory localization of reconstructed ears were clear, and the position, shape, size, and height of bilateral ears were basically symmetrical. Mastoid region scar hyperplasia occurred in 3 patients, which was relieved by anti-scar drugs injection. No scaffolds exposure, absorption, or structural deformation occurred during follow-up period.Conclusion Application of three-dimensional mechanical equilibrium concept in cartilage scaffold construction can reduce the dosage of costal cartilage, obtain more stable scaffold, and acquire better aesthetic outcomes.

Citation： ZHANG Zhenyu, LIU Ruiqi, WANG Ru, TANG Jun, LIU Chuanqi, CHEN Xinghan, CEN Ying, LI Zhengyong. Application of three-dimensional mechanical equilibrium concept in cartilage scaffold construction for total auricular reconstruction. Chinese Journal of Reparative and Reconstructive Surgery, 2019, 33(3): 332-336. doi: 10.7507/1002-1892.201807137 Copy

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