EAR RECONSTRUCTION FOR MICROTIA WITH CRANIOFACIAL DEFORMITIES_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

HE Leren ¹ , ZHANG Jinguang ² , JIANG Haiyue ¹ , YANG Qinghua ¹ , ZHUANG Hongxing ¹

1The Seventh Plastic Department, Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100144, P.R.China;;
2Department of Plastic Surgery, Tongzhou Luhe Hospital of Beijing. Corresponding author: JIANG Haiyue, E-mail: jianghaiyue@sohu.com;

Corresponding author：

Keywords：

Ear reconstruction; Microtia; Hemifacial microsoma; New ear location

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Objective To investigate the methods and effectiveness of ear reconstruction for the microtia patients with craniofacial deformities. Methods Between July 2000 and July 2010, ear reconstruction was performed with tissue expander and autogenous costal cartilages in 1 300 microtia patients with degree II+ hemifacial microsoma, and the clinical data were reviewed and analyzed. There were 722 males and 578 females, aged 5 years and 8 months to 33 years and 5 months (median, 12 years and 2 months). The expander was implanted into the retroauricular region in stage I; ear reconstruction was performed after 3-4 weeks of expansion in stage II; and reconstructed ear reshaping was carried out at 6 months to 1 year after stage II in 1 198 patients. Results Of 1 300 patients, delayed healing occurred in 28 cases after stage II, healing by first intention was obtained in the other 1 272 cases, whose new ears had good position and appearance at 1 month after stage II. After operation, 200 cases were followed up 1-9 years (mean, 3 years). One case had helix loss because of trauma, and 1 case had the new ear loss because of fistula infection. At last follow-up, the effectiveness were excellent in 110 cases, good in 65 cases, and fair in 23 cases with an excellent and good rate of 88.4%. Conclusion It is difficulty in ear reconstruction that the reconstructed ear is symmetrical to the contralateral one in the microtia patients with degree II+ hemifacial microsoma. The key includes the location of new ear, the fabrication of framework, and the utilization of remnant ear.

Citation： HE Leren,ZHANG Jinguang,JIANG Haiyue,YANG Qinghua,ZHUANG Hongxing. EAR RECONSTRUCTION FOR MICROTIA WITH CRANIOFACIAL DEFORMITIES. Chinese Journal of Reparative and Reconstructive Surgery, 2012, 26(12): 1477-1481. doi: Copy

1.	Brent B. The correction of microtia with autogenous cartilage grafts: I. The classic deformity? Plast Reconstr Surg, 1980, 66(1): 1-12.
2.	Brent B. The correction of microtia with autogenous cartilage grafts: II. A typical and complex deformities. Plast Reconstr Surg, 1980, 66(1): 13-21.
3.	Brent B. Technical advances in ear reconstruction with autogenous rib cartilage grafts: personal experience with 1200 cases. Plast Reconstr Surg, 1999, 104(2): 319-334.
4.	Nagata S. Modification of the stages in total reconstruction of the auricle: Part I. Grafting the three-dimensional costal cartilage framework for lobule-type microtia. Plast Reconstr Surg, 1994, 93(2): 221-230.
5.	Nagata S. Modification of the stages in total reconstruction of the auricle. Part II. Grafting the three-dimensional costal cartilage framework for lobule-type microtia. Plast Reconstr Surg, 1994, 93(2): 231-242.
6.	Fukuda O. Long-term evaluation of modified Tanzer ear reconstruction. Clin Plast Surg, 1990, 17(2): 241-249.
7.	Song YG, Song YL. An improved one-stage total ear reconstruction procedure. Plast Reconstr Surg, 1983, 71(5): 615-623.
8.	庄洪兴, 蒋海越, 潘博, 等. 先天性小耳畸形的皮肤软组织扩张器法外耳再造术. 中华整形外科杂志, 2006, 22(4): 286-289.
9.	Jiang H, Pan B, Lin L, et al. Ten-year experience in microtia reconstruction using tissue expander and autogenous cartilage. Int J Pediatr Otorhinolaryngol, 2008, 72(8): 1251-1259.
10.	Pan B, Jiang H, Guo D, et al. Microtia: ear reconstruction using tissue expander and autogenous costal cartilage. J Plast Reconstr Aesthet Surg, 2008, 61 Suppl 1: S98-103.
11.	Zhang Q, Quan Y, Su Y, et al. Expanded retroauricular skin and fascial flap in congenital microtia reconstruction. Ann Plast Surg, 2010, 64(4): 428-434.
12.	Jiang H, Pan B, Zhao Y, et al. A 2-stage ear reconstruction for microtia. Arch Facial Plast Surg, 2011, 13(3): 162-166.
13.	Chen Z, Zhang W, Huang J, et al. Exceedingly expanded retroauricular flaps for microtia reconstruction. J Plast Reconstr Aesthet Surg, 2011, 64(11): 1448-1453.
14.	Liu J, Sun J, Li X. Total auricular reconstruction without skin grafting. J Plast Reconstr Aesthet Surg, 2011, 64(10): 1312-1317.
15.	Park C. Subfascial expansion and expanded two-flap method for microtia reconstruction. Plast Reconstr Surg, 2000, 106(7): 1473-1487.
16.	Bauer BS. The role of tissue expansion in reconstruction of the ear. Clin Plast Surg, 1990, 17(2): 319-325.
17.	Hata Y, Umeda T. Reconstruction of congenital microtia by using a tissue expander. J Med Dent Sci, 2000, 47(2): 105-116.
18.	Breugem CC, Stewart KJ, Kon M. International trends in the treatment of microtia. J Craniofac Surg, 2011, 22(4): 1367-1369.
19.	Park C. An algorithm and aesthetic outcomes for a coverage method for large- to medium-remnant microtia: I. Coverage in the one-stage erect position. Plast Reconstr Surg, 2012, 129(5): 803e-813e.
20.	Jinguang Z, Leren H, Hongxing Z. Prevention and treatment of rupture and infection in expanded flaps during auricular reconstruction. J Craniofic Surg, 2010, 21(5): 1622-1625.

1. Brent B. The correction of microtia with autogenous cartilage grafts: I. The classic deformity? Plast Reconstr Surg, 1980, 66(1): 1-12.
2. Brent B. The correction of microtia with autogenous cartilage grafts: II. A typical and complex deformities. Plast Reconstr Surg, 1980, 66(1): 13-21.
3. Brent B. Technical advances in ear reconstruction with autogenous rib cartilage grafts: personal experience with 1200 cases. Plast Reconstr Surg, 1999, 104(2): 319-334.
4. Nagata S. Modification of the stages in total reconstruction of the auricle: Part I. Grafting the three-dimensional costal cartilage framework for lobule-type microtia. Plast Reconstr Surg, 1994, 93(2): 221-230.
5. Nagata S. Modification of the stages in total reconstruction of the auricle. Part II. Grafting the three-dimensional costal cartilage framework for lobule-type microtia. Plast Reconstr Surg, 1994, 93(2): 231-242.
6. Fukuda O. Long-term evaluation of modified Tanzer ear reconstruction. Clin Plast Surg, 1990, 17(2): 241-249.
7. Song YG, Song YL. An improved one-stage total ear reconstruction procedure. Plast Reconstr Surg, 1983, 71(5): 615-623.
8. 庄洪兴, 蒋海越, 潘博, 等. 先天性小耳畸形的皮肤软组织扩张器法外耳再造术. 中华整形外科杂志, 2006, 22(4): 286-289.
9. Jiang H, Pan B, Lin L, et al. Ten-year experience in microtia reconstruction using tissue expander and autogenous cartilage. Int J Pediatr Otorhinolaryngol, 2008, 72(8): 1251-1259.
10. Pan B, Jiang H, Guo D, et al. Microtia: ear reconstruction using tissue expander and autogenous costal cartilage. J Plast Reconstr Aesthet Surg, 2008, 61 Suppl 1: S98-103.
11. Zhang Q, Quan Y, Su Y, et al. Expanded retroauricular skin and fascial flap in congenital microtia reconstruction. Ann Plast Surg, 2010, 64(4): 428-434.
12. Jiang H, Pan B, Zhao Y, et al. A 2-stage ear reconstruction for microtia. Arch Facial Plast Surg, 2011, 13(3): 162-166.
13. Chen Z, Zhang W, Huang J, et al. Exceedingly expanded retroauricular flaps for microtia reconstruction. J Plast Reconstr Aesthet Surg, 2011, 64(11): 1448-1453.
14. Liu J, Sun J, Li X. Total auricular reconstruction without skin grafting. J Plast Reconstr Aesthet Surg, 2011, 64(10): 1312-1317.
15. Park C. Subfascial expansion and expanded two-flap method for microtia reconstruction. Plast Reconstr Surg, 2000, 106(7): 1473-1487.
16. Bauer BS. The role of tissue expansion in reconstruction of the ear. Clin Plast Surg, 1990, 17(2): 319-325.
17. Hata Y, Umeda T. Reconstruction of congenital microtia by using a tissue expander. J Med Dent Sci, 2000, 47(2): 105-116.
18. Breugem CC, Stewart KJ, Kon M. International trends in the treatment of microtia. J Craniofac Surg, 2011, 22(4): 1367-1369.
19. Park C. An algorithm and aesthetic outcomes for a coverage method for large- to medium-remnant microtia: I. Coverage in the one-stage erect position. Plast Reconstr Surg, 2012, 129(5): 803e-813e.
20. Jinguang Z, Leren H, Hongxing Z. Prevention and treatment of rupture and infection in expanded flaps during auricular reconstruction. J Craniofic Surg, 2010, 21(5): 1622-1625.

Chinese Journal of Reparative and Reconstructive Surgery

EAR RECONSTRUCTION FOR MICROTIA WITH CRANIOFACIAL DEFORMITIES

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