Objective To discuss the effects of the temporoparietal fascial flap and the postauricular fascial flap as the materials to cover the postauricular-frame during the second stage operation of the total auricular reconstruction Methods From June 2005 to May 2007, the second stage elevation of the reconstructed auricle was performed at 6-10 months after the first stage total auricular reconstruction for 72 cases (left 31, right 41), 47 males and 25 females, aged 5-28 years old (12on average). According to the Nagata’s classification, 56 cases were lobule-type microtia with no external auditory canal, and the other 16 cases were concha-type microtia with external auditory canal (narrow in 9 cases). Homolateral temporoparietal fascial flap was used to cover the postauricular-frame in 29 patients (group A), and the homolateral postauricular fascial flap was used in the other 43 patients (group B). Results All the patients were followed up for 3-22 months. A total of 55 cases had excellent skin flap and fascial flap (22 in group A and 33 in group B). Darker epidermis could be seen in 15 cases (6 in group A and 9 in group B), and it healed within one month after the operation. Two cases (1 in group A and 1 in group B) suffering from partial grafted skin and fascial flap necrosis (lt; 1 cm2) healed by means of coverage of local flap transfer. All the patients’ reconstructed auriculocephal ic angles were close to the normal side. There existed scars of varying degrees at the area of skin graft in both groups: 47 cases had flat scars (19 in group A and 28 in group B); 18 cases had hyperplastic scars (7 in group A and 11 in group B); and 7 cases had severe scars with the auriculocephal ic angles draw-off (3 in group A and 4 in group B). Furthermore, there were obvious scars in temporal region and severe hair thinning at the donor site in group A, but there were no such conditions in group B. At 6 months of follow-up, reduction of the auriculocephal ic angle occurred in 3 cases of group A and obvious in 5 cases of group B (gt; 0.5 cm). Conclusion Both the temporoparietal fascial flap and the postauricular fascial flap can be appl ied to cover the postauricular-framework in the second stage reconstructed ear elevation, with superiority of the latter over the former.
Objective To explore an effective method to repair penile-scrotal or perineal hypospadias in one stage with prepuce island flap.Methods Different prepuce island flaps were designed according to thedifferent pathological anatomy of the penile-scrotal or perineal hypospadias. The prepuce island flaps were thus translocated and sutured to form the urethra.Thirty-one cases of hypospadias (21 cases of peinil-scrotal type, 10 cases of perineal type) were repaired with prepuce island flap.The biggest length and the width of the prepuce island flapwere 7.5 cm and 1.5-1.8 cm respectively.Results All the cases resulted in a good contour of the penis and a normal anatomic position of urethral meatus without any redundancy or tortuosity.The urination was perfect and acceptable.Conclusion One stage repair of penilescrotal or perineal hypospadias with prepuce island flap can be considered as an acceptable effective surgical technique.