Refinements in the elevation of reconstructed auricles in microtia.
BACKGROUND
In the treatment of microtia, the search has been for surgical techniques that prevent postoperative complications and realize sufficient and stable projection of the constructed ear.


METHODS
Cartilage was fixed with absorbable synthetic thread instead of wire because wire has a high risk of exposure. A subcutaneous pedicle was added to the concha to prevent skin necrosis. Dead space and hematoma creation were prevented with vacuum aspiration, bolster fixation, and microdrainage with small tubes. A triangular skin flap connecting to the ear lobe was used to prevent shrinkage on the posteroinferior portion of the concha. Projection of the inferior portion of the auricle was supported with a hydroxyapatite-tricalcium phosphate ceramic.


RESULTS
Our technique was applied to 42 patients, and none of them experienced slip of the fixed cartilage, auricular deformation, skin necrosis, or infections. Shrinkage of the inferior portion of the auricle was minimal, and good projection was obtained.


CONCLUSIONS
The authors' technique prevents complications and realizes good shape and projection of the auricle in total reconstruction of the auricle. Hydroxyapatite-tricalcium phosphate ceramic is a useful material that complements the cartilage shortage.
Tai
Yoshiaki
Y
Department of Plastic and Reconstructive Surgery and Maxillofacial Surgery, Kurume University School of Medicine, Fukuoka 830-0011, Japan. prsmf@med.kurume-u.ac.jp
Tanaka
Shinsuke
S
Fukushima
Junichi
J
Kizuka
Yuichiro
Y
Kiyokawa
Kensuke
K
Inoue
Yojiro
Y
Yamauchi
Toshihiko
T
D002648:Child; D004427:Ear Diseases / Q000151:congenital / Q000601:surgery*; D004431:Ear, External / Q000002:abnormalities / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D013506:Otologic Surgical Procedures / Q000379:methods*; D019651:Plastic Surgery Procedures / Q000379:methods*; D016896:Treatment Outcome