title: Refinements in the elevation of reconstructed auricles in microtia.
abstract: 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.
authors.affiliation: Department of Plastic and Reconstructive Surgery and Maxillofacial Surgery, Kurume University School of Medicine, Fukuoka 830-0011, Japan. prsmf@med.kurume-u.ac.jp
authors.forename: Yoshiaki
authors.initials: Y
authors.lastname: Tai
authors.forename: Shinsuke
authors.initials: S
authors.lastname: Tanaka
authors.forename: Junichi
authors.initials: J
authors.lastname: Fukushima
authors.forename: Yuichiro
authors.initials: Y
authors.lastname: Kizuka
authors.forename: Kensuke
authors.initials: K
authors.lastname: Kiyokawa
authors.forename: Yojiro
authors.initials: Y
authors.lastname: Inoue
authors.forename: Toshihiko
authors.initials: T
authors.lastname: Yamauchi
mesh_terms: 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