Aesthetic microtia reconstruction with Medpor.
The complex architecture of the auricle makes it one of the most challenging structures for the reconstructive surgeon to re-create. Overlying the ear's unique cartilage framework are layers of varied soft tissues forming a three-dimensional organ, which is distinctively positioned on the head. Arguably, the most challenging auricle to reconstruct is third-degree microtia due to a near-total absence of native tissue and a need for lifelong durability of the reconstruction. Many methods of reconstruction have been studied; autogenous costal cartilage reconstruction has been one of the more traditional methods, with favorable long-term results reported by several surgeons. However, this technique requires tremendous artistic and technical skill on the part of the surgeon-sculptor to construct a realistic-appearing ear. High-density porous polyethylene (Medpor) is a stable, alloplastic implant that can integrate with host tissues, is resistant to infection, and has been successfully applied to reconstruction of the head and neck. For auricular reconstruction, Medpor--enveloped in a temporoparietal fascial flap with full-thickness skin graft coverage--is a durable and aesthetically gratifying alternative in microtic patients. This alternative surgical technique reduces surgical time and morbidity, standardizes results among surgeons, and facilitates an aesthetic, natural-appearing reconstruction of the auricle.
Romo
Thomas
T
Division of Facial Plastic & Reconstructive Surgery, Lenox Hill Hospital, New York, New York 10021, USA.
Reitzen
Shari D
SD
D001672:Biocompatible Materials; D004431:Ear, External / Q000002:abnormalities* / Q000601:surgery; D004954:Esthetics; D005205:Fascia / Q000637:transplantation; D006801:Humans; D010347:Patient Care Planning; D011095:Polyethylenes; D011182:Postoperative Care; D011183:Postoperative Complications; D019736:Prostheses and Implants; D011474:Prosthesis Design; D019919:Prosthesis Implantation; D019651:Plastic Surgery Procedures / Q000009:adverse effects / Q000145:classification / Q000379:methods*; D016038:Skin Transplantation / Q000379:methods
D001672:Biocompatible Materials; C084562:Medpor; D011095:Polyethylenes