title: [Modified two-stage surgery for total auriculoplasty with autogenous rib cartilage].
abstract: OBJECTIVE
  To introduce a modified surgery for total auriculoplasty and the experience in one hundred and forty-six cases (155 ears).
  
  
  METHODS
  The procedure was a two-stage operation. The first stage involved fabrication and grafting of a costal cartilage framework. A U-shaped skin incision was made on the posterior edge of the lobule and the remnant ear cartilage was removed completely. The area for the insertion of the cartilage framework was undermined. Skin flaps were sutured after insertion of the cartilage framework. The second-stage surgery was usually performed six months after the first-stage operation. The reconstructed auricle was elevated, and a costal cartilage block was fixed to the posterior part of the auricle. A temporoparietal fascia flap was then used to cover the costal cartilage block. Finally, the posterior aspect of the projected auricle was covered with a spit-thickness skin graft.
  
  
  RESULTS
  The incisions healed in one hundred and forty-one patients (150 ears) after the first stage operation. Partial necrosis of the postauricular flap was observed in five cases (5 ears) after the first stage operation, but no exposure or absorption of the cartilage took place. The skin grafts survived in one hundred and thirty-nine cases (147 ears) after the second-stage surgery. Partial necrosis of the skin graft was observed in seven cases (8 ears), but healed after one-week of dressing changes. Ninety-four cases (97 ears) were followed up, but fifty-two cases (58 ears) were lost to follow up. The follow-up at six months to two years showed satisfactory contour and projection of the constructed ears.
  
  
  CONCLUSIONS
  This two-stage surgery is simple and ideal for auricloplasty with few complications.
authors.affiliation: Department of Plastic Surgery, Henan Provincial People's Hospital, Zhengzhou 450003, China. zzw6114@sina.com
authors.forename: Zheng-wen
authors.initials: ZW
authors.lastname: Zhang
authors.forename: Shen-song
authors.initials: SS
authors.lastname: Kang
authors.forename: Feng
authors.initials: F
authors.lastname: Xie
authors.forename: Teng-xiao
authors.initials: TX
authors.lastname: Ma
authors.forename: Lei
authors.initials: L
authors.lastname: Li
authors.forename: Hong-feng
authors.initials: HF
authors.lastname: Zhai
authors.forename: Hai-yan
authors.initials: HY
authors.lastname: Chou
authors.forename: Hao
authors.initials: H
authors.lastname: Li
authors.forename: Ai-mei
authors.initials: AM
authors.lastname: Zhong
authors.forename: Dong-yi
authors.initials: DY
authors.lastname: Zhang
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D002675:Child, Preschool; D054644:Ear Auricle / Q000601:surgery*; D004431:Ear, External / Q000601:surgery; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D019651:Plastic Surgery Procedures / Q000379:methods*; D016038:Skin Transplantation / Q000379:methods*; D013524:Surgical Flaps; D055815:Young Adult