title: [Total auricular reconstruction with single big expander at dual plane through incision at remnant ear].
abstract: OBJECTIVE
  To investigate the feasibility and advantages of total auricular reconstruction with single big expander at dual plane through incision at remnant ear.
  
  
  METHODS
  52 patients with microtia were treated. Through incision at remnant ear, one big expander (150 ml) was implanted in the post-auricular area beneath the superficial facial in the hairless area, and above the superficial fascia in the area with hair. In the second stage, total auricular was reconstructed with autologous cartilage framework and expanded skin. Skin graft was not necessary. Another 32 paitents with single big expander above the superficial fascia were used as control. The downward shift distance of expanders, the appearance of auriculocephalic sulcus and complication were recorded in order to assess the effect of these two methods.
  
  
  RESULTS
  The downward shift distance of expanders in the dual plane group (0.7 ± 0.3) cm were lower than that in the control group (1.3 ± 0.4) cm, showing significant difference (P < 0.05). After a follow-up period of 6-12 months, shallow auriculocephalic sulcus was presented in 5 patients of the dual plane group and 12 patient of the control group. The shallow auriculocephalic sulcus was cut to make it deeper and covered with full skin graft.
  
  
  CONCLUSIONS
  Dual plane skin expansion could reduce the downward shift distance of expander. Adequate skin on the upper part of expander could make satisfactory auriculocephalic sulcus.
authors.forename: Liu
authors.initials: L
authors.lastname: Jiafeng
authors.forename: Li
authors.initials: L
authors.lastname: Xiaodan
authors.forename: Sun
authors.initials: S
authors.lastname: Jianming
mesh_terms: D002356:Cartilage / Q000637:transplantation*; D065817:Congenital Microtia / Q000601:surgery*; D005240:Feasibility Studies; D006197:Hair; D006801:Humans; D019651:Plastic Surgery Procedures / Q000379:methods*; D016038:Skin Transplantation / Q000379:methods; D040521:Subcutaneous Tissue; D013524:Surgical Flaps / Q000639:trends*; D015626:Tissue Expansion / Q000379:methods*; D015625:Tissue Expansion Devices