title: Surgical Reconstruction of Traumatic Partial Ear Defects Based on a Novel Classification of Defect Sizes and Surrounding Skin Conditions.
abstract: BACKGROUND
  Although a standard classification system and corresponding reconstruction methods are well described for microtia, establishing a classification system and corresponding surgical strategies for traumatic ear defects is difficult because the size, shape, and local skin conditions of each defect differ considerably. In this article, the authors describe a useful new classification system and corresponding surgical approaches.
  
  
  METHODS
  Ear defects were classified into four types according to defect size and surrounding skin conditions. Defects in which the postauricular skin is of good quality are classified as types I, II, and III. The rest are type IV defects. Four ears (type I defects) were reconstructed using conchal cartilage and posterior auricular flaps. In 51 ears, costal cartilage and posterior auricular flaps were used for single-stage (type II defects, n = 31) or two-stage (type III defects, n = 20) reconstructions. In five instances of severe posterior auricular cutaneous scarring (type IV defects), temporoparietal fascial flaps were created to cover costal cartilage frameworks.
  
  
  RESULTS
  Sixty subjects with traumatic partial ear defects were followed for 6 months to 6 years. Most (n = 55) were satisfied with their results. Two patients complained of an unnatural junction between the graft framework and residual ear stump. One was dissatisfied with the reduced ear size, caused by improper fixation and skin flap contraction. Another developed minor framework exposure because of skin necrosis, which healed with conservative management.
  
  
  CONCLUSIONS
  Using our new classification system for partial traumatic ear defects based on defect size and contiguous skin condition, the corresponding surgical repair approach was applied consistently, yielding acceptable results and few complications.
  
  
  METHODS
  Therapeutic, IV.
authors.affiliation: Shanghai, People's Republic of China.|From the Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine.
authors.forename: Datao
authors.initials: D
authors.lastname: Li
authors.affiliation: Shanghai, People's Republic of China.|From the Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine.
authors.forename: Feng
authors.initials: F
authors.lastname: Xu
authors.affiliation: Shanghai, People's Republic of China.|From the Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine.
authors.forename: Ruhong
authors.initials: R
authors.lastname: Zhang
authors.affiliation: Shanghai, People's Republic of China.|From the Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine.
authors.forename: Qun
authors.initials: Q
authors.lastname: Zhang
authors.affiliation: Shanghai, People's Republic of China.|From the Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine.
authors.forename: Zhicheng
authors.initials: Z
authors.lastname: Xu
authors.affiliation: Shanghai, People's Republic of China.|From the Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine.
authors.forename: Yiyuan
authors.initials: Y
authors.lastname: Li
authors.affiliation: Shanghai, People's Republic of China.|From the Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine.
authors.forename: Cheng
authors.initials: C
authors.lastname: Wang
authors.affiliation: Shanghai, People's Republic of China.|From the Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine.
authors.forename: Tianya
authors.initials: T
authors.lastname: Li
mesh_terms: D000328:Adult; D002356:Cartilage / Q000637:transplantation; D066186:Costal Cartilage; D004426:Ear Deformities, Acquired / Q000145:classification* / Q000209:etiology / Q000601:surgery*; D004431:Ear, External / Q000293:injuries / Q000601:surgery*; D005205:Fascia / Q000637:transplantation; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D013506:Otologic Surgical Procedures / Q000379:methods; D019651:Plastic Surgery Procedures / Q000379:methods*; D016038:Skin Transplantation / Q000379:methods*; D013524:Surgical Flaps; D013997:Time Factors; D015599:Trauma Severity Indices; D014947:Wounds and Injuries / Q000150:complications* / Q000601:surgery; D055815:Young Adult