A new strategy for total auricular reconstruction using prelamination of an extended retroauricular flap with tissue expansion

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• 作者：Chuan Li^a ; Haiyue Jiang^a ; Chenyu Huang^b ; Jingning Chen^c ; Rongwei Wu^a ; Ye Bi^a ; Meirong Yang^a ; Ye Zhang^a ; Bo Pan^a ; ^{15098733987@126.com" class="auth_mail" title="E-mail the corresponding author}
• 关键词：Microtia ; Ear reconstruction ; Flap prelamination ; Tissue expansion ; Skin grafts
• 刊名：Journal of Plastic, Reconstructive & Aesthetic Surgery
• 出版年：2016
• 出版时间：June 2016
• 年：2016
• 卷：69
• 期：6
• 页码：819-826
• 全文大小：2810 K

文摘

To accomplish total ear reconstruction with aesthetic appearance is a great challenge for plastic surgeons worldwide due to insufficient skin coverage. A retroauricular fascial flap and skin graft technique are commonly used, but the results obtained are not satisfactory due to color mismatch, severe edema, and donor-site morbidity. Here, we describe a novel strategy for total ear reconstruction, utilizing an extended retroauricular flap prelaminated with tissue expansion to obtain enough skin for ear reconstruction.

Methods

About 2 months before ear reconstruction, a kidney-shaped tissue expander was inserted at the mastoid region subcutaneously. The retroauricular skin became enlarged and thinner in 2 months after expansion. Next, the expander was removed and the retroauricular flap was extended by dissecting the surrounding scalp subcutaneously. By mobilizing the scalp-extended retroauricular flap, we could encapsulate the entire framework with thin and non-hair-bearing skin.

Results

From August 2014 to September 2015, 36 microtia patients had undergone ear reconstruction using the novel strategy. Satisfactory aesthetics along with fine structure, symmetry, and maintenance of the auriculocephalic angle was achieved in all patients.

Conclusions

Using our novel strategy, we can obtain satisfactory aesthetic outcomes by fully mobilizing the expanded skin without additional morbidities of the donor sites. Patients are satisfied with the vivid ear contour and lack of groin scar.