ABSTRACT
Objective@#To discuss the strategy for dealing with the failed reconstructed ears.@*Methods@#From January 2010 to January 2015, 14 cases (14 ears) were admitted to our department because of failed reconstructed ears. It was impossible to improve their appearance greatly just by adjusting the original structures. We had to take out the framework and re-reconstruct the ear with autologous costal cartilages. Depending on the conditions of soft tissue, we divided them into three groups: Group 1, 8 ears(57.1%), the soft tissue could be reused simultaneously after being dealt with appropriately although the original frameworks were distorted badly. We took out the original frameworks, harvested cartilages again, fabricated the new frameworks and wrapped them with the original soft tissue. Group 2, 4 ears(28.6%), the structures were damaged completely, just with the constricted scars and skin graft clinging on the mastoid bone. We wrapped the new framework with axial temporal superficial fascia flap and then covered the wound with skin graft; Group 3, 2 ears(14.3%), the structures were distorted seriously. The skin flap covering the framework constricted badly while the post-auricular fascia flap was unspent. We took out the framework, implanted the skin expander under the spread skin flap, and then re-reconstructed the ear with expansion method.@*Results@#13 of 14 cases( 92.9%)were rebuilt successfully. The new ears maintained the landmark subunits 1 month after surgery. In 1 case (7.1%) from group 3, the creased skin had a rupture during skin expansion period. The expander had been taken out, and then a new one was replaced 3 months later. Follow-up period was 3-12 months. The structures of all the 14 rebuilt ears were stable and much better than before.@*Conclusions@#Good results could be achieved when appropriate method was selected for failed reconstructed ear. The condition of soft tissue of distorted reconstructed ear should be considered.
ABSTRACT
Objective To explore the feasibility of treating the microtia aided with the digital technology,harvesting the rib cartilage precisely,and carving fabric the ear framework in more details.Methods From July 2015 to January 2017,22 microtia patients accepted clinical therapy aided with digital technology.Preoperatively,the three-dimensional model of the costal cartilage and ear were made to design the cartilage scaffold fabrication.After the operation,the difference of the three dimensional morphology between the reconstructed ear and the normal ear was measured by digital technology.Results With average 7 months follow up,19 cases were satisfied with the outcome of the reconstructed ear including three dimensional position and subunit appearance.The outcomes were acceptable in 3 cases.There were no postoperative complications related to chest wall deformity or affected normal physical function.Conclusions Digital technology can achieve accurate harvesting and reasonable utilization of autogenous rib cartilage,provide accurate guidance for the sculpture of auricle scaffold and objective evaluation for the three-dimensional structure of the reconstructed ear.