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Objective:To establish silicone cartilage models of donor-sites for the microtia patients by using digital technology, and to explore the application of surgical simulation in auricular reconstruction.Methods:From June 2018 to October 2019, 19 congenital microtia patients underwent thoracic CT scans and following three-dimensional costal cartilage imaging with Mimics software at the Nanfang Hospital, Southern Medical University. Among these patients, 16 were males and 3 were females. The mean age of patients was 16 years (range 8 to 35 years). Silicon cartilage models were produced by 3D printing and used for surgical planning and preoperative simulation in ear framework fabrication. Cartilaginous framework was sculptured according to the simulation during operation. Patients were followed up for a minimum of six months to evaluate the size, outline, height and auriculocephalic angle of the reconstructed ear. The satisfactory outcomes of the patients were scored according to a 5-point Likert scale.Results:All the patients received the surgical simulation and sculpture training with silicone cartilage models before operation. Auricular reconstruction was completed successfully according to the simulation. The duration of sculpture was shortened to 1-1.5 hours. There were no serious complications, such as hematoma, inflammation, skin necrosis and framework exposure. The contour of reconstructed ear was natural and clear over a 6 months follow-up, and all the patients were satisfied with their surgical outcomes.Conclusions:With the application of digital technology and silicone cartilage models by 3D printing to the surgical planning and training in microtia patients, patient-specific framework is fabricated with precisely assembling, which not only shortens the operation time, but also provides the unexperienced surgeons with a safe and effective training of ear framework fabrication.
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Management of auricular defect is still a challenge for reconstructive plastic surgeons. The complexity of anatomy and shape will make the reconstruction complicated. It is also inevitable that choosing the right donor to close the defect that resembles the original contour is one of the success indicators of any ear reconstruction. There are wide selections of techniques for the management of auricular defect. Retroauricular flap is one of the best choices in auricular reconstruction due to its vascular richness, low of failure rate, similarity of tissue contour and the ease of closing the donor-site defect primarily. This article reported three cases of auricular defect with various causes: crushed injury, human bite, and tumor excision. Two stages of surgeries were performed on all three patients. After sufficient debridement, the ear defect is planted beneath retroauriculomastoid dermis. The second stage, three weeks from the first surgery, the donor flap is separated from it host. One week follow up after the second stage surgery, all of the post-operative wounds showed no signs of infection, minimal scar formation and has satisfied aesthetic outcomes. The retroauricular flap has the advantages of simple dissection, low failure rate and has a good shape, texture, color for a very good aesthetic results. This flap may be considered as a good solution in the management of auricular defect and a flap bank for ear reconstruction.
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Objective: To explore the reasonable utilization of residual ear tissue after total ear reconstruction with total expansion method in patients with microtia of concha cavity, in order to obtain the best appearance. Methods: The clinical data of 150 patients with microtia of concha cavity between January 2012 and January 2017 were retrospectively analyzed. There were 92 males and 58 females, with an average age of 11.1 years (range, 6.5-35.0 years). The shallow upper auriculocephalic angle was found after the first stage expander embedding and the second stage total expansion, and the third stage auricular reconstruction was carried out 6-12 months later. The residual earlobe was transferred through Z-plasty to reconstruct the lobe. An arc incision was made to release and deepen the upper auriculocephalic angle. And then a skin flap pedicled on the upper part of the residual ear was formed and then transferred to cover the wound on the auriculocephalic angle. The residual ear cartilage tissue flaps with subcutaneous tissue pedicle were inserted into the lacuna under the framework to increase the height of the scaffold. The remaining residual ear skin flaps were sutured to cover the wound of concha. Results: A epidermis blister in diameter of 0.5 cm was found in 1 patient's flap at 7 days after operation, and healed after 2 weeks of dressing change. The other patients' flaps survived well. All the patients were followed up 6-12 months, with an average of 9.6 months. The auriculocephalic angle in the upper part of the reconstructed ear was obviously deepened, the height of the reconstructed ear was increased. The symmetry of the ears was better than before. The concha was not obviously contracted and the appearance of the reconstructed ear was satisfactory. The hair on the upper surface of the reconstructed ear decreased obviously, and the hairline around the ear moved up. Conclusion: The transfer of the upper residual auricular skin flap and residual auricular cartilage in patients with microtia of concha cavity can not only deepen the auriculocephalic angle, but also increase the height of the upper framework. The symmetry between the reconstructed auricle and the normal auricle is better than before.
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Objective: To summarize clinical experience and curative effect in applying three-dimensional mechanical equilibrium concept to cartilage scaffold construction in total auricular reconstruction. Methods: Between June 2015 and June 2017, ninety-seven microtia patients (102 ears) were treated with total ear reconstruction by using tissue expanders. The patients included 43 males and 54 females and their age ranged from 7 to 45 years with an average of 14 years. There were 92 unilateral cases (45 in left side and 47 in right side) and 5 bilateral ones. There were 89 congenital cases and 8 secondary cases. According to microtia classification criteria, there were 21 cases of type Ⅱ, 67 cases of type Ⅲ, and 9 cases of type Ⅳ. Tissue expander was implanted in the first stage. In the second stage, autogenous cartilage was used to construct scaffolds which were covered by enlarged flap. According to the three-dimensional mechanical equilibrium concept, the stable ear scaffold was supported by the scaffolds base, the junction of helix and inferior crura of antihelix, and helix rim. The reconstructed ears were repaired in the third stage operation. Results: All patients had undergone ear reconstruction successfully and all incisions healed well. No infection, subcutaneous effusion, or hemorrhage occurred after operation. All skin flaps, grafts, and ear scaffolds survived completely. All patients received 5- to 17-month follow-up time (mean, 11.3 months) and follow-up time was more than 12 months in 61 cases (64 ears). All reconstructed ears stood upright, and subunits structure and sensory localization of reconstructed ears were clear, and the position, shape, size, and height of bilateral ears were basically symmetrical. Mastoid region scar hyperplasia occurred in 3 patients, which was relieved by anti-scar drugs injection. No scaffolds exposure, absorption, or structural deformation occurred during follow-up period. Conclusion: Application of three-dimensional mechanical equilibrium concept in cartilage scaffold construction can reduce the dosage of costal cartilage, obtain more stable scaffold, and acquire better aesthetic outcomes.
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Resumen Introducción La reconstrucción auricular traumática es un reto para el cirujano plástico. Su objetivo es reproducir y recrear la forma y topografía de la región auricular, haciendo que los estigmas propios de la reconstrucción sean mínimos. Caso clínico Se presenta el caso de un paciente varón de 5 años de edad, con lesión por mordedura de perro en la oreja derecha, y lesión corto-contusa en pabellón auricular con pérdida de cobertura cutánea, pérdida parcial de cartílago auricular y exposición cartilaginosa a nivel de hélix y porción retroauricular. Se realizó reconstrucción auricular mediante reparación auricular y colgajo retroauricular. En un segundo tiempo quirúrgico, se realizó sección de la base del colgajo, y se logró un adecuado contorno auricular, así como cobertura cutánea definitiva Conclusiones Las lesiones auriculares, por su situación anatómica, son frecuentes en la práctica profesional de un cirujano plástico y reconstructivo. Existen múltiples técnicas quirúrgicas para la reconstrucción de defectos auriculares, sin embargo, el colgajo retroauricular ofrece una técnica sencilla y versátil.
Abstract Introduction Traumatic auricular reconstruction is a challenge for the plastic surgeon. The purpose of this reconstruction is to reproduce and recreate the shape and topography of the auricular region, diminishing the typical stigmas of a reconstruction. Clinical case The case of a 5-year-old male patient with right bite of a dog in a right ear presenting a short-contusional lesion in the auricular hall with loss of cutaneous cover, partial loss of atrial cartilage and cartilage exposure At the level of helix and retroauricular portion. Auricular reconstruction is performed by atrial repair and retroauricular flap. In a second surgical time, a section of the base of the flap is performed, achieving a suitable atrial contour and definitive skin coverage. Conclusions Auricular injuries, due to their anatomical situation, are frequent in the professional practice of a plastic and reconstructive surgeon. There are multiple surgical techniques for the reconstruction of atrial defects, however, the retroauricular flap offers a simple and versatile technique.
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Objective To explore the operating methods and its related questions of auricular reconstruction with totally expanded skin in combination with laser hair removal for the treatment of adolescent microtia.Methods From Jan.2013 to Dec.2016,30 adolescent microtia patients were treated with totally expanded skin.At the first stage,the 100 ml kidney-shaped expander was implanted under the skin of mastoid.After expanding capacity of 80 ml,the hair on the expanded skin was depilated once a month with reference to the healthy ear;at the second stage,after expanding capacity of 150 ml,the expander was taken out and the fiber capsule was removed;the tautologous rib cartilage was harvested and the scaffolds were sculptured;the cartilage was implanted and the expanded skin flap was used to cover the frontal surface and back surface of the scaffold;at the third stage,the earlobe transposition,conchal excavation and tragus construction were performed at the same time.Results All the patients were followed up for 3 to 24 months;the results showed 1 case of leakage of expander,4 cases of hematoma,2 case of expanded skin burst,and the complications were treated correctly,all patients were satisfied with the appearance;the color,texture,location,size;and height of ear cranial angle were matched with health ear;there was no obvious scar and auricle subunit structure was clear.Conclusions The laser in combination with the large capacity tissue expander in auricular reconstruction is simple,less trauma and less scarring.
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Aim: To assess the presence of donor site sequel of patients undergoing ear reconstruction with costal cartilage harvest, using supraperichondrial technique. methods: Cross-sectional study; patients under 15 years. The cartilages were harvested with perichondrium. Three observers performed donor site assessment; they were independent to this study (validated Strasser score: deformity, asymmetry, contour and scar). Children and their mothers were applied satisfaction survey. Analysis of the association between variables: nonparametric tests. Results: 19 reconstructions, 18 patients, age 8 (6-15) years, follow-up 50 (14-96) months; number of rib cartilage harvested 3 (2-4) units. Expert assessment: excellent in 2 (10.5%) cases, good in 10 (52.6%), regular in 7 (36.8%). Most mothers and patients rated the result as good. There was no significant difference in the score, with respect to the number of harvested costal cartilages. To separate them by age, poorer results were obtained at surgery before 10 years of age than in older (p < 0.03). Conclusion: Ear reconstruction and supraperichondrial technique for costal cartilage allows obtain good results in donor site. There is high satisfaction when evaluated by the patient and his mother, as well as observers. The result is not dependent on the number of harvested cartilage, but is related to age at surgery, best results were obtained in patients operated over 10 years of age.
Objetivo: Evaluar presencia de secuela en zona dadora de pacientes sometidos a reconstrucción auricular con cartílago costal con técnica suprapericóndrica. material y método: Corte transversal; pacientes menores de 15 años. Cartílagos fueron levantados con pericondrio. Evaluación de zona dadora fue realizada por tres observadores independientes (escala validada de Strasser: deformidad, asimetría, contorno y cicatriz). A niños y madres se les aplicó encuesta de satisfacción. En el análisis de la asociación entre variables se utilizan pruebas no paramétricas. Resultados: 19 reconstrucciones, 18 pacientes, mediana edad 8 (6-15) años, seguimiento 50 (14-96) meses, número de cartílagos costales obtenidos 3 (2-4) unidades. Evaluación de expertos: excelente en 2 (10,5%) casos, bueno en 10 (52,6%) y regular en 7 (36,8%). La mayoría de las madres y pacientes calificó como bueno el resultado. No hubo diferencia significativa en el puntaje con respecto al número de cartílagos costales cosechados. Al separarlos por edad se obtuvo peores resultados en los intervenidos antes de los 10 años que en mayores (p < 0,03). Conclusión: La reconstrucción auricular con cartílago costal y técnica suprapericóndrica, permite obtener buenos resultados en zona dadora. Existe alta satisfacción al ser evaluada por el paciente y su madre, así como por los observadores. El resultado no es dependiente del número de cartílagos; sí en relación a la edad de la cirugía: mejores resultados en pacientes operados sobre los 10 años de edad, lo que concuerda con otros estudios.
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Humans , Child , Adolescent , Tissue Transplantation/methods , Plastic Surgery Procedures/adverse effects , Costal Cartilage/transplantation , Congenital Microtia/surgery , Cross-Sectional Studies , Surveys and Questionnaires , Follow-Up Studies , Patient Satisfaction , Transplant Donor SiteABSTRACT
La posición expuesta de la oreja la hace vulnerable a muchos tipos de lesiones, entre las que se encuentran los traumas. Nuestro propósito es presentar un caso clínico en el que se realizó la reconstrucción de una pérdida parcial del pabellón auricular por trauma. Acude al cuerpo de guardia del Hospital Universitario General Calixto García; un paciente masculino de 42 años refiriendo haber perdido un fragmento de oreja en una riña. Se decide realizar hemostasia y fijación mediante puntos de sutura del pabellón auricular remanente a la región temporal, previa incisión en la zona. A los 3 meses del evento traumático se reevalúa con fines de realizar la planificación preoperatoria reconstructiva. Se decide la realizarla mediante injerto de cartílago costal colocado en forma de bolsillo; en la región temporal. Al mes de esta última intervención quirúrgica se realiza, bajo anestesia local, la liberación de la región auricular, el avance de un colgajo temporal y la colocación de un injerto libre de piel en la cara posterior del área reconstruida. Se observa una excelente evolución posoperatoria. El paciente refirió una gran satisfacción por los resultados estéticos obtenidos. En este caso se empleó una secuencia diagnóstica y terapéutica, según elección de los cirujanos involucrados, ante un defecto traumático parcial del pabellón auricular en sus tercios superior y medio. Este tipo de secuela traumática requirió el empleo de procederes quirúrgicos en varios tiempos operatorios que garantizaran un buen aporte sanguíneo de los tejidos y adecuados resultados estéticos finales(AU)
The exposed position of the ear makes it vulnerable to many types of injuries, including traumas. It is our purpose to present a clinical case in which reconstruction was performed of a partial traumatic auricular loss. A 42-year-old male patient presents at the emergency service of General Calixto García; University Hospital and reports having lost a piece of his ear in a fight. It was decided to perform hemostasis and fixation by stitching the remaining section of the auricle to the temporal region, after making an incision in the area. Three months after the traumatic event re-evaluation was conducted with a view to planning reconstructive surgery. It was decided to carry out the reconstruction placing a pocket-shaped rib cartilage graft in the temporal region. One month after the operation, auricular release, advancement of a temporary flap and placement of a free skin graft on the back of the reconstructed area were performed under local anesthesia. Excellent postoperative evolution was observed. The patient reported great satisfaction with the esthetic results obtained. The case herein presented was based on a diagnostic and therapeutic sequence of actions determined by the surgeons involved with a view to correcting a partial traumatic defect of the upper and middle thirds of the auricle. This type of traumatic sequel required the use of surgical procedures at several operative moments ensuring good blood supply to tissues and appropriate final esthetic results(AU)
Subject(s)
Humans , Male , Adult , Ear Auricle/injuries , Ear Auricle/surgery , Ear Cartilage/transplantation , Surgical Flaps/surgery , Wounds and Injuries/diagnosisABSTRACT
Objective To compare the rate of postoperative complications and satisfaction between skin flap -extension auricular recon-struction ( hereinafter flap-extension ) and improved Brent auricular reconstruction ( hereinafter improved Brent ) .Methods From October 2009 to October 2014, totally 199 patients who have been diagnosed as congenital microtia and received auricular reconstruction were divided into two groups.Group A (159 patients) received flap-extension and Group B (40 patients) received improved Brent.The medical records, pre-and post-surgery photos of all patients were analyzed and satisfaction of patients was collected by the telephone follow -up.Results Pa-tients in both of the two groups were satisfied with their therapies .There were 47 cases of complications in Group A (29.6%, 47/159) and 5 cases of complications in Group B (12.5%, 5/40).The postoperative complications were significantly different between the two groups (P<0.05).Conclusion There was no difference in patients ’ satisfaction between the two methods ,but the postoperative complications of improved Brent were much lower .
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Objective To study the methods and clinical effects of joint expansion of double fascia flaps wrapping the Medpor to perform full-ear reconstruction on congenital microtia deformity.Methods 60 patients with congenital microtia deformity were selected.including 22 left ears and 38 right ears.Majority had loss of ear auricle or only partial earlobe.Phase Ⅰ procedures included:temporal-parietal branch was used for the vascular pedicle,and mastoid area behind the ear was moved and expanded for fascia flap.Phase Ⅱ included:the joint expansion of double fascia flap wrapped Medpor to do full-ear reconstruction.Results Flaps survived and no complications for all 60 patients.Reconstructed ears had lifelike appearance and clear anatomical structures.Auriculocephalic angulars positions and sizes were consistent with the healthy ears.None of them had exposed prosthesis and scar contraction.Three-dimensional shapes were good.Conclusions Joint expansion of double fascia flap wrapping Medpor could avoid the chest wall deformity and exposed prosthesis.The fine structure of the reconstructed ear is satisfactory.
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Tissue engineering (TE) has become an alternative for auricular reconstruction based on the combination of cells, molecular signals and biomaterials. Scaffolds are biomaterials that provide structural support for cell attachment and subsequent tissue development. Ideally, a scaffold should have characteristics such as biocompatibility and bioactivity to adequate support cell functions. Our purpose was to evaluate biocompatibility of microtic auricular chondrocytes seeded onto a chitosan-polyvinyl alcohol-epichlorohydrin (CS-PVA-ECH) hydrogel to propose this material as a scaffold for tissue engineering application. After being cultured onto CS-PVA-ECH hydrogels, auricular chondrocytes viability was up to 81%. SEM analysis showed cell attachment and extracellular matrix formation that was confirmed by IF detection of type II collagen and elastin, the main constituents of elastic cartilage. Expression of elastic cartilage molecular markers during in vitro expansion and during culture onto hydrogels allowed confirming auricular chondrocyte phenotype. In vivo assay of tissue formation revealed generation of neotissues with similar physical characteristics and protein composition to those found in elastic cartilage. According to our results, biocompatibility of the CS-PVA-ECH hydrogel makes it a suitable scaffold for tissue engineering application aimed to elastic cartilage regeneration.
La ingeniería de tejidos (TE) es una alternativa para la reconstrucción auricular basada en la combinación de células, señales moleculares y biomateriales. Los andamios fabricados con biomateriales brindan un soporte estructural que favorece la adhesión cellular y el desarrollo del tejido. Un andamio debe poseer características como biocompatibilidad y bioactividad para soportar adecuadamente funciones celulares. Nuestro objetivo fue evaluar la biocompatibilidad de condrocitos auriculares de microtia cultivados sobre un hidrogel a base de quitosano-alcohol polivinílico-epiclorhidrina (CS-PVA-ECH) y proponerlo como andamio con aplicaciones en ingeniería de tejidos. La viabilidad de los condrocitos auriculares es superior al 81% después de ser cultivados sobre el hidrogel. El análisis por SEM reveló la unión celular y formación de matriz extracellular sobre el hidrogel; confirmada mediante detección por IF de colágena tipo II y elastina. La expresión de marcadores moleculares durante la expansión in vitro y el cultivo sobre los hidrogeles confirmaron el fenotipo condral. El ensayo de formación de tejido in vivo demostró la generación de neotejidos con características físicas y composición similar al cartílago elástico. Nuestros resultados indican que la biocompatibilidad del hidrogel de CS-PVA-ECH lo hace un andamio adecuado para aplicaciones en ingeniería de tejidos enfocadas a regeneración de cartílago elástico.
Subject(s)
Humans , Chondrocytes/cytology , Tissue Engineering/methods , Chitosan/chemistry , Ear Cartilage/cytology , Polyvinyls/chemistry , Biocompatible Materials , Immunohistochemistry , Cell Culture Techniques , Chondrocytes/metabolism , Hydrogels , Epichlorohydrin/chemistryABSTRACT
Objective To summarize and explore the clinical effect of auricular reconstruction with autologous costal cartilage grafts and delaying postauricular skin flap.Methods The procedure involved three stages.The first stage was the delay procedure of postauricular skin flap.The second stage was the auricular reconstruction with autologous costal cartilage grafts and delaying postauricular skin flap about 3 weeks after the delay procedure.The third stage involved construction of tragus and conchal cavity and other local correction 6 months or longer after the second stage surgery.The clinical effect,patients' satisfaction and complication were observed.Results This method was used in 28 patients,31 ears of congenital microtia.23 cases completed auricular reconstruction with three stages,the other 8 cases completed only two stages.All auricular reconstruction were successful.The location,size and shape of reconstructive ears were good.The complications were few.The patients or their relatives were basically satisfactory.Conclusions Auricular reconstruction with autologous costal cartilage grafts and delaying postauricular skin flap is a safe and effective method.
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PURPOSE: Patients with serious burns are prone to chondritis due to lack of soft tissue in the auricle, which can cause severe defects in the auricular morphology. In addition, skin damage occurs frequently in the vicinity of post-burn wounds, presenting difficulties in reconstruction surgery. An auricular reconstruction has functional and cosmetic significance. The aim of this study is to develop appropriate reconstruction methods for auricular defects. METHODS: Thirty seven patients, who were treated for auricular defects from 2005 to 2009, were enrolled in this study. A local flap, multiple regional flaps and cartilage framework with or without a temporal fascial flap were applied in reconstruction surgery according to the location of the auricular defect. RESULTS: The age of the subjects ranged from 11 to 56. Some subjects had defects that cover more than half of the helical rim with most exhibiting post-burn scars in the vicinity, for whom a multiple regional flap was used. A single use of a tubed flap was sufficient for subjects with defects that covered less than half of the helical rim. A regional flap was also used for reconstruction in subjects with defects covering both the helical rim and antehelix. CONCLUSION: Achieving satisfactory results from the skin flaps and skin grafts for post-burn auricular defects in both functional and cosmetic aspects is a difficult task. Therefore, selecting an appropriate surgical method through proper diagnosis of the auricular defect and the state of the available skin in the vicinity is essential.
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Humans , Burns , Cartilage , Cicatrix , Cosmetics , Skin , TransplantsABSTRACT
Objective To explore the protective affect of individual earmuffs in microtia reconstruction using tissue expander.Methods 95 patients performed the implantation of tissue expander had been grouped into the experimental group(49 cases)and the control group(46 cases).Patients in the experimental group wore individual earmuffs,whereas patients in the control group wore traditional earmuffs.The survey including the information of patients' experience in wearing the earmuffs was carried out on the day when patients were given auricular reconstruction.Data collected from the two groups were analyzed to evaluate the aspects of permeability and safety.Results Patients in the experimental group complained less discomfort in sultry in permeability and tinnitus than patients in the control group.From the perspective of safety,there was no complaints of mosquitoes climbing into the earmuffs from the two groups.Because of the good adhesiveness of the individual earmuffs to the skin,the incidence of redness of skin in the experimen tal group was significantly lower than that in the control group.Conclusions Individual earmuff is a safe and comfortable nursing appliance which is practical for clinical application because of its good permeability,adhesiveness and less incidence of redness of skin.
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Introducción. El pabellón auricular es una estructura sofisticada y compleja. La presentación clínica más frecuente de deformidades es la microtia. Los métodos reconstructivos tienen como objetivo reproducir los relieves naturales de la oreja, con resultados estéticos variables. Material y métodos. Pacientes con microtia que acudieron a consulta externa en el período del año 2002 al 2004. Se diseñó la prótesis auricular tomando el modelo de la oreja normal; en caso de microtia bilateral, de un familiar. Se realizó colocación de implantes osteointegrados. Posterior a 6 meses, se colocaron los tornillos de cicatrización para fijación de la prótesis. Resultados. Se incluyeron 34 pacientes con microtia, 20 masculinos y 14 femeninos; edad promedio: 9.5 años. La presentación clínica más frecuente fue microtia unilateral (n =31). Tiempo quirúrgico promedio: 35 min. Se observó adecuada integración de implantes en los pacientes. El resultado estético fue muy satisfactorio. En el seguimiento (1.5 años) se encontró un paciente con cicatrización hipertrófica, ninguna complicación asociada al uso de prótesis ni necesidad de recambio protésico. Conclusiones. La utilización de prótesis auriculares externas e implantes osteointegrados es un método reconstructivo eficiente, con poca morbilidad y excelente resultado estético.
Introduction. The external ear is a sophisticated and complex structure. The most frequent congenital ear deformity is microtia. The different reconstructive methods are focused in reproducing the natural reliefs of the ear, with different aesthetics results. Material and methods. Microtia patients who were seen between 2002 to 2004. The external prosthetic device was designed taking the pattern of the normal ear. In patients with bilateral microtia the ear pattern of a family member was used. Placements of the osseointegrated implants was carried out, and after 6 months of integration the scarring screws were placed in order fix de prosthesis Results. Thirty four microtia patients were included, 20 were males, the median age was 9.5 years. The most frequent clinical presentation was unilateral microtia (n =31). The surgical time for the procedure averaged: 35 min. All patients had appropriate integration of the implant. The aesthetic result of the prosthetic reconstruction was very satisfactory. In the follow-up period (1.5 years) we found an hypertrophic scar in 1 patient, no complications were associated to the use of prosthetic reconstruction and no patient required prosthetic replacement. Conclusions. The prosthetic reconstruction with osseointegrated implants is an efficient reconstructive method, with little morbidity and excellent aesthetic result.
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Objective To introduce a new technique of one-stage auricular reconstruction by using the retroauricular fascial flap. Methods The retroauricular fascial flap was designed to cover a cartilage framework for auricular reconstruction. Results Seventeen cases who had injured over two years and received no surgical treatment, underwent auricular construction. In 3-month to 2-year follow-up, all patients obtained satisfactory appearance of the reconstructed ears that possess delicate structure and close color to adjacent skin. Conclusion For retroauricular fascial flap has adequate blood supply, it makes operating procedure simple and the occurrence rate of complication reduced. It is proven that this is a good method of auricular reconstruction.