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La microtia es un padecimiento congénito de etiología desconocida que se puede presentar asociado a síndromes, su frecuencia es mayor en hombres, tiene predilección por el oído derecho. Se han propuesto distintas alternativas de tratamiento tanto estéticas como funcionales que disminuyan riesgos y aumenten la calidad de vida de los pacientes. Entre los tratamientos más comunes se encuentra el injerto costocondral, siendo una alternativa viable, aunque de mayor riesgo y que puede necesitar varios procedimientos quirúrgicos con el fin de lograr el mejor resultado estético; por lo mismo, uno de los tratamientos más realizados actualmente, es la reconstrucción auricular con implantes osteointegrados que se colocan en la región mastoidea y soportan una prótesis auricular. Se presenta el caso de un paciente masculino quien fue rehabilitado con implantes mastoideos ostoeintegrados para reconstrucción auricular implantosoportada. Las prótesis implantosoportadas reducen la necesidad de realizar cirugías correctivas y posibilitan la buena higiene de la prótesis al ser ésta removible, pero sin sacrificar su estabilidad. Los sistemas más utilizados son los mismos que se emplean en sobredentaduras, ya que el diseño del aditamento transmucoso, se adapta perfectamente al grosor del epitelio en la región mastoidea, por lo que es una excelente alternativa de tratamiento (AU)
Microtia is a congenital condition of unknown etiology that can occur associated with syndromes. Its frequency is greater in men and has a predilection for the right ear. Different treatment alternatives, both aesthetic and functional, have been proposed that reduce risks and increase the quality of life of patients. Among the most common treatments can be found the costochondral graft being a good alternative although greater risk of failure and the probability of several surgeries to get the best aesthetic result. Because of that one of the most used treatments is the placement of osseointegrated implants that can hold a prosthetic ear. Here is a case of a male patient who was rehabilitated with osseointegrated mastoid implants for ear reconstruction. Implant-supported prostheses significantly reduce the number of surgeries that must be performed and is a good option to maintain excellent hygiene as the prosthetic ear is removable, without compromising stability. The most common system is the same as those used in overdentures since the design of the transmucosal attachment fits perfectly to the thickness of epithelium in mastoid region (AU)
Subject(s)
Humans , Male , Adult , Dental Prosthesis, Implant-Supported/methods , Ear Auricle/surgery , Congenital Microtia/rehabilitation , Plastic Surgery Procedures/methods , Ear Auricle/abnormalitiesABSTRACT
Objective:To investigate the safety and efficiency of depilation with intense pulsed light (IPL) in congenital microtia patients during different phase of reconstruction treatment sessions.Methods:The hairy skin was treated with the M22TM system (Lumenis, German) using a filter of 695-1 200 mm. A three pluses mode of the radiant setting with a pulse width of 3.5 ms, a delay of 60 ms, and an energy density of 16-18 mJ/cm 2 was applied in the expanded patients. Depilation efficacy was evaluated as follows: excellent (hair density reduction >75%), good (50%-75%), fair (25%-50%), and poor (<25%). The depilation effect was compared between different phases. And the adverse effect was observed. Results:A total of 131 cases were included. There was no difference of the hair density reduction between patients with different expander volume after same IPL depilation treatments [15 (13-19) vs. 16 (15-19) root/cm 2, Wilcoxon rank analysis]. The hair density reduction in the expansion group was lower than the non-expansion group after two IPL depilation treatments [15 (13-19) vs. 17 (15-21) root/cm 2, P<0.05, Wilcoxon rank analysis]. The depilation efficacy was highly related with the numbers of IPL depilation treatments the patients received [Kendall′ stat b=0.74 (95% CI: 0.71-0.77), P<0.05]. There were 3 cases of folliculitis, 2 cases of blisters occurred in this study, and no expander exposure and cartilage absorption were observed. Conclusions:Hair removal with IPL is a safe and effective photo-epilation method during all stages of ear reconstruction using tissue expander. The volume of the expander does not significantly affect the hair removal efficiency. Depilation in the expansion phase is more efficient than that in the non-expansion phase, and the ideal result of " hair-free" or " less hairy" reconstructed ears can be achieved in 5 treatments, with suboptimal results in 3 treatments.
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@#Prosthetic rehabilitation offers an alternative to surgical procedures for repositioning implant-retained auricular prosthesis. This report illustrates a prosthetic rehabilitation of a 15-year- old male with a unilateral microtia who presented with an unfavorable implant-retained left auricular prosthesis. The implants placed seven years ago were drifted posterosuperior away from the ideal ear canal position. The fabrication of a new prosthesis on the existing bar-clip attachment using a custom acrylic base was planned to correct the location. A skin-colour perforated custom acrylic base was fabricated and designed to extend anteriorly, therefore, shifting the prosthesis forwards into a more natural location. The custom base was able to relocate the prosthesis’ position without compromising its retention whilst engaging the existing implant attachment. This in turn enhanced prosthesis acceptability and improved the patient’s confidence. The custom acrylic base serves as a viable option to reposition the prosthesis influenced by age related growth and development.
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Introducción: La reconstrucción de la oreja en la actualidad es un problema difícil de solucionar. Se han propuesto varias técnicas quirúrgicas y solo las que se basan en el uso de cartílago costal autólogo son las que se aceptan a nivel mundial. Objetivo: Evaluar la efectividad de la técnica de reconstrucción del pabellón auricular descrita por Burt Brent. Métodos: Se realizó un estudio cuantitativo con diseño descriptivo de corte transversal con 41 pacientes que presentaron microtia congénita o perdida adquirida de la oreja; a quienes se les realizó reconstrucción auricular con cartílago costal autólogo tratados en el Hospital "William Soler", el Centro de Investigaciones Médico-Quirúrgica y Clínica Central "Cira García" en el Servicio de Cirugía Plástica desde 1994 hasta 2019. Se describió y se documentó la técnica empleada descrita por Burt Brent. Se utilizó una escala de 10 puntos que se basó en la anatomía auricular normal para la valoración de los resultados. Resultados: Se encontraron 32 pacientes portadores de microtia congénitas (78,04 %) y 9 pérdidas traumáticas (21,95 %), predominó el sexo femenino (56,09 %). La incidencia fue mayor en el lado derecho (68,75 %) en pacientes con microtia congénita. En el 95 % de los casos se alcanzaron resultados favorables y satisfactorios. Conclusiones: La reconstrucción del pabellón auricular requiere el empleo de un fragmento de cartílago costal de suficiente tamaño, forma y proyección. La clave consiste en esculpir un marco cartilaginoso de la oreja y mantener estos detalles a través de la piel lo más semejante a la oreja normal. Para un resultado satisfactorio se requiere una alta especialización.
Introduction: Auricle reconstruction is, nowadays, a difficult problem to solve. Several surgical techniques have been proposed and only those based on the use of autologous costal cartilage are accepted worldwide. Objective: To evaluate the effectiveness of the auricle reconstruction technique described by Burt Brent. Methods: A quantitative study with a cross-sectional descriptive design was carried out with 41 patients who presented congenital microtia or acquired loss of the ear and who were performed auricle reconstruction with autologous costal cartilage in the plastic surgery service at Hospital "William Soler", Centro de Investigaciones Médico-Quirúrgicas and Clínica Central "Cira García", from 1994 to 2019. The used technique described by Burt Brent was, in turn, described and documented. A 10-point scale based on the normal atrial anatomy was used to assess the outcomes. Results: Thirty-two patients with congenital microtia (78.04 %) and nine traumatic losses (21.95 %) were found, with a predominance of the female sex (56.09 %). The incidence was higher on the right side (68.75 %) in patients with congenital microtia. Favorable and satisfactory outcomes were achieved in 95 % of cases. Conclusions: Auricle reconstruction requires the use of a costal cartilage piece of enough size, shape and projection. The key is to sculpt a cartilaginous framework of the ear and to maintain these details through the skin as close as possible to the normal ear. A high level of specialization is required for a satisfactory outcome.
Subject(s)
Humans , Costal Cartilage/injuries , Epidemiology, Descriptive , Cross-Sectional StudiesABSTRACT
Microtia is the second most common maxillofacial birth defect in neonates and has an prevalence rate of 3.06/10 000 in China, and 20%-60% of microtia cases is associated with a certain type of syndrome. This article elaborates on the clinical phenotypes and genetic characteristics of three microtia-associated syndromes (MASs) with high prevalence, high incidence rate of ear deformity, and definite genetic etiology, i.e., oculo-auriculo-vertebral spectrum, branchio-oto-renal spectrum disorder, and Treacher-Collins syndrome, and summarizes another three common MASs, so as to provide a reference for the genetic diagnosis of neonatal MAS.
Subject(s)
Humans , Infant, Newborn , China , Congenital Microtia/genetics , Phenotype , Prevalence , SyndromeABSTRACT
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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A macrostomia congênita, também denominada fissura facial transversa, horizontal ou lateral, constitui 1,5% de todas as fissuras. A expressão clínica variável envolve desde uma forma discreta até casos graves com malformações desfigurantes. Deformidades da orelha externa podem estar presentes, desde excesso de pele até ausência do pavilhão. A macrostomia congênita deve ser submetida a uma investigação sistemática clínica e de imagem para definir o âmbito das anomalias, uma vez que a doença é rara, complexa e manifesta-se fenotipicamente de maneiras distintas. Este presente artigo relata um caso de macrostomia congênita associada à microtia unilateral.
Congenital macrostomia, also called transverse, horizontal, or lateral facial cleft, constitutes 1.5% of all clefts. The variable clinical expression ranges from mild to severe cases with disfiguring malformations. External ear deformities can be present, from excess skin to the absence of the pinna. Congenital macrostomia must be submitted to a systematic clinical and imaging investigation to define the scope of the anomalies, since the disease is rare, complex and manifests itself phenotypically in different ways. This article reports a case of congenital macrostomia associated with unilateral microtia.
Subject(s)
Humans , Adult , Congenital Microtia , Craving , MacrostomiaABSTRACT
Objective@#This study collected and analyzed data from patients with microtia in multiple clinical centers to obtain the incidence characteristics of microtia in Chinese.@*Methods@#Data from 746 patients with microtia were collected from six hospitals, including theThird Hospital of Hebei Medical University, Hunan Provincial People′s Hospital, the Second Hospital of Hebei Medical University, Weihai Municipal Hospital, West China Hospital Sichuan University, Plastic Surgery Hospital, Chinese Academy of Medical Sciences from January 2016 to December 2017. These data included the results of physical examination and the results of auxiliary examination such as electrocardiogram, chest CT, and abdominal ultrasound. Then, the accompanying malformations of the microtia were statistically analyzed and discussed. Data were entered and processed using SPSS 19.0 statistical software. The relationship between microtia deformities and associated malformations was analyzed by Pearson χ2 test. P<0.05 was considered statistically significant.@*Results@#A total of 746 patients with microtia were included, including 513 males and 233 females, aged 5-27 years old. There were 678 cases of unilateral microtia, 68 cases of bilateral microtia; 128 cases of Ⅰ degree, 564 cases of Ⅱ degree, and 54 cases of Ⅲ degree. In addition, 336 cases (45%) were associated with dysplasia of other systems. Detected anomalies were 321 cases of the ear, face, and neck, 261 cases of musculoskeletal system and 76 cases of cardiovascular system, 30 cases of anomalies of the urogenital system, eye, 27 cases of respiratory system, 7 cases of central nervous system, 5 case of digestive system and 1case of diaphragmatic hernia. The proportion of male and female with microtia was 47.0% (241/513) and 40.8% (95/233), respectively, and there was no significant difference in between (χ2=2.493, P=0.114); The composition ratios of unilateral and bilateral associated malformations were 45.7% (310/678) and 38.2% (26/68 ), and there was no significant difference in between (χ2=1.400, P=0.237); The composition ratios of Ⅰ, Ⅱ, Ⅲ degree-associated malformations were 39.8% (51/128), 42.6% (240/564), and 83.3% (45/54), and the difference was statistically significant (χ2= 34.794, P<0.001).@*Conclusions@#Microtia has significant clinical heterogeneity with a higher proportion of associated malformations. A higher incidence of associated deformities in patients with severe microtia was observed. Systematic examination is required, which will be helpful to clinical therapy and etiology analysis.
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Objective@#To investigate the association between ABO blood-group system and congenital microtia.@*Methods@#Patients with congenital microtia treated in the Plastic Surgery Hospital of the Chinese Academy of Medical Sciences from January 1, 2017 to February 28, 2019 were collected as the case group. Non-malformed patients admitted to the same hospital from January 1, 2017 to February 28, 2019 were collected as the control group. ABO blood group was determined by tube agglutination test. The distribution of ABO blood group in both group was counted and Chi-square test was used for statistical analysis with a significance level α=0.05. Then spilt chi-square test was applied to compare the difference between blood groups using Bonferroni correction for multiple comparisons (significance level α′=0.008 3) if a statistically significant difference was found in chi-square test. Odds ratio (OR) and its 95% confidence intervals (CI) were calculated to compare the association between ABO blood group and risk of microtia by using Woolf’s method . All statistical analysis was performed with SPSS version 25.0.@*Results@#2 317 patients with congenital microtia (case group) and 5 411 patients without malformation (control group) were included in this study. The distribution of ABO blood types in congenital microtia group was 29.39% (681/2 317) for type A, 31.89% (739/2 317) for type B, 9.75% (226/2 317) for type AB, and 28.97% (671/2 317) for type O. The distribution of blood group was B>A>O>AB. While, the distribution of blood groups in the control group was O>B>A>AB, which was statistically different from the congenital microtia group (χ2=8.387, P=0.039). The incidence of congenital microtia differed significantly between A blood group and O blood group (χ2=7.448, P=0.006). The risk of congenital microtia was significantly lower in blood group O (OR=0.863, 95% CI: 0.776-0.960, P=0.007) and relatively higher in blood group A (OR=1.110, 95% CI: 0.997-1.236).@*Conclusions@#In the population managed in the Plastic Surgery Hospital of the Chinese Academy of Medical Sciences, ABO blood group is correlated with the occurrence of congenital microtia. O blood group is a potential protective factor. While A blood group is susceptible to congenital microtia.
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Objective@#To investigate the effect and safety of ultra-thin oblique posterosuperior auricular fascial flap in the second stage of ear reconstruction.@*Methods@#Fifty-six cases with congenital microtia treated in The Second Affiliated Hospital of Zhengzhou University Medical Cosmetology Department from November 2015 to November 2018 were selected as the research objects. In the first stage, the costal cartilage ear stent was implanted, and in the second stage. The ultra-thin posterior oblique fascia flap was used to cover the stent. And the cranioauricular angle was reconstructed by free skin grafting.@*Results@#48 cases of the 54 cases completely survived, and 8 cases had hemorrhage after operation. The wounds were healed after dressing change. The postoperative cranioauricular angle was close to the healthy side.@*Conclusions@#In the second stage of ear reconstruction, the retroauricular ultra-thin fascial flap method has reliable blood supply, small wound, unswollen reconstructed ears, and good outcome. It is a good choice for covering the ear framework.
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Objective@#To establish the local data on the growth of ear in Hong Kong children and provide a reference for the timing of reconstruction in unilateral microtia.@*Methods@#We reviewed case notes of paediatric patients up to 18 years of age who had attended our Ear, Nose and Throat Out-patient Clinic from March to November 2017. We recorded the pinna length of these patients and that of their parents, compared the patients’ ear length against that of their parents, and investigated any discrepancy of pinna.@*Results@#We recruited 226 local individuals (139 males and 87 females). The patients were divided into different age groups. The means of ear length of patients were compared with the mean length of pinna of their parents. Data of boys and girls are analyzed separately. Boys at 7-8 years old achieved 87.33% and 93.54% of their fathers’ and mothers’ ear length respectively. Girls at 7-8 years old achieved 83.00% and 90.80% of their fathers’ and mothers’ ear length respectively. Moreover, the average ratio of the length of left and right ear ratio is 97.3% in all groups of children.@*Conclusions@#In Hong Kong children, at the age of 7-8 the ear approaches the size of normal adult ear and is the feasible age with less asymmetry after reconstruction of the microtia.
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IIn recent years, an increasing trend of the birth prevalence of anotia/microtia is observed in China, contributed by changes of social environment and lifestyle. There seems to be no major breakthroughs in exact pathogenesis of microtia, though the research results related to molecular genetics unceasingly appear. Animal studies have important implications for exploring the pathophysiologic mechanism of microtia. In this review, we focused on the types and modeling approaches of animal models, as well as the advantages and disadvantages respectively. We believe that this review will provide references for researchers to select and establish appropriate animal models.
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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 the current progress of clinical therapy for concha-type microtia. Methods: The domestic and overseas literature about the treatment of concha-type microtia was reviewed and the contents of operative timing, operation selection, and complications were analyzed. Results: The unified therapeutic schedule of the concha-type microtia has not yet been determined due to its complicated various therapeutic methods and unknown etiology. The operation methods commonly used in clinic are partial ear reconstruction with autologous costal cartilage framework and free composite tissue transplantation. The timing of the partial ear reconstruction depends on the development of costal cartilage and children's psychological healthy. The timing of free composite tissue transplantation depends on the severity. It is recommended to perform the operation at about 10 years old for mild patients. For moderate patients, ear cartilage stretching should be performed at 1-2 years old and free composite tissue transplantation would be performed at about 10 years old. The complications of partial ear reconstruction with autologous costal cartilage framework for concha-type microtia mainly include framework exposure, deformation, infection, cartilage absorption, and skin necrosis. The complications of free composite tissue transplantation have not been reported. Conclusion: Etiology and elaborated classifications with individualized treatment are the future research directions.
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Objective: To explore the anthropometric changes of the auricle after auricular cartilage unfolding in moderate concha-type microtia patients, so as to provide the basis to help evaluate surgical timing and prognostic. Methods: A total of 33 children with moderate concha-type microtia, who were treated with auricular cartilage unfolding between October 2016 and September 2018 and met the inclusive criteria, were included in the study. There were 24 boys and 9 girls with an average age of 1.4 years (range, 1-3 years). Sixteen cases were left ears and 17 cases were right ears. The follow-up time was 12-23 months (mean, 17.5 months). The affected auricular detailed structures were observed and quantitatively analyzed before operation and at immediate after operation. The width, length, and perimeter of auricle before operation and at immediate after operation and at last follow-up were noted with three dimensional-scanning technology. The normal auricle was noted as control. Results: There were (7.5±1.0) and (11.3±0.8) structures of the affected auricle at pre- and post-operation, respectively, showing significant difference between pre- and post-operation ( t=23.279, P=0.000). The length, width, and perimeter of the affected auricle constantly increased after operation, and there were significant differences between pre-operation and immediately after operation and between immediately after operation and last follow-up ( P0.05). Conclusion: The auricular cartilage unfolding in treatment of the moderate concha-type microtia can receive more ear structures and increase auricle sizes, which make it possible for free composite tissue transplantation. In addition, the affected and the contralateral normal auricles have a very similar growth rate and it offers the theoretical foundation for the early treatment for moderate concha-type microtia.
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Anotia is the severe form of microtia anomalies that involve pinna and external auditory canal present at birth is rare to be associated with congenital facial nerve palsy. The author reports a man with Right side Anotia and ipsilateral facial nerve palsy. This is rare report of such an association in adult patient had right Anotia and ipsilateral right facial palsy.
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OBJECTIVES: The aim of this study was to analyze the incidence of inner ear anomalies in patients with unilateral congenital aural atresia (CAA) combined with microtia. METHODS: We retrospectively reviewed 61 patients with unilateral CAA combined with microtia who underwent high-resolution temporal bone computed tomography (TBCT) and hearing examination. Inner ear anomalies were analyzed using TBCT and evaluated according to the Jahrsdoerfer grading system, Marx classification, and extent of inferior displacement of the mastoid tegmen. RESULTS: Inner ear anomalies were observed in 14 patients (23.0%). Lateral semicircular canal (LSCC) dysplasia was the most common inner ear anomaly, with an incidence of 16.4%. The incidence was significantly higher on the pathologic side than on the unaffected side (P=0.002). All vascular anomalies were observed in the high-riding jugular bulb, with an incidence of 24.6%. The incidence was significantly higher on the pathologic side than on the unaffected side (P<0.001). LSCC dysplasia was significantly more common in patients with a lower Jahrsdoerfer score (odds ratio, 0.66; P=0.004). CONCLUSION: The incidence of inner ear anomalies was relatively high in patients with unilateral CAA combined with microtia; LSCC dysplasia was the most common anomaly and the probability of coexistence was higher in patients with a lower Jahrsdoerfer score.
Subject(s)
Humans , Classification , Congenital Microtia , Ear, Inner , Hearing , Incidence , Mastoid , Retrospective Studies , Semicircular Canals , Temporal BoneABSTRACT
Objective:To discuss clinical practice,efficacy and surgical techniques for ear reconstruction with Medpor.Methods:Medpor ear reconstructions were used to treat 19 microtia in 17 patients (including 2 bilateral patients) in Xiangya Hospital,Central South University from January 2011 to December 2015.Reconstructions included 2 patients with one-stage ear reconstruction with temporoparietal fascial flap,2 patients with one-stage operation implanting Medpor directly into skin pocket,and 13 patients with two-stage ear reconstruction.Results:After 1-3 years of follow-up,16 microtia in 14 patients gained ideal appearance.Scaffold exposure occurred in 3 unilateral cases,among which one patient who underwent debridement,removal of superficial exposed scaffold and transposition of local flap to salvage exposure was not significantly influenced,and the other 2 patients' scaffolds were still exposed after repairs and finally removed.One stent was removed at the patient's urging because it induced an exacerbation of periarthritis of the right shoulder.Conclusion:Medpor ear scaffold has advantages,such as easy assembly,good immunologic compatibility,fast vascular ingrowth,simple operation,short operative time and ideal appearance of the reconstructed ear.Medpor is an alternative for microtia repair when patients are unwilling to use autologous rib cartilage or costal cartilages are calcified.However,the relatively high incidence of scaffold exposure reminds us that the indications of Medpor should be taken seriously,and measures to avoid skin necrosis and scaffold exposure should be implemented.Long-term follow-up efficacy needs to be proved.
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Objective@#This study aimed to present our clinical experience of the utilization of remnant ear for the inferior part and lobule reconstruction in microtia patient with the fully pre-expansion ear reconstruction technique.@*Methods@#During 2017.01—2018.12, 156 cases of unilateral ear reconstruction were performed. The operation was divided into three stages. Six months after the ear reconstruction, the third stage of the remnant ear utilization was performed. The surgery was planned according to the microtia classification and the remnant morphology.@*Results@#All the patients had no complications. Follow-up period ranged from 7—24 months, and ten months on average. All the patients with typeⅠmicrotia had satisfying results of the inferior part and lobule reconstruction. Sixteen cases of types Ⅱand Ⅲ microtia patients had unfortunate outcomes, because the residual ears were too small to reconstruct the earlobe, and the incisure appeared when remnant and reconstructed ear was connected in cases of severe remnant malposition. The rest of patients were satisfied with the reconstruction.@*Conclusions@#The utilization of the remnant ear based on the types of microtia and the remnant morphology could achieve the satisfying result of reconstruction for most of the microtia patients.
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Objective@#To analyze growth changes in the ear by measuring the width and length of ears in a Chinese population and its application for auricular reconstruction.@*Methods@#A total of 480 participants were enrolled into 1 year, 3 years, 5 years, 7 years, 9 years, 12 years, 14 years and adult groups (half were boys and half were girls in each group). Ear length and width were measured and recorded. Ear index was calculated according to ear length and ear width. The growth of auricle and differences between genders were analyzed.@*Results@#Ear length and width increased with age. Ear length achieved its mature size in both 14-year-old males and females. Ear width reached its mature size in males of 7 years and in females of 5 years. Different trends of ear index were shown between males and females.@*Conclusions@#The data indicated that ear developed with age. There were gender and ethnic difference in the development of ear. Ear reconstruction should not be performed when the age of patient is less than 12 years old, if only the development of ear width is considered, the age of patient for surgery to be performed should not be less than 7 years old.