Selection of surgical plan for the congenital microtia with deformities of external auditory meatus (EAM) and middle ear / 解放军医学杂志

ABSTRACT

Objective To investigate the best way for the operation of congenital microtia with deformities of external auditory meatus (EAM) and middle ear. Method To analyze retrospectively 305 cases (332 ears) of auricle reconstruction operated in the Plastic Department of Auricle, Plastic Surgery Hospital, PUMC, CAMS during June to October 2005, and 49 cases (58 ears) of reconstructions of EAM and middle ear operated in the Otolaryngology Department, General hospital of PLA from December 1988 to July 2002. Results The patients/families rested content with the reconstructed auricles operated with the 3-stage way. The hearing was improved obviously after reconstruction of the EAM and ossicle for the patients with normal stapes footplate. In those patients, for whom EAM was reconstructed first, the scar developed around the orifice which affected the skin flap for auricle reconstruction later, while in those patients, for whom the auricle was reconstructed first, wrong location of the EAM orifice happened easily. Conclusions For the patients with congenital deformities of EAM and middle ear and with the requirement of recovering the appearance and hearing function, the EAM orifice should be located first according to the results of temporal CT, then the auricle reconstruction was conducted with 3-stage method. A simultaneous reconstruction of EAM and ossicle at the third stage may ensure the improvement of both outward appearance and hearing function.