Auricular reconstruction with Medpor framwork and expended fascial flap / 中国组织工程研究

ABSTRACT

Auricle reconstruction involves auricular framework construction and selection of skin soft tissues that coats the auricular support. To date, there has no ideal biomaterial for the auricular framework. The materials of auricular framework include autologous costal cartilage, medical grade silicon rubber, and porous polyethylene. The autologous costal cartilage avoids rejection, and has advantages such as good flexibility, easy combination with surrounding coated tissues, and low surgical cost. However, the acquisition causes injury, increases pain of patients, alters thoracic cage structure, and the cartilage graft is absorbable and deformable. The medical grade silicon rubber exhibits good exposure rate and high inflammation, which limit its clinical application. Medpor implant has been used recently as novel medical chemical synthesis materials. It makes of high density polyethylene, with strong plasticity, time-efficacy, stable fusion with local tissue and good biocompatibility. However, the exposure of Medpor implant is the complication. In this study, the Medpor implant in combination with total auricle reconstruction was used to treat 12 cases of congenital microtia, trauma-induced auricular defect, auricular defect complicated by atresia of external auditory canal and hearing disturbance. Postauricular fascial flap was expanded to form reconstructed auricle, followed by wound skingrafting. The expanded fascial flap improves blood supply, with close coating, decreases complications. Moreover, all reconstructed auricle survived, with no ulcerate or exposure, and the appearance is similar to normal auricle.