Exceedingly expanded retroauricular flaps for microtia reconstruction

Chen, Zhen‐Yu; Zhang, Weina; Jing, Huang; Ren, Jizhen; Zhu, Yunfan

doi:10.1016/j.bjps.2011.06.025

Cited by 18 publications

(15 citation statements)

References 13 publications

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“…One early article mentioned the start of the serial ear reconstruction before 4 years old. 47 Most of the others start to perform the surgery at the age older than 7 years in average, 3,4,9,10,12,14,15,18,20,22,24,27,28,31,34–36,39–41,43,45,48–54 which is consistent with the US national survey published in 2013 1 and the international survey on the fourth International Ear Reconstruction Congress in Edinburgh. 55 …”

Section: Resultssupporting

confidence: 79%

“…No author reported 1-stage ear reconstruction within the recent 10 years. (2) Tissue expansion group: Chinese surgeons mostly reported their techniques using tissue expander in recent 5 years 24–34 with the expander size varing from 50 to 90 ml. Most authors chose skin graft to reconstruct the postauricular sulcus, the concha, or the mid-ear canal.…”

Section: Resultsmentioning

confidence: 99%

“…Only 3 articles using tissue expander declared that skin graft was not used at all. 24,26,35 Authors of twelve articles reported their experiences of simultaneously external and mid-ear reconstruction. 10–12,15,17,27,36–40 Sixteen articles reported the technique of using fascia to cover the framework, including temporoparietal fascia 4,5,7,10,36,41–44 or mastoid fascia.…”

Section: Resultsmentioning

confidence: 99%

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Complication Rate of Autologous Cartilage Microtia Reconstruction

Long

Huang

2013

Plastic and Reconstructive Surgery Global Open

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Background:Autologous cartilage has been widely accepted as the frame material of ear reconstruction for patients with microtia. Although rare, there are multiple complications related with the surgical reconstruction techniques. The authors performed a systematic review of the English literature of microtia reconstruction to determine significant surgical factors that are predictors of postoperative complications.Methods:A PubMed search using the terms “ear reconstruction” and “microtia” was conducted. Articles were screened using predetermined inclusion and exclusion criteria. Data collected included patient characteristics, surgical techniques, the incidence of all kinds of complications, and the specific postoperative morbidity. Patient cohorts were pooled, and the incidence of complications was calculated. Significant predictors such as the use of tissue expander, simultaneously mid-ear reconstruction, with/without skin graft, and different fascia coverage were analyzed by chi-square test.Result:Of 320 articles found, 60 met the inclusion criteria. Totally 9415 patients with microtia were analyzed in this review with 1525 cases with complications. The overall complication incidence is 16.2% in average with a range of 0–72.9%. There was no significant difference when comparing the overall complication rate between with/without preexpansion 2-stage and multiple-stage techniques or with/without mid-ear reconstruction simultaneously.Conclusion:Although there is little agreement in literature regarding risk factors for complications, the authors were able to demonstrate several significant predictors by systematically analyzing 60 articles. Improved knowledge of the incidence of different complications related with various surgical methods can help surgeons provide improved preoperative counseling and take measures to minimize the risk.

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Section: Resultssupporting

confidence: 79%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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Complication Rate of Autologous Cartilage Microtia Reconstruction

Long

Huang

2013

Plastic and Reconstructive Surgery Global Open

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“…11 Expansion in auricular reconstruction was then later described by several other authors. [12][13][14][15] Rather than tissue expand, we harvest a large TPF flap to cover the entire cartilage construct.…”

Section: Discussionmentioning

confidence: 99%

A True Single-Stage Reconstruction of a Projected Auricle for Concha-Type Microtia Incorporating Endoscopically Harvested Temporoparietal Fascia

Nataliya

Martin²

2015

Journal of Craniofacial Surgery

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Reconstruction of microtia with autogenous costal cartilage that produces a well-projected ear in a single stage is a challenging endeavor. In this case report, we describe a single-stage, projected costal cartilage-based reconstruction of concha type mitoria. Due to the patient's low hairline, his hair-bearing scalp would encroach on the ear framework if placed subcutaneously in the standard fashion. Thus, a large TPF flap harvested with endoscopic assistance was planned to achieve both a color-matched hairless skin envelope and a well-projected ear in single stage.

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“…However, this method increases the complexity of the operation and increases the risks of complications associated with expansion, including hematoma, exposure, and an obvious post-auricular scar. Chen et al [11] reported implanting a 50-mL kidney-shaped expander in the retroauricular mastoid region and infusing saline solution to a final volume of 100-120 mL. In this fashion, sufficient retroauricular non-hair-bearing skin was obtained for coverage of the auricular cartilage framework without the use of skin grafts or a retroauricular fascial flap.…”

Section: Discussionmentioning

confidence: 99%

Full retroauricular skin and fascia expansion in microtia reconstruction: a single center experience of 166 cases

Wang¹,

Tang²,

He³

et al. 2016

PAR

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Aim: Ear reconstruction is a challenge for plastic and reconstructive surgeons. The ear requires sufficient skin coverage and a three-dimensional (3D) cartilage framework. In this paper, the authors present their 10-year experience in microtia reconstruction using tissue expansion and an autogenous rib cartilage framework. Methods: Ear reconstruction was performed in 3 operative stages. During the first procedure, a 50-80 mL kidney or cylinder-shaped expander was implanted deep to the subcutaneous fascia of the retroauricular mastoid region. Over a period of 3-5 months, the expander was filled to a final volume of 80-110 mL. In the next operation, the retroauricular fascia was eliminated or reserved following expander removal, and the autogenous costal cartilage framework was placed below the expanded skin flap. At the third and final stage, the earlobe transposition, tragus construction and conchal deepening were performed. Results: A total of 165 patients (166 ears) were reconstructed using tissue expansion and an autogenous rib cartilage framework. Complications included hematomas in 3 cases, expander exposure in 8 cases, cartilage exposure in 6 cases, infection and cartilage resorption in 2 cases, exposure of steel wire in 4 cases, and aseptic seroma in 2 cases. Follow-up ranging from 3 months to 5 years showed that 159 patients were satisfied with the reconstructed ear including size, location, projection, convolution, skin-colour matching, symmetry with opposite ear. Conclusion: Expansion of the retroauricular skin and fascia can provide sufficient non-hair-bearing skin and tissue for coverage of a three-dimensional costal cartilage framework. Avoidance and prompt treatment of complications are advised in order to obtain a satisfactory reconstruction of the ear. Key words:Microtia, expansion, autogenous costal cartilage, ear reconstruction ABSTRACTArticle history:

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Exceedingly expanded retroauricular flaps for microtia reconstruction

Cited by 18 publications

References 13 publications

Complication Rate of Autologous Cartilage Microtia Reconstruction

Complication Rate of Autologous Cartilage Microtia Reconstruction

A True Single-Stage Reconstruction of a Projected Auricle for Concha-Type Microtia Incorporating Endoscopically Harvested Temporoparietal Fascia

Full retroauricular skin and fascia expansion in microtia reconstruction: a single center experience of 166 cases

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