Team Approach to Total Auricular Reconstruction

Kesselring, Ulrich K.; Goumöens, R de

doi:10.1097/00000637-199104000-00003

Cited by 4 publications

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“…In cases of bigger ossicular deformities autotransplant of cortical bone, or other reconstructive materials can be used. 8 Audiologic results of combined reconstruction are unequally reported. The success depends on the degree of deformity of external and middle ear.…”

Section: Discussionmentioning

confidence: 99%

Modified Surgical Technique for Combined Congenital External and Middle Ear Malformations

Stanković

Zivaljevic

Simic

et al. 2008

International Bulletin of Otorhinolaryngology

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Hypothesis: There is a positive correlation between type and intensity of combined congenital ear malformations and results of surgical reconstruction. Background: Combined congenital malformations of external and middle ear pose a lot of surgical problems and demand adequate skill and planned, fractioned therapy. The goals of these operations are: limited number of operations with minimal complications, well cosmetic result, hearing improvement and easier use of hearing aid, removal of congenital cholesteatoma, preservation of labyrinth and facial nerve. Methods: The aim of this work is to present the experience in treating patients with combined malformations of external and middle ear. In the period between 1992 and 2001 seventeen patients with this type of congenital malformations were operated. Classical dilemma who operates first, plastic surgeon or otosurgeon is solved here by complete otosurgical treatment with reduced number of operations. Results: Totally 36 operation was performed, two reoperations were made in four patients, and also three operations in three patients for the reconstruction of deformity of auricle. In seven patients costal rib cartilage was used for auricular framework. Reoperations were done during the course of auricular reconstruction (14 operations), or because of meatal restenosis (five operations), or cartilage graft necrosis (one case). Atresia was adequately solved in 14 patients, while in three cases connective tissue meatal restenosis was found. The results of reconstruction of auricular malformation were aesthetically good in 13 patients and sufficient in four patients. Conclusion: We found positive correlation between external ear and middle ear deformity, and the results of reconstruction, as well. Two thirds of patients have hearing threshold level under 30 dB, while the threshold in other patients is 30-40 dB. Residual airbone gap amounting about 20 dB was universally present.

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Section: Discussionmentioning

confidence: 99%

Modified Surgical Technique for Combined Congenital External and Middle Ear Malformations

Stanković

Zivaljevic

Simic

et al. 2008

International Bulletin of Otorhinolaryngology

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“…In a previous work, 70 the author of this thesis endorsed the Brent method of reconstruction. So did Kesselring and de Goumoens, 71 whose technique consolidated the surgical procedure into three stages. Their first stage is the creation and transplantation of the supporting autogenous cartilaginous framework; the second stage is the detachment of the reconstructed auricle and simultaneous middle ear surgery; and the third stage is refinement, including the tragus graft and the earlobe transposition.…”

Section: Advances In Techniques Of Auricular Reconstructionmentioning

confidence: 99%

Auricular Reconstruction of Congenital Microtia (Grade III)

Aguilar

1996

The Laryngoscope

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The auricular deformity of congenital microtia (Grade III) is almost always associated with congenital atresia, an affliction that can cause devastating physical and psychological trauma in children. Auricular reconstruction for congenital microtia (Grade III) should provide a child with a reasonable facsimile of an ear through a limited number of surgical procedures, with minimum complications. To achieve this result, the author developed the Integrated Auricular Reconstruction Protocol (IARP). The IARP consists of five stages: Stage I--framework construction and placement; Stage II--lobule creation; Stage III--atresia repair; Stage IV--tragal creation; and Stage V-auricular elevation. Over a period of 5.5 years, the author performed 188 surgical procedures on 63 patients, completing 31 ears. This thesis has four objectives. The first is to strongly recommend that a child with congenital microtia and atresia be seen as early as possible by both a plastic surgeon and an otologist. The second objective is to describe a protocol by which both defects can be corrected without endangering the integrity of either. The third objective is to advocate the involvement, from the very beginning, of not only the child but also the family--a critical but often over-looked component of the treatment of congenital microtia and atresia. The fourth and final objective is to propose that plastic surgeons interested in auricular reconstruction dedicate themselves to the performance of at least 10 such reconstructions per year.

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Combined Aesthetic and Functional Treatment of Microtia

Meyer

Goumöens

Derder

1997

Aesthetic Plastic Surgery

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The reconstruction of the ear pavilion includes at least two stages, usually three, and in many cases more. Complete reconstruction must begin with the plastic surgeon, who sculpts the cartilaginous skeleton, assembles parts of three ribs, and inserts the finished framework under the expanded skin of the mastoid area. During the second stage, the otologist intervenes, performing the cophosurgery, carving an external auditory canal, and completing the ossicular chain in the middle ear. The plastic surgeon harvests the skin for lining the external auditory canal and for the retroauricular fold and forms the lobule with a part of the microtic vestige. The third stage is dedicated to refinements. Cophosurgery may also be performed during the third stage or in an interval between two stages of pavilion construction. Twenty-one cases are discussed.

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Team Approach to Total Auricular Reconstruction

Cited by 4 publications

References 0 publications

Modified Surgical Technique for Combined Congenital External and Middle Ear Malformations

Modified Surgical Technique for Combined Congenital External and Middle Ear Malformations

Auricular Reconstruction of Congenital Microtia (Grade III)

Combined Aesthetic and Functional Treatment of Microtia

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