Total Reconstruction of the Auricle: Our Experiences on Indications and Recent Techniques

Abstract

Introduction. Auricular reconstruction is a great challenge in facial plastic surgery. With the advances in surgical techniques and biotechnology, different options are available for consideration. The aim of this paper is to review the knowledge about the various techniques for total auricular reconstruction based on the literature and our experience. Methods. Approximately 179 articles published from 1980 to 2013 were identified, and 59 articles were included. We have focused on the current status of total auricular reconstruction based on our personal experience and on papers of particular interest, published within the period of review. We have also included a prospective view on the tissue engineering of cartilage. Results. Most surgeons still practice total auricular reconstruction by employing techniques developed by Brent, Nagata, and Firmin with autologous rib cartilage. Within the last years, alloplastic frameworks for reconstruction have become well established. Choosing the reconstruction techniques depends mainly on the surgeon's preference and experience. Prosthetic reconstruction is still reserved for special conditions, even though the material is constantly improving. Tissue engineering has a growing potential for clinical applicability. Conclusion. Auricular reconstruction still receives attention of plastic/maxillofacial surgeons and otolaryngologists. Even though clinical applicability lags behind initial expectations, the development of tissue-engineered constructs continues its potential development.

Rare defect at superior helix as morphological variation of right auricle

“…12 Base on Weerda classification, morphological defect of right auricle at superior helix in this case belong in grade I malformations, sub group small deformities. 4 Characteristic of grade I malformations and small deformities in this case indicated that most structures of normal auricle are present, and small deformities of right auricle at superior helix were indentation ( Figure 1B, Figure 1D). Refer to the appearance of auricle abnormality turns out to involve a variety of auricular component malformations 3 and the term of means "small ear" although in the literature it applies to small or malformed ears, then small deformities of right auricle at superior helix in this case were indentation be able to classified in microtia.…”

“…The size of normal auricle depends on various factors such as age, 4 gender, and body height has been reported. 2,4 The TEL in adults is about 58-66mm (in women 58-63 mm and men 62-66mm) and EB approximately 32-34mm.…”

“…2,4 The TEL in adults is about 58-66mm (in women 58-63 mm and men 62-66mm) and EB approximately 32-34mm. 4 Based on guideline used by Storck et al, TEL of the left and right auricles in this case is longer and EB is normal. 4 Beside that the TEL and LW in this case are longer than means of population study results.…”

“…2 Moreover, the characteristic of morphological appearance and biometric of auricle in individual are influenced by genetic and environment factors. 3,4 Because that, of course that the shape, size and orientation of each auricle in individual is specific and associate with genetic and or environment factors. With regard to auricle size, length and width of the auricle increase with age.…”

“…malformations and or external factors such as trauma, burns, tumors, punctured defects, scars, and inflammation/allergies. 4 More over that congenital defect of auricle show varying degrees, and is more commonly unilateral than bilateral, more effecting on the right ear than left ear and occurs in males more than females. 9 Certainly, the consequences of congenital defect will affect the morphological variation in the individual.…”