Experience of external ear reconstruction by applying completely expanded retroauricular flap in 52 patients with congenital microtia
Objective To summarize the clinical experience of external ear reconstruction with large-capacity dilator in patients with congenital microtia.Methods The surgery was carried out in three stages.In the first stage,the soft tissue expander of post-auricular skin was placed in the residual ear,and the post-auricular skin was fully expanded.In the second stage,the expander was removed and the right side of rib cartilage was taken to sculpture the ear cartilage scaffolding,which was embedded under the expanded flap to obtain a three-dimensional ear shape.Finally,the reconstructed ear was partially trimmed,so that the reconstructed ear was close to the normal ear.Results The 52 patients operated in Wuhan Third Hospital from 2013 to 2022 were followed up for 6 months to 3 years.46 patients of reconstructed ear were satisfied with clear and three-dimensional ear structure,good symmetry with the healthy ear,and no displacement or deformation of cartilage scaffolding,and 4 patients had shallow cranio-auricular angles,and full-thickness skin grafts were performed to deepen the cranio-auricular angle in stage III.In 2 cases,the scaffolds were absorbed,and the reconstructed ears were poorly shaped.Conclusion For patients with congenital microtia,applying completely expanded retroauricular flap method of external ear reconstruction can provide a clear and three-dimensional structure of the reconstructed ear,with good uniformity of complexion and texture,and fewer complications,solving the drawbacks of the traditional expansion method that requires skin grafting and reducing the possibility of scarring.
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