Techniques for improving ear definition in microtia reconstruction

Leach, Joseph L.; Jordan, Jennifer A.; Brown, Karla R.; Biavati, Michael J.

doi:10.1016/s0165-5876(99)00008-7

Cited by 13 publications

(7 citation statements)

References 5 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%

“…The salvage procedures included local flap coverage 34,49 or temporoparietal fascia transfer and skin graft 41,46,54 for frame exposure, cartilage removal, 39,48 or expander removal 18,27,43 due to infection and wire or suture removal after exposure. 34,52,54 Using temporoparietal fascia in the first stage of microtia reconstruction is controversial as it is a useful salvage procedure to cover the exposed cartilage frame.…”

Section: Discussionmentioning

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: Discussionmentioning

confidence: 99%

Complication Rate of Autologous Cartilage Microtia Reconstruction

Long

Huang

2013

Plastic and Reconstructive Surgery Global Open

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“…Twodimensional template, as proposed by Tanzer and Brent [2][3][4][5], was made by placing a piece of X-ray film against the normal ear and tracing its anatomic landmarks. The mirror-imaged three-dimensional auricular model [12] was developed by using laser scanning and rapid productive technology. This method facilitated fabricating, improved the contours of the cartilage framework and decreased operative time.…”

Section: Discussionmentioning

confidence: 99%

Ten-year experience in microtia reconstruction using tissue expander and autogenous cartilage

Jiang

Pan

Lin

et al. 2008

International Journal of Pediatric Otorhinolaryngology

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“…1,6 Methods and surgical techniques over the years have been based largely on the work of Tanzer and Brent using autogenous costal cartilage. 5,[9][10][11][12][13] In Tanzer's long-term follow-up study of 44 reconstructed auricles with autogenous costal cartilage over 6 to 19 years, he reported no diminution in height; no softening, shrinkage, or exposure of the framework; excellent resistance to trauma; and no functional deformity of the chest. 11 However, Tanzer did encounter noticeable blurring of the reconstructed auricle's contour in five patients, exposure of the framework in five patients, extrusion of metal sutures in the framework in 11 patients, hypersensitive chest scars in three patients, a hypertrophic chest scar in one patient, and seven patients with a depression in the region of the chest incision.…”

Section: Total Auricular Reconstructionmentioning

confidence: 99%

Aesthetic Microtia Reconstruction with Medpor

Romo

Reitzen²

2008

Facial plast Surg

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The complex architecture of the auricle makes it one of the most challenging structures for the reconstructive surgeon to re-create. Overlying the ear's unique cartilage framework are layers of varied soft tissues forming a three-dimensional organ, which is distinctively positioned on the head. Arguably, the most challenging auricle to reconstruct is third-degree microtia due to a near-total absence of native tissue and a need for lifelong durability of the reconstruction. Many methods of reconstruction have been studied; autogenous costal cartilage reconstruction has been one of the more traditional methods, with favorable long-term results reported by several surgeons. However, this technique requires tremendous artistic and technical skill on the part of the surgeon-sculptor to construct a realistic-appearing ear. High-density porous polyethylene (Medpor) is a stable, alloplastic implant that can integrate with host tissues, is resistant to infection, and has been successfully applied to reconstruction of the head and neck. For auricular reconstruction, Medpor--enveloped in a temporoparietal fascial flap with full-thickness skin graft coverage--is a durable and aesthetically gratifying alternative in microtic patients. This alternative surgical technique reduces surgical time and morbidity, standardizes results among surgeons, and facilitates an aesthetic, natural-appearing reconstruction of the auricle.

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Techniques for improving ear definition in microtia reconstruction

Cited by 13 publications

References 5 publications

Complication Rate of Autologous Cartilage Microtia Reconstruction

Complication Rate of Autologous Cartilage Microtia Reconstruction

Ten-year experience in microtia reconstruction using tissue expander and autogenous cartilage

Aesthetic Microtia Reconstruction with Medpor

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