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A New Microtia Reconstruction Method Using Delayed Postauricular Skin Flap

Li, Gaofeng M.D.; Zhang, Fan M.Sc.; Ding, Wei M.Sc.; Wu, Zihan M.Sc.; Hu, Yigao M.Sc.; Luo, Tao M.B.; Zhang, Bo M.Sc.; Jiang, Xia M.B.

Plastic and Reconstructive Surgery: April 2017 - Volume 139 - Issue 4 - p 946–955
doi: 10.1097/PRS.0000000000003227
Pediatric/Craniofacial: Original Articles

Background: This article presents a new microtia reconstruction method using a delayed postauricular skin flap.

Methods: The surgery is scheduled in three stages, the first of which delays the postauricular skin flap and deals with the remnant auricle. Three weeks later, the second stage is carried out. An erect, three-dimensional ear framework fabricated from autogenous rib cartilage is inserted between two flaps. The anterior auricular surface of the framework is draped with the delayed skin flap, and the postauricular surface is draped with postauricular fascia and overlying grafted skin. Six months later, the third stage reconstructs the tragus and shapes a hollow mimicking the external auditory meatus, and locally improves the reconstructed auricle.

Results: Ninety-six cases of microtia were reconstructed using the delayed skin flap. All ear reconstructions were successful, with good locations, sizes, and shapes, with few complications.

Conclusions: The authors’ method enables an adequately large, thin skin flap with sufficient blood supply, and also appropriately manages the remnant auricle. A delayed postauricular skin flap with a three-dimensional autologous costal cartilage framework represents a promising approach to microtia reconstruction.

Supplemental Digital Content is available in the text.

Changsha, Hunan Province, People’s Republic of China

From the Department of Plastic and Cosmetic Surgery, Hunan Provincial People’s Hospital, The First Affiliated Hospital of Hunan Normal University.

Received for publication May 3, 2016; accepted August 31, 2016.

Disclosure: The authors have no financial interest to declare in relation to the content of this article.

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Gaofeng Li, M.D., 61 Jiefangxi Road, Changsha 410005, Hunan Province, People’s Republic of China,

©2017American Society of Plastic Surgeons