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New Strategies for Remnant Ear Treatment in Lobule-Type Microtia Reconstruction

Xu, Zhicheng, M.D., Ph.D.; Zhang, Ruhong, M.D., Ph.D.; Zhang, Qun, M.D., Ph.D.; Xu, Feng, M.D., Ph.D.; Li, Datao, M.D., Ph.D.; Li, Yiyuan, M.D., Ph.D.

Plastic and Reconstructive Surgery: August 2018 - Volume 142 - Issue 2 - p 471–479
doi: 10.1097/PRS.0000000000004610
Pediatric/Craniofacial: Original Articles

Background: Numerous modifications have been successfully applied in microtia reconstruction over the past several decades, and lobular transposition has become a routine technique in a two-stage operation. However, it is still a demanding challenge to manipulate the remnant ear with various quantities or positions in lobule-type microtia. The authors demonstrate the relevant details of treating remnant tissue in different conditions.

Methods: A total of 390 lobule-type microtia patients underwent autogenous costal cartilage auricular reconstruction between 2010 and 2015. Because the quantity or position of the remnant ear varies from patient to patient, corresponding tactics need to be taken into consideration for appropriate treatment. Four possible scenarios of remnant ear shape have been described, and relevant strategies for each were introduced.

Results: Favorable reconstructed auricles with aesthetic natural earlobes have been produced; the location of the reconstructed ear is symmetric to the contralateral ear. It provides a harmonized framework and periphery tissue for the integrity of the contour of the constructed auricle.

Conclusions: Proper use of the remnant ear along with framework fabrication and skin flap dissection are critical factors for attaining a satisfactory contour of the auricle in microtia reconstruction. The authors’ technique made it possible to construct a cosmetically refined ear with harmonious integrity.

CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, V.

Shanghai, People’s Republic of China

From the Department of Plastic and Reconstructive Surgery, Shanghai Ninth People’s Hospital, Shanghai JiaoTong University, School of Medicine.

Received for publication July 9, 2017; accepted January 24, 2018.

Disclosure: None of the authors has a financial interest to declare in relation to the content of this article.

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Ruhong Zhang, M.D., Ph.D., Department of Plastic and Reconstructive Surgery, Shanghai Ninth People’s Hospital, Shanghai JiaoTong University School of Medicine, No. 639, Zhi Zao Ju Road, Shanghai 200011, People’s Republic of China, zhangruhong@163.com

©2018American Society of Plastic Surgeons