Monday, April 25, 2016

Working on an ear template for complicated microtia reconstruction

•The costal cartilage is the most commonly used and preferred material because it is durable and 

stable; however it leaves an anterior chest wall deformity

The cartilage framework is harvested from the synchondrosis of the 6th,7th and 8th ribs

The pericondrium is preserved

Silicon and porous polyethylene are not popular anymore because of the high complication rate post 

op (migration, infection,extrusion even after minor trauma)

Trace the normal ear on a piece of x ray film

The template is made several mm smaller to accommodate for the thickness of skin
For symmetry: ear relationship to nose, lateral canthus and position of lobule, superior pole of opposite ear
* The cartilage is stacked in 2-3 layers(fig7);nylon sutures can also be used

2nd stage after 6 months: The ultra thin skin graft for second stage microtia repair
(Chen C OT hands on OT demos CGMH 2006)

suggested reading:

  .   Kotaro Y MD:One stage recon of upper defect of auricle: Aesthetic Plastic 

         Surgery.22:352 355,1998

   .  LF Ou :firm elevation in recon of microtia with a retroauricular fascial wrapping an 
          autogenous cartilage wedge : BJPS 2001,54,573-580

Eli                  Elisabeth KB,MD :Microtia Part 1 :PRS  CME June 2002

          Elisabeth KB,MD :Microtia Part 2: PRS CME July 2002

      . Zung Chen MD :Microtia Recon with adjuvant 3D template model: Annals Plastic Surgery       2004;53:282-287

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