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

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 utilization of the remnant ear as well as framework fabrication and skin flap dissection are critical factors to attain a satisfactory contour of the auricle in microtia reconstruction. Our technique made it possible to construct a cosmetically refined ear with harmonious integrity. Financial disclosure: None of the authors has a financial interest to declare in relation to the content of this article. ACKNOWLEDGMENT: The authors thank Dr. Françoise Firmin, M.D., Ph.D., Dr. Cheng Wang M.D., Dr. Chunxiao Cui M.D., Ph.D., Dr. Tianya Li M.D., Ph.D. and Dr. Wei Chen M.D., Ph.D. for contributing to the work. Corresponding Author: Dr. Ruhong Zhang M.D., Ph.D., Professor in the Department of Plastic and Reconstructive Surgery, Shanghai 9 th People's Hospital, Shanghai JiaoTong University School of Medicine, No. 639, Zhi Zao Ju Rd., Shanghai, China. 200011, Phone: 86-21-23271699-5122(EXT.) Fax: 86-21-63136856, Email: zhangruhong@163.com ©2018American Society of Plastic Surgeons

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