| Title | Subfascial expansion and expanded two-flap method for microtia reconstruction. | | Author(s) | Park C | | Institution | Department of Plastic Surgery, Yonsei University College of Medicine, Yongdong Severance Hospital, Seoul, Korea. Chulpark@yumc.yonsei.ac.kr | | Source | Plast Reconstr Surg 2000 Dec; 106(7):1473-87. | | MeSH | Adolescent
Adult
Cartilage
Child
Ear Cartilages
Ear, External
Esthetics
Fascia
Female
Follow-Up Studies
Humans
Male
Mastoid
Middle Aged
Patient Care Planning
Postoperative Complications
Reconstructive Surgical Procedures
Skin
Skin Transplantation
Surgical Flaps
Time Factors
Tissue Expanders
Tissue Expansion
Transplantation, Autologous
Treatment Outcome
| | Abstract | This article presents an improved two-flap method for microtia reconstruction. In the first stage of this method, a tissue expander is inserted in the mastoid region through a subfascial pocket, after which the overlying fascia and skin are expanded simultaneously with saline infusion for about 5 months. In the second stage, the expanded fascial and skin layers are split and prepared as anteriorly based skin and fascial flaps defined by their vascularity. An erect, three-dimensional, contour-accentuated ear framework fabricated with autogenous rib cartilage is inserted between the two flaps. The anteroauricular surface of the framework is draped with the thin, expanded skin, and the postauricular surface is draped with the thin, expanded fascia and overlying grafted skin. In the third stage, remnant auricular cartilage is removed and the crus helicis, tragus, intertragic notch, conchal floor, and a hollow mimicking the external auditory meatus are shaped. In this study, 146 microtias were reconstructed consecutively using the improved two-flap method. The final results were promising--major complications were minimal and most patients showed consistently favorable aesthetic results. This method married a two-flap procedure with a gradual tissue expansion, conveniently exploiting the advantages of both methods, but without the disadvantages. | | Language | eng | | Pub Type(s) | Journal Article
| | PubMed ID | 11129174 |
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