Clinical Research Of Improvement For Nagata Method In Auricular Reconstruction

Objective:The Nagata(two stage)method in Auricular reconstruction improvement in clinical application,in order to better meet the demand of microtia patients and their families in Chinese,offer less trauma and pain,improve the safety and effect of the treatment plan.Methods:From January 2015 to January 2016,a total of 584 patients with congenital microtia malformation were treated,microtia on the left side of the 254 cases,the right side of the microtia 312 cases;A total of 385 of the patients were male,and 199 were female,ranging in age from 6 to 14 years with an average of 7.60±2.56 years old.By preoperative local soft tissue condition assessment,selected the 106 cases of patients the Nagata(two stage)method,completed in two phases:the costal cartilage was harvested and the framework was fabricated,The earlobe transposition and The tragus reengineering;Second stage surgery for cranial ear forming Angle,ear fascia flap coverage,medium thickness skin grafting.Results:The latest 228 cases choose The Nagata(two stage)method in Auricular reconstruction,were followed up for 6 months to 16 months,an average of 8.3 months.By methods of outpatient service,telephone follow-up,the reengineering ear and overall assessment of the operation,are very satisfied with this group of patients with postoperative follow-up(15-20)of 167 cases with 28 cases(8 to 14),not satisfied(0 to 7)9 cases,24 cases received no follow-up,satisfaction rate of 95.5%.This group of patients with a total of 5 cases happen complications,all were restored after treatment.First stage complications is hematoma;Groups of 3 patients with postoperative hematoma,1 case after clean dressing indoor recovery,2 case with active bleeding,in the operating room to remove the hematoma and to stop bleeding;second stage complications mainly for:after ear skin graft survival,ear holder leakage.This group of patients after ear skin graft survival were 1 case,after dressing the healing;Ear cartilage constructs the leakage in 1 cases,Helix 1/3 cartilage on the leakage in 1 case,use the temporoparietal fascia flap covering the outer ear cartilage of leakage through the subcutaneous tunnel,fascia surface free skin graft,recovering well after surgery.Conclusion:The ear reengineering with the Nagata(two stage)technology applied to the practice in our country,we according to the requirements of the patient and family to redesign the Nagata(two stage)technology.Pass the assurance of pair of surgical indications and the improvements of rib cartilage engraving technology and adopt method of rib cartilage renewal,meet the requirements of the patient and family to school before surgery.Reduce the scalp and chest scar;Reduces the demand of rib cartilage,better avoid thoracic deformity;Better highlight the helix,antihelix and tragus anatomical structure,improved the shape of the ear reconstruction in patients with satisfaction.