Auricle Reconstruction Using Soft Tissue Skin Expansion And Autogenous Rib Cartilage Transplantation

Objective: To report a group of auricle reconstruction cases of congenital or acquired auricle defect from Shandong Provincial Hospital , and to investigate the clinical effects of surgical treatment and the appearance of improvements, to probe the recent development and the relative merits of scaffold materials hoping to heighten the clinical treatment level of this kind of patients.Methods:â‘ Study subjects: 10 auricle defect cases were investigated and recruited in Shandong Provincial Hospital from March 2004 to March 2009.â‘¡Materials and methods: Soft tissue skin expansion and autogenous rib cartilage transplantation were used for auricle reconstruction in three stages: stage I : An appropriate size expander was implanted in the superficial fascia layer in the retroauricular mastoid area. Fluid(sterile physiological saline) was injected into expander gradually for about 3 months; stage II: Reconstruction of the external ear was carried out. The 6th-8th rib cartilage were harvested and carved into ear framework. The expander was removed, and the cartilage framework was placed between the expansive skin and the post ear fascia, stageIII: About six months after the stage II operation, the ear cavity and tragus were rebuilt.â‘¢Research assessment: The reconstructed auricle and patterns of survival were observed through out patient clinic records or telephone follow-up; and the medical literature about the treatment of auricular defect and the recent development of scaffold materials were reviewed simultaneously. Results: Nine (one has just completed stage I operation) reconstructed auricles all survived, and were followed in a period from 2 to 60 months. To the time this study achieved, there haven't been exposions of cartilage framework or splicing wires, flap necrosis, pleural injury, thoracic deformity or other complications. Ten reconstructed auricles have realistic shape, flexible texture, strong three-dimensional sense, almost the same color and location as the normal side. Cartilage framework had no obvious degeneration, absorption and deformation.Conclusion: It is a satisfactory method for auricle reconstruction by using soft tissue skin expander together with autogenous rib cartilage framework at present .The reconstructed ear can keep good shape, also make up for the disadvantages of other reconstruction materials, such as Medpor which is more hard and easily exposes. With the development of tissue engineering and computer technology, more and more scaffold materials of excellent biocompatibility will be created and will be better sculptured, so the treatment of auricular defect will be progressed.