Retrospective Analysis On The Reconstruction Of Acquired Partial Auricle Defect By Combined Autologous Costingcartilage With Pre-expanded Bi-pedicle Flap

As surface symmetrical organsand expose externally to the sides of heads,auricles are vulnerable to injuriedsuch as cut,squeeze,tear and tumor resection resulting in defects with varying severities.Auricle defect affects the patient's appearance and can lead to severe psychological problems in patients that include depression,anxiety,lacking of confidence and poor social skills Patients often actively seek ear reconstruction and the surgical correction is the only treatment currently available.At present,partial auricle deformitycan be repaired by many methods.Generally,the main operation mode accepted by patients and clinicians can be divided into one-stageand multi-stage ear reconstructions.Although each of these methods can satisfy the requirement of repair,many problems still exist,namely bloated auricle,hard texture,ambiguous three-dimensional structure,different colour and lustre,contracture deformity,shallow cranial ear angle.To improve the outcomes of the reconstruction,a method that combines pre-expanded bi-pedicle flaps with autologous costicartilagescaffolds was adopted to repair the auricle defects.The results were satisfactory and the repaired earshad good continuities,overt postoperative subunit structures,identical colors and textures with adjacent skin tissues.Objective To introduce the procedure of the combined pre-expanded bi-pedicle flap with autologous costicartilage scaffold in the repair of acquired partial auricle defects and to analyze the clinical outcomes and the advantages and disadvantages of this surgical method.Methods A retrospective study was performed to analyzethe demographic data,surgical procedures,complications and outcomes of patients withacquired partial auricle defects who received treatments in the Department of Plastic and Reconstructive Surgery,Xijing Hospital during 2010-2015 by the reconstruction method of combined pre-expanded bi-pedicle flap with autologous costicartilage scaffold.Results Twenty-nine patients undergoing the reconstructive procedure were followed up for 1-2 years,with 8 months of mean follow-ups,postoperatively.Twenty-one patients were satisfied with the treatment results whereas the surgical outcomes were regarded as acceptable by 7 patients and non-acceptable by 1 patient.Complications were recorded in 6 cases and all of them were corrected by further procedures.Conclusion The repair of acquired partial auricle defects with the combined pre-expanded bi-pedicle flap with autologous costicartilage scaffold satisfactorily restores the overt three-dimensional structures of the ears.Our study indicates that this method is an appropriate procedure for treatment of acquired partial auricle defects and can effectively overcome the bloat,ambiguous structure,and color mismatch of the ears that are commonly seen with other conventional reconstructive methods.