The Effects Of Applying Endoscopic Temporoparietal Fascia Flap Harvest For The Second-stage Operation In Auricular Reconstruction Of Nagata’s Technique

Objective: In the second stage operation of the auricle reconstruction of congenital microtia a temporoparietal fascia flap is often used to cover the posterior part of the auricle scaffold.The traditional surgical incision includes the temporal skin along the fascial flap,which is traumatic and very long.Alopecia and long scars are often left behind,and a large amount of bleeding occurs is also caused during the harvest of temporoparietal fascia flap.Combining the anatomical structure of the temporoparietal fascia and the results of previous studies,we conducted a study on the application of endoscopic surgery to harvest the temporoparietal fascia in the second stage operation of the auricle reconstruction.Methods: This is a retrospective nonrandomized controlled study.The patients with microtia were included from the Department of Reconstructive and Plastic Surgery,General Hospital of Northern Theater Command from January,2015 to January,2022.The patients with microtia undergoing endoscopic temporoparietal fascia harvest in the secondstage operation were analyzed as the endoscopic group,and patients undergoing open surgery in the second-stage operation were selected as the control group.The follow-up time was 12 months.The satisfaction questionnaires used to evaluate the satisfaction and the quality of life of patients,conducted.The POSAS was used to evaluate the scar of surgical areas.Results: There were no significant differences in the satisfaction score,length of hospital stay,estimated blood loss and postoperative complications between the two groups.Operation time of endoscopic group was statistically longer.The length of scars in temporal area of endoscopic group is significantly shorter than the control group.Endoscopic groups showed statistically lower scores in POSAS and higher scores in GQOLI-74 than the control group.Conclusions: After the application of endoscopic assisted temporoparietal fascia flap harvest for the second-stage operation in auricular reconstruction for microtia,the scars in temporal area were minimized and the patients were more satisfied with the results.There were no obvious difference in the auricular appearance and the complication.