Microtia Reconstruction - Stage 3

Considerations

• • Stages

  • 1995: Microtia repair

    • 2011: A Novel Algorithm for Autologous Ear Reconstruction - Françoise Firmin

  • Nagata Method

  • Technique 

  • 2007: Two-stage reconstruction of the auricle in congenital microtia using autogenous costal cartilage

  • 2008: Ten-year experience in microtia reconstruction using tissue expander and autogenous cartilage

  • 2010: Expanded retroauricular skin and fascial flap in congenital microtia reconstruction

  • 2012: Implant double tissue expanders superposingly in mastoid region for total ear reconstruction without skin grafts

Preparation

• • Trays: Plastics, Eye

  • Weck blade

  • Local anesthesia: 1% lidocaine with 1:100,000 epinephrine and 0.25% marcaine with 1:200,000 epinephrine.

  • Sutures: 5-0 Biosyn, 3-0 and 4-0 Maxon, 5-0 Fast Gut, 5-0 Plain Gut

  • Steri-strips, skin glue, Mastisol, Telfa, Tegaderm, Glasscock dressing

Procedure

Sample operative report

Post-op

• • Medications

    • Antibiotics - skin coverage x 7 days 

    • Analgesic - Acetaminophen +/- narcotic, Ibuprofen OK

• Wound care

  • Glasscock dressing can be removed as needed and then replaced 

  • Leave the mold in place for 7-10 days 

  • Remove the groin outer dressing in 2 days, OK to wash, do not soak for 2 weeks 

  • Keep ears until mold removed then light washing OK 

Pearls & Pitfalls

High-Yield

Links

• eMedicine - Pediatric Microtia Surgery Treatment & Management

• UTMB Gran Rounds - Microtia Reconstruction

• YouTube (5:56) - Second stage of Ear Reconstruction – Correction of Microtia - Dr. S.M Balaji