Retrospective Study On The Treatment Of Burn Ear Deformity

Purpose:The external ear is an intricate structure composed of a delicate framework of thin cutaneous tissue and cartilage.Because of the protruded shape and location,the ear is particularly vulnerable to various damages,such as traffic accidents,sports injuries,burns,bites and falls.And the ear malformation caused by burns is the most difficult type to deal with in plastic surgery.Reparation and reconstruction of the burn ear undoubtedly remains a huge challenge for both plastic surgeons and otolaryngologists.This paper was aimed to summarize the features of the burned ear deformity and report the different therapeutic regimes according to the condition of the remnant ear and the surrounding soft tissue.Methods:We retrieved all the cases between January 2013 and December 2016 in seven department of Plastic Surgery Hospital of Medical Sciences to find the patients who visiting for burned ear deformity.A total of 38 cases(49 ears)were selected in our article,among them,4 cases(5 ears)received correction surgery,34 cases(44 ears)underwent reconstruction surgery by 3 different treatment protocols.Autologous costal cartilage was used to form the ear framework in all of the reconstruction cases.The differences among the treatment protocols are the soft tissue covering the ear scaffold,including expended postauricular scar flap in combination with postauricular fascial flap,postauricular scar flap combined with superficial temporal fascial flap and expanded cervical flap.Results:The external ear healed well after operation in 38 burn ear deformities.The anatomical structure was clear,and the location,size and shape of both ears were basically symmetrical.Complications occurred in 8 cases(8 ears)during the treatment,which were mainly related to the malfunction of the bloodsupply in skin flap,including 1 scab and 4 rupture in expanded skin flap,and 3 frameworks revealed,which healed soon after timely treatment.Conclusions:The cartilaginous integrity,the condition of the remnant ear and surrounding skin must be taken into account when planning correction and reconstruction surgery for the burn ear deformity.Autologous costal cartilage is an ideal material to form ear scaffold.Expended postauricular scar flap in combination with postauricular fascial flap,postauricular scar flap combined with superficial temporal fascial flap and expanded cervical flap are all good choices to cover the ear cartilage for patients with burn ear deformity.During the operation,we should observe the blood supply of the auricle skin carefully,and the complications related to the skin flap should be prevented and treated actively to achieve a satisfying result.