Research Of The Current Problems In Ear Reconstruction

Background: There are still some difficulties in ear reconstruction.Such as how to fabricate a predictable costal cartilage framework,how to shorten the learning curve and create a natural auricle simultaneously.There are classical classification and corresponding reconstruction methods for microtia.However,for traumatic ear defects,it is difficult to establish a classification system and corresponding surgical strategies,because the size,shape,and local skin conditions of each defect differ considerably.Autologous fat tissue transfer is a potential method to restore the volume and contour defects of mastoid areas in microtia patients.The author's aim was to offer a series techniques that resolve some lingering issues.Methods: When fabricating the antihelix complex,the superior crus is broadened,and a gentle slope is sculpted on both aspects.The inferior crus is maintained in high relief and the width of inferior crus is the one-third that of the superior crus.A groove in the base frame is carved for the complex sitting on.The smooth junction between the helix and the earlobe attained by strengthening and lengthening the helix cartilage framework.Simultaneously,an enough width of the inferior one-third of the cartilage framework is critical for creating a natural auricle.The post-traumatic ear defects are classified into four types according to defect size and surrounding skin conditions,Defects in which the postauricular skin is of good quality are classified as Type-I,-II,and-III.The rest are Type-IV defects.Four reconstructive methods are utilized properly and favorite results achieved.An animal model of fat graft is established in the nude mice,the histologic modifications of grafted cartilage are investigated.Results: Natural contours of superior and inferior crura,antihelix,scapha and triangular fossa are achieved by the modification of framework fabrication,the enough width of the inferior one-third framework enhances the overall aesthetics and harmonious integration of the reconstructed ear.The new classification system for partial traumatic ear defects based on defect size and contiguous skin condition is practical.Most traumatic partial ear defects(n=55)were satisfied with their reconstructive results.There is a significant difference in survived chondrocytes number between the fat tissue graft group and the control group.But there is no significant difference in collagen II content between the two groups.Conclusions: The decreasing learning curve of cartilage framework fabrication can be achieved by the modifications in the research.The reconstructed ears can be more natural and predictable.Depending upon the defect size and condition of contiguous skin,the type of ear defect and corresponding surgical approach for repairing partial ear defect can be applied consistently,yielding acceptable results and fewer complications.In the fat graft animal model,the grafted fat will decrease the chondrocytes activity in the first nine months,but the influence to collagen II content is limited.However,the long-term effects remain undetermined and need further investigation.