Research On Homeochronous Surgical Technique Of Auricular Reconstruction And Aural Rehabilitation

Objective.To discuss the homeochronous surgical technique of auricular reconstruction and aural rehabilitation for congenital microtia with defects of external acoustic meatus(EAM) and middle ear,and to investigate the outcome by examining aesthetic effect,hearing results and complications.Methods.The patients who suffer from congenital microtia with defects of EAM and middle ear need auricular reconstruction and aural rehabilitation,which will be operated by plastic surgeon and otologic surgeon.These specialists might ideally achieve their treatment respectively,but lack of communication between each other has often led to less than satisfactory long-term results.For patients whose EAMs were reconstructed first,scar developed around the orifice and affected the skin flap and later auricle reconstruction,while reconstructing the auricle first sometimes resulted in the location of the EAM orifice deviating from an ideal position.The surgical project we present accomplishes auricular reconstruction and aural rehabilitation concurrently.The project consists of three stages:Stageâ… :framework construction and placement,and the EAM and middle ear reconstruction at the same time;Stageâ…¡:lobule creation;Stageâ…¢:auricular elevation.First the site of auricula and external auditory meatus(EAM) orifice must be located according to the results of the temporal CT scan,the facial marks and the remains,the location of the EAM orifice deviating from an ideal position will be corrected in stageâ…¡.12 patients underwent three-stage operations were retrospectively investigated about the outcome by examining aesthetic effect,hearing results and complications.Results.With homeochronous operation,auricular reconstruction will assort with aural rehabilitation.The site of auricula and external auditory meatus(EAM) orifice can be located ideally with the approach we present.The effects of reconstructed auricles were classified according to their structure verisimilitude and the bilateral symmetry.The majority of patients/families were satisfied,reconstructions of EAM and middle ear improve their hearing.1 ears with reconstructed EAM exhibited relapse of atresia,which need further procedure.1 ear exhibited recurrent effusion.1 ear had been repaired by skin graft due to infection of EAM.No other serious complications were found during the follow-up.Conclusions.With the surgical project we present,Increased efficiency are achievable for congenital microbia with defects of external auditory meatus(EAM) and middle ear.The aesthetic effect,hearing results and complications were satisfied. Some problem need for being resolved,such as relapse of atresia,recurrent effusion, infection of EAM and so on.