The Application Of Medpor Stent And Skin Grafts Of Blade-thickness Scalp In The Ear Elevation Sulcus By Auricular Reconstruction In Microtia Patients

Objective：To investigate the application and efficacy of Medpor stent and skin grafts of blade-thickness scalp in the ear elevation by auricular reconstruction in microtia patients with Nagata method.Method:The first stage operation was fulfilled according to Nagata’s two-stage auricular reconstruction method which mainly included earlobe transposition and formation of costal cartilage framework and grafting of costal cartilage framework to its proper location. Ear elevation was undertaken6months later:skin graft of blade-thickness scalp with the required size close to occipital side was incised with No.15blade; the incised scalp was elevated and another incision5mm outside external ear helix deep to subcutaneous layer was done to separate and lift cartilage framework; then Medpor stent was used to prepare a" C" shaped stent with a height of1.0-1.2cm to support the rear side of reconstructed ear stent, and then the back side and the surface of reconstructed ear stent were covered with Superficial temporal fascia flap, finally blade-thickness skin graft was sewed to the surface of temporal fascia flap and fixed with wet gauze.Results:22ears in20cases underwent operation from July2010to August2012; of them,15were male and5were female with an age range of6-29years.8were left-sided microtias and14were right-sided microtias; of the22microtias,15were lobule-type,5were concha-type, and2were small concha-type. Necrosis of temporal superfacial fascia flap and exposure of stent were observed in one case and they were repaired by displacement of retroauricular fascial flap and grafting of blade thickness skin. All other patients successfully completed the two-stage surgery. The follow up was in the range of6-18months with an average of13months. The shapes of cranioauricular angle in20cases with22ears after ear reconstruction surgery were satisfying.Conclusion:The application of Medpor stent and skin grafts of blade-thickness scalp in the ear elevation by auricular reconstruction in microtia patients with Nagata method can achieve satisfied results with the reduction of scarring. This method not only avoid the obvious scarring of full-thickness and intermediate-thickness skin grafts, but also reduce chest trauma by removing less costal cartilage and greatly increase doctor and patient satisfactions with this surgery.