关键词: 小耳畸形, 单腔双扩张器, 皮肤扩张术, 全耳廓再造

Abstract: Objective To present our clinical experience in using two tissue expanders implanted superposingly in the mastoid region and Medpor ear framework for congenital microtia reconstruction. Methods During the period from Jan 2008 to Dec 2011, 27 patients were treated by total ear reconstruction. In the first surgical stage, a 50 mL and 80 mL (or 100 mL) of kidney-shaped tissue expanders were implanted subcutaneously in mastoid region and then overlaid the big expander on the small one. After the first surgery stage they were inflated with normal saline alternately for 3 to 6 months until the tissue expander was removed in the second surgical stage. After that the anterior and posterior wall of the Medpor ear framework was directly covered by expanded skin flap. A drainage tube was introduced into the space between the expanded skin flap and the ear framework to maintain a healthy contact between them and the contour of the reconstructed auricle. Results The postoperative follow-up time ranged from 4 to 50 months. 27 patients acquired symmetrical, subtle contour, prominent reconstructed auricles. The new reconstructed ear had a good contour and nearly normal skin. The postauricular sulcus was stable and the expanded skin flap looked well without necrosis. The Medpor ear framework was exposed in 2 patients (7.4%) because of wound dehiscence and he healed uneventfully after a further repair surgery. Conclusion For this operation, overlying implantation of double tissue expanders solved the problem of insufficient amount of the skin flap, avoided postauriclar skin grafting and application of the temporoparietal fascia and postauriclar fascia, simplified the surgical procedure and shortened the operation time significantly. The subunit of some reconstructed ear was unclear, but this method gets reliable and satisfactory results.

Key words: Congenital microtia, Overlapping double tissue expander, Skin expansion, Total auricular reconstruction