Objective: To summarize different treatments of the residual ear in auricular reconstruction, to investigate the reasonable applications of the residual ear.
Methods: From September 2005 to July 2006, 128 patients (79 males, 49 females; aging 5-21 years with an average of 11 years) with unilateral microtia underwent the staged repair. In the patients, there were 44 cases of left-unilaterally microtia and 84 cases of right-unilaterally microtia. The residual ears looked like peanut in 56 patients, like sausage in 35 patients, like boat in 27 patients, and like shells in 10 patients. Among all the patients, the external acoustic meatus was normal in 5 patients, stenosis in 11 patients, and atresia in 112 patients. According to auricular developmental condition, the patients were divided into three types: 17 cases of type I, 98 cases of type II, and 13 cases of type III. In the first stage operation, a 50 mL kidney-liked expander was implanted into post aurem subcutaneous tissue. The residual ear whose superior extremity was close to the hair line was treated. The middle and superior part of the residual ear was cut. The redundant residual auricular cartilage was removed. In the second stage operation, the inferior part of the cartilage frame was covered by the middle and superior part of the residual ear. According to the location of the residual ear, "V-Y" plasty, "Z"-plasty and reversal of the residual ear were used to correct the location of the residual ear. In the third stage operation, the remained residual ear was used to reconstruct crus of helix or cover the wound surface which was resulted from repairing the reconstructed ear.
Results: The residual ears which were reshaped and transferred had good blood circulation. All residual ears were survival. The wounds healed by first intention. The follow-up for 8-15 months showed that the auricular lobule of the reconstructed ear was turgor vital is and natural. The locations of the reconstructed ear and normal side ear were symmetry. The auricular lobules of the reconstructed ear survived well. The reconstructed crus of helix, helix, antihelix and triangular fossa were clear. The results were satisfactory.
Conclusion: Using residual ear reasonably is an important procedure of successful auricular reconstruction and the symmetry of the reconstructed ear and uninjured side ear.