Objective: To investigate relative indications for three different surgical techniques used in total ear reconstruction.
Methods: A total of 1864 cases requiring complete ear reconstruction were performed. In 1485 cases reconstruction was effected by skin expansion and subsequent grafting of autogenous rib cartilage frameworks. In 355 cases skin expansion was followed by insertion of a Medpor framework. Twenty-four cases were repaired with titanium dowel retained prosthesis. Clinical results of these three surgical techniques were evaluated.
Results: All three methods were successfully used in total ear reconstruction and showed a satisfactory appearance. For patients less than 30 years old and with intact mastoid skin, the rib cartilage grafting methods were preferred. A Medpor framework was suitable for cases over 30 years old, despite the appearance of mild inflammation in the skin flap. We resorted to a prosthetic reconstruction in patients whose mastoid skin was seriously damaged when they were unwilling to accept more complex methods of ear reconstruction.
Conclusions: The three methods described provide satisfactory clinical results and are each indicated for specific patient cohorts.