Single-stage Auricular Reconstruction in Hemifacial Microsomia With Low Hairline by Using Temporoparietal Fascia Flap

Author:

Gao Dejin1,Sun Qing2,Chen Xueying3,Wang Bingqing3,Liu Tun3

Affiliation:

1. Comprehensive Ward of Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, P.R. China

2. Department of Stomatology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, P.R. China

3. Department of Ear Reconstruction, Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China

Abstract

Background: Auricular reconstruction is one of the most complicated operations in plastic surgery and is more difficult for patients with a low hairline due to limited skin availability. In traditional operations, the skin of the mastoid area was used to cover the front of the ear scaffold, and the retroauricular fascia, combined with a free skin graft, was used to cover the back of the ear framework. This may cause problems such as inadequate skin coverage and affecting the shape of the reconstructed ear when the hairline is low. Methods: Hemifacial microsomia patients with low hairline have little skin flap to perform the ear reconstruction, and we refined a single-stage ear reconstruction surgery to solve the problem. The temporoparietal fascia is used to cover the entire costal cartilage scaffold, and its surface is covered with a free split-thickness skin taken from the chest wall, thigh, and other parts. Results: From December 2019 to December 2020, 12 patients with hemifacial microsomia underwent single-stage reconstruction with temporoparietal fascia. The duration of patient follow-up was 6 to 24 months. The application of this technique can solve the problem of insufficient available skin flap, complete the ear reconstruction through 1 operation, reduce the treatment cycle, achieve a good shape of the reconstructed ear, and the postoperative effect is satisfactory. Conclusion: According to the characteristics of the HFM patients with low hairline, we recommend this new, improved single-stage auricular reconstruction using the temporoparietal fascia for these patients. This method is a suitable choice for HFM patients with low hairline. Level of Evidence: Level—IV, Cases Study.

Publisher

Ovid Technologies (Wolters Kluwer Health)

Reference19 articles.

1. Hemifacial microsomia: Treatment alternatives-a systematic review of literature;López;J Clin Pediatr Dent,2022

2. Craniofacial microsomia;Brandstetter;Facial Plast Surg Clin North Am,2016

3. A new method of total reconstruction of the auricle for microtia;Nagata;Plast Reconstr Surg,1993

4. The correction of mi-rotia with autogenous cartilage grafts: I. The classic deformity;Brent;Plast Reconstr Surg,1980

5. Auricular reconstruction in hemifacial microsomia with an expanded two-flap method;Qian;Plast Reconstr Surg,2017

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