An Experimental Study of Auricular Reconstruction Using a Thin Porous Silastic Frame Assisted by Tissue Expansion: An Animal Study.

Abstract

In the 1960s, the silastic ear frame was used for auricular reconstruction. Most surgeons abandoned the use of the silastic ear frame in the 1980s because of the high incidence of exposure. In this study, we introduce the computer-aided design and manufacture of a thin, porous silastic auricle frame and investigate the possibility of auricular reconstruction using this frame assisted by tissue expansion. An adult male with average sized, normal ears was selected. A spiral CT scan was performed to obtain primitive data on his external ear. Mimics-8.1 and Geomagic studio-12 were used for 3D reconstruction and image processing. A thin, porous silastic auricle frame 1.4 mm in thickness was manufactured. A 50 ml kidney-shaped tissue expander was implanted between the panniculus carnosus and the deep fascia through an incision on the back of each of 10 New Zealand white rabbits. Each week the expander was inflated with 10 ml saline to a total of 160 m1. Maintenance of the expansion lasted for a month. The expander was then removed, and the silastic auricle frame was inserted into the pocket. The reconstructed ears were observed for 6 months postoperatively. The reconstructed ears remained soft and flexible, with no deformation, contracture, or extrusion observed 6 months postoperatively. The scaphoid fossa, triangular fossa, cavum, helix, and antihelix remained defined. The silastic frame, 1.4 mm in thickness manufactured by computer-aided design, stood up to the contraction of the overlying expanded flap. It is possible to be used for auricular reconstruction assisted by tissue expansion.