Ear reconstruction: from reconstructive to cosmetic

Abstract

Previous literatures have reported favorable results in ear reconstruction. Many details in fabricating cartilage framework have been paid much attention. Whereas, many patients still complain about unnatural contours. This article is to provide a new technique to solve some of the problems. A total of 253 patients underwent reconstruction using the modified technique from 2011 to 2014. In fabricating the complex of antihelix, the authors modified the prior method. Instead of sculpting a sharp Y-shaped cartilage graft for projecting the prominent structures, the authors increased the width of the superior crura, sculpted a gentle slope in the both sides of superior crura, simultaneously carved a groove in the base frame to join with the carved attachment smoothly. The width of inferior crura was about one third of the superior crura width, and the inferior crura was narrow and prominent. A gentle slope was carved on the antihelix and a groove was carved on the base frame for the antihelix to sit on. Four cases have been selected to illustrate the favorable results of this technique. Due to the modified details, the superior crura, inferior crura, antihelix and the structures around them, in these cases, show natural contours, and provide a coordinated figure to the integrity of reconstructed ear. Antihelix complex is one of the most important structures for creating a natural auricle. The natural superior and inferior crura and antihelix can enhance the impression of a harmonious shape, and acquire an increased satisfaction for both patients and surgeons.