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Objective To explore the method of elevating and fixing the auricular cartilage scaffold to adjust the overall height of the auricle. Methods A corresponding incision was made behind the ear, and then separate and release the adhesion between the back of the auricular cartilage scaffold and the cranial wall. Several stitches were sewn at the corresponding position on the bottom of the cymba auriculae, and the cartilage scaffold was lifted and fixed on the periosteum of the cranial wall to elevate the cartilage scaffold to normal height or the same height as the contralateral side. Results Sixty-five cases of various deformities of the auricle were clinically treated after 6 to 12 months of follow-up. The height of all other patients' auricles was improved, and the height of both auricles was symmetrical except for one patient with cryptotia deformity who had a loose fixation causing the stent to move down again, three patients with cup ears and two other ear deformities due to the ear being smaller than the normal side. The lifting height of all auricles is (0.6±0.4) cm. The patient satisfaction rate is 87.7%. Conclusion This method can significantly improve the overall height of the auricle while correcting cartilage abnormalities, making the two auricles more symmetrical, and the effect is satisfactory. [ABSTRACT FROM AUTHOR]

Objective To explore the application of totally expanded skin for auricular reconstruction in patients with grade III microtia. To reconstruct tragus and concha cavity by rational utilization of remnant ear. Methods There were 36 patients suffered from microtia with remnant ear in the new method group. In the first stage of operation, a tissue expander of 150 ml was implanted to the dual- plane of postauricular mastoid region through the incision of remnant ear. In the second stage, autologous costal cartilage framework was implanted for auricular reconstruction. In the third stage, the skin of remnant ear was designed to reconstruct the tragus and cover partial wounds of the concha cavity. The cartilage of remnant ear was used as the internal support of tragus or inserted to the bottom to increase the height of framework. There were 46 patients in the traditional expansion group. In the third stage of operation, the remnant earlobe was transferred to reconstruct earlobe. The tragus was reconstructed by M flap. The free skin graft was applied for concha cavity. All patients were followed up from 6 to 12 months, the size of tragus and concha cavity and satisfaction of patients were evaluated. Results No obvious scar was found on the surface of reconstructed auricle in the new method group. A blister of 0.6 cm × 0.4 cm at distal remnant earlobe flap was found in 1 patient and cured after dressing change of 10 days. In the traditional expansion group, blister was found in skin graft of concha cavity in 5 patients and cured after dressing change. During the follow-up, the contracture and deformity of tragus and retraction rate of concha cavity was less than that of the traditional expansion group. The patients' satisfaction of the new method group was significantly higher than that of the traditional expansion group (P<0.05). The fullness of reconstructed earlobes was slightly worse than normal. ConIIIclusion Enough skin could be expanded to totally covered the surface of the whole cartilage framework. There was no need for earlobe transposition. No surgical scar was found on the framework surface of the reconstructed ear. The remnant ear could be adequately used. The appearance of tragus and concha cavity of reconstructed ear was good. [ABSTRACT FROM AUTHOR]

目的 探讨局部皮瓣联合耳前带蒂组织移植矫治耳垂发育不良的临床效果。方法 自 2008 年 1 月至 2020 年 1 月，华中科技大学同济医学院附属协和医院整形外科对 8 例先天性耳垂发育不良患者进行手术治疗，在耳垂下方设计切口， 形成一皮瓣，局部旋转缝合，以增加耳垂的皮肤；再于耳前形成一蒂在耳垂前的真皮脂肪瓣，将之插入耳垂前外侧与后内侧皮肤 之间分离形成的腔隙内，缝合固定，缝合供瓣区切口。结果 所有患者的切口均一期愈合，无皮瓣坏死发生。1 例患者出现切口 瘢痕增生，经外用药物涂抹等治疗后瘢痕软化。所有患者仅经 1 次手术治疗；获随访 6~18 个月，无脂肪液化、感染、硬结、 皮下包 块等并发症发生。手术后耳垂形状正常，较术前明显饱满，患者对耳垂外观满意度较高。结论 采用自体局部皮瓣联合带蒂真皮 脂肪组织转移修复，可明显改善耳垂外观，效果稳定持久。 [ABSTRACT FROM AUTHOR]