Utility of Bolus Suture and Silicone Protector in Auricular Reconstruction of Microtia

Kim, Jeong Tae; Lee, Seung Hoon; Lee, Ye Jin; Jo, Dong In

Abstract

In auricular reconstruction of microtia patient, delicate surgical strategy is necessary for natural shape and maintenance of immediate postoperative contour. However, postoperative edema and inadequate coaptation sometimes caused unintended and unsatisfactory contour. Therefore many methods were introduced to compress and keep the contour of the reconstructed auricular shape. The authors reconstructed an auricle in 2 steps for 13 microtia patients. Bolus suture was applied for adequate coaptation for at least 3 weeks after first stage operation and silicone protector was used for maintaining the auricular shape after second stage operation. Bolus suture could be released a little if tension was excessive or the blood supply for skin flap was inadequate. Customized silicone protector was effective for maintaining the auriculocephalic angle after ear elevation. The silicone protector was translucent and could be easily applied to the patient without difficulty. This treatment modality was satisfactory for maintaining the auricular framework contour and elevated auriculocephalic angle without any serious complications. Canaloplasty was performed in the selected patients at the same stage in accordance with mastoid pneumatization. This procedure thus saved the additional operation for canaloplasty and improved the hearing results.