Arch Craniofac Surg.  2018 Mar;19(1):79-82. 10.7181/acfs.2018.19.1.79.

Tragus formation during concha-type microtia repair using a chondrocutaneous island flap

Affiliations
  • 1Department of Plastic and Reconstructive Surgery, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea.
  • 2Department of Plastic Surgery, SMG-SNU Boramae Medical Center, Seoul, Korea. ejeong.md@gmail.com
  • 3Cirurgia Plástica Transplante Capilar, Pará de Minas, Brasil.

Abstract

Formation of an ideally-shaped tragus remains one of the most challenging issues during staged tragus reconstruction in microtia patients. The authors describe a new method used to treat a unique case of concha-type microtia in which the 10-year-old male patient had only a portion of pre-existing cartilage at the tragus site. An anomalous skin lump was also present. During the initial stages of the reconstruction, the two-stage Nagata method was used for surgical correction of the microtia. An autologous rib cartilage graft was used to form the ear framework. A temporoparietal fascia flap was also constructed. Remnant skin tags and anomalous cartilage that accompany microtia are usually removed during microtia repair. However, the cartilage and skin lump were preserved during the reconstruction. The skin lump was later used to form a vascularized chondrocutaneous island flap that supplemented the portion of cartilage during tragus formation. The result was a new tragus that was satisfactorily improved in both size and shape. Patients with concha-type microtia may benefit from the use of this new method for tragus formation.

Keyword

Congenital microtia; Surgical flaps; Ear auricle

MeSH Terms

Cartilage
Child
Congenital Microtia*
Ear
Ear Auricle
Fascia
Humans
Male
Methods
Ribs
Skin
Surgical Flaps
Transplants
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