Discuss your case We reconstruct the auricle in microtia and anotia, after trauma, burns or tumour removal, and correct the effects of unsuccessful otoplasty.
FIG. 04 / CONCEPTUAL VISUALIZATIONAn earshell is recommended, an operation that creates a new ear or restores a lost part in the form of a healthy one.
Cochlear reconstruction is one of the most complex branches of plastic and reconstructive surgery. It requires the reproduction of a unique three-dimensional architecture of an ear in cases of defects caused by injury, burns, oncological resections or congenital developmental abnormalities such as microthia (underdevelopment of ear) and anothia(complete absence).
Parents of children with microtia, adults after injuries, bites and burns, as well as those whose previous otopoplasty has given deformation.
The specific indications, method and expected result are determined individually by the doctor after consultation and necessary examinations.
Four situations that most often occur.
The shell is underdeveloped or absent from birth.
The ear frame is modeled from the rib cartilage of a child (usually from 6-10 years, in two stages or more) or an implant (from 3-4 years old, often in one stage). Hearing checked by an ENT doctor: with microtia, the auditory canal is also often underdeveloped.
After the injury, bite, care or removal of the tumor.
Small defects are covered with local flaps and cartilage, larger defectes by a framework of rib cartilages under the skin or fascia as in microthia.
After severe burns or radiation therapy, there's not enough tissue.
The skull cyst contains an alternative prosthesis of titanium implants.
After the operation, press too hard, asymmetrically, with sharp crests or scars.
A repeat operation is planned when the swelling has subsided and the scar has stabilized. The cartilage is remodelled, if necessary reinforced or covered with a flap. Methods — in section 04.
Modern surgery uses two principles for an ear frame, as well as digital technology.
The method is based on the use of a patient's own living tissue, usually using modified Brent or Nagata techniques.
Alternative direction using artificial implant instead of rib cartilage.
Early complications – hematoma, infection, skin necrosis – occurred in 0-8.4% of cases (except for two studies with higher figures) in a review of 20 studies. Repeated surgery is more often done later: the ear has bulged again, threads have been cut, the Ear is too tightly pressed.
Early illness is treated immediately, without waiting for the disease to occur.
The surgeon will first find out what's wrong and how the first surgery was done and then choose the technique.
The gold is marked with the framework from which the ear forms.
From the cartilage of several ribs, the surgeon cuts the base and the lunch and sews it into a three-dimensional frame, following the pattern of a healthy ear.
After 6-12 months, the ear is removed from the head and a pleat is created on its back. The implant is then inserted under the skin of the temporal area.
The artificial framework is wrapped with a thin layer of temporal fascia on its own vessels — it nourishes the skin above the implant.
The schemes are simplified and not scaled up.
When the cartilage is sufficient for a framework and the size of the ear for an adult.
It used to be without a reger, but with the risk of cutting the implant.
When the wounds heal and the scars mature, the plan depends on the state of the skin around it.
When the swelling drops and the scar stabilizes after surgery.
The term depends on the method; the plan is individual.
First days are protective bandages, skin control over the frame.
After rib cartilage removal, pain in the scar area for several weeks. Chest deformation is also possible in this area; risk reduces with preservation of ribs.
For months, they avoid ear pressure and contact sports.
Between the first and second stages, 6-12 months, check-ups.
The value depends on the method, the number of periods and days in the hospital; the surgeon calls it after examination.
You describe the request and, if you have it, you provide the results of the previous examination and treatment.
The doctor determines what situation we are in, what circumstances we need, what we need, and what his limitations are.
It discusses the next steps, the sequence of phases and the issues of reconstruction.
Patients come from all over Ukraine and abroad.
How old is the patient, what height and weight?
Have they checked the hearing?
Was there an ear surgery?
Is there a picture of both ears?
The short answers are that what suits you is what the doctor will tell you.
From his rib cartilage, usually from the age of 6 to 10, when the cartilage is sufficient.
Own cartilage is less likely to be exposed and infected, can grow with the child but requires rib removal (possibly deformation of chest) and two or more stages. Implant – earlier and often in one step, but with risk of piercing and removal.
No, reconstruction restores the shape of the ear, hearing evaluates and treats the LOR-licar separately.
So far only in clinical research, in normal practice, the ear is modelled from rib cartilage or implant.
When the edema and the scar stabilizes after surgery, the surgeon's timing is determined on sight.
Metaspects and studies on methods described on the page.
Start consulting to see what questions and materials are needed for the evaluation.