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Microtia repair: creation of a functional postauricular sulcus
1Department of Otolaryngology, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, MA, USA.
Objective:
Auricular reconstruction for repair of severe congenital microtia can provide the patient with a realistic-looking pinna. However, an unseen functional cephaloauricular sulcus is necessary, especially for patients with eyeglasses.
Technique:
(1) A skin graft is harvested. (2) The ear framework is separated substantially from the side of the head. (3) A crescent of hair-bearing scalp skin is excised. (4) The donor skin graft is divided. One part of the graft surfaces the superolateral and medial portions of the auricular framework into the sulcus depth; the remainder covers the side of the head.
Results:
This simple technique was effective. Minor transient sequelae have included granulation tissue (2 patients), localized infection (2 patients), and adhesion (1 patient). Patients requiring glasses have worn frames soon after surgery, and no sulcus problems have resulted.
Conclusion:
Creation of this postauricular sulcus during microtia reconstruction is easily performed and offers the patient a durable and functional space, especially for eyeglass wear.