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Microtia Reconstruction in Hemifacial Microsomia Patients: Three Framework Coverage Techniques.

Jung Youl Park1, Chul Park1

  • 1From the Seoul Center for Developmental Ear Anomalies and the Department of Plastic and Reconstructive Surgery, Korea University Anam Hospital.

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|November 30, 2018
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Summary

The embedding technique offers superior aesthetic outcomes for microtia reconstruction in mild to moderate cases. For severe hemifacial microsomia, the temporoparietal fascia flap technique is recommended.

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Area of Science:

  • Plastic Surgery
  • Otolaryngology
  • Craniofacial Surgery

Background:

  • Microtia with hemifacial microsomia presents significant reconstructive challenges due to skin volume deficiency.
  • Surgical coverage techniques are crucial for successful microtia reconstruction.

Purpose of the Study:

  • To evaluate and compare the effectiveness of different surgical coverage techniques for microtia reconstruction.
  • To provide data to inform optimal surgical strategies for microtia repair.

Main Methods:

  • Retrospective analysis of 52 patients with microtia and hemifacial microsomia who underwent reconstruction between 2006 and 2016.
  • Review of medical records and photographic data, with follow-up ranging from 6 months to 10 years.

Main Results:

  • Surgeon satisfaction scores varied: embedding and elevation (median 9), temporoparietal fascia flap (median 8), and subfascial expansion (median 7).
  • The embedding technique showed a statistically significant difference compared to subfascial expansion (p=0.03).
  • Aesthetic complications included large reconstructed ears, cartilage resorption, and mismatched skin color, with specific techniques linked to certain complications.

Conclusions:

  • The embedding technique is recommended for mild to moderate microtia with low hairline and remnant vestiges.
  • The temporoparietal fascia flap technique is advised for cases with severe associated anomalies in hemifacial microsomia reconstruction.