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Clinical applications of ear reconstruction with Medpor
Bihang Zhang1, Xiaoling Zeng2, Xinghua Yang1
1Department of Plastic Surgery, Xiangya Hospital, Central South University, Changsha 410008, China.
Objective:
To discuss clinical practice, efficacy and surgical techniques for ear reconstruction with Medpor. Methods: Medpor ear reconstructions were used to treat 19 microtia in 17 patients (including 2 bilateral patients) in Xiangya Hospital, Central South University from January 2011 to December 2015. Reconstructions included 2 patients with one-stage ear reconstruction with temporoparietal fascial flap, 2 patients with one-stage operation implanting Medpor directly into skin pocket, and 13 patients with two-stage ear reconstruction. Results: After 1-3 years of follow-up, 16 microtia in 14 patients gained ideal appearance. Scaffold exposure occurred in 3 unilateral cases, among which one patient who underwent debridement, removal of superficial exposed scaffold and transposition of local flap to salvage exposure was not significantly influenced, and the other 2 patients' scaffolds were still exposed after repairs and finally removed. One stent was removed at the patient's urging because it induced an exacerbation of periarthritis of the right shoulder. Conclusion: Medpor ear scaffold has advantages, such as easy assembly, good immunologic compatibility, fast vascular ingrowth, simple operation, short operative time and ideal appearance of the reconstructed ear. Medpor is an alternative for microtia repair when patients are unwilling to use autologous rib cartilage or costal cartilages are calcified. However, the relatively high incidence of scaffold exposure reminds us that the indications of Medpor should be taken seriously, and measures to avoid skin necrosis and scaffold exposure should be implemented. Long-term follow-up efficacy needs to be proved.
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