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Microtia and cholesteatoma: Implications for the reconstructive surgeon
R M van Hogezand1, A L Smit1, C C Breugem2
1Department of Plastic, Reconstructive and Hand Surgery, University Medical Center Utrecht, Heidelberglaan 100, PO Box 85500, 3508 GA Utrecht, the Netherlands.
Abstract:
Infection after reconstructive surgery for microtia is a technical challenge. This can be a sign of cholesteatoma formation by entrapment of epithelium in the middle or outer ear, specifically when the patient does not respond to first choice antibiotic therapy and debridement. Two patients with microtia presented themselves with severe infections after ear reconstruction. In both cases cholesteatoma was diagnosed as the cause of the infection. After cholesteatoma management an additional surgical procedure was necessary to improve the esthetic outcome. The plastic surgeon should identify possible signs of cholesteatoma after reconstruction of the auricle.
Insights
Severe ear infections after microtia reconstruction may indicate cholesteatoma. Early identification and management of this epithelial entrapment are crucial for successful surgical outcomes and patient recovery.
Area of Science:
- Otolaryngology
- Plastic Surgery
- Medical Microbiology
Background:
- Reconstructive surgery for microtia presents challenges, particularly concerning post-operative infections.
- Infections resistant to initial antibiotic therapy and debridement can signal underlying complications.
Observation:
- Two patients with microtia experienced severe infections post-auricular reconstruction.
- Cholesteatoma, an epithelial entrapment, was diagnosed as the causative agent in both cases.
Findings:
- Cholesteatoma formation requires specific management strategies beyond standard infection protocols.
- Successful cholesteatoma treatment necessitated further surgical intervention to address aesthetic concerns.
Implications:
- Plastic surgeons must be vigilant for cholesteatoma signs following auricle reconstruction.
- Recognizing cholesteatoma early can prevent complications and improve reconstructive surgery results.
