Reconstruction of the burned external ear using a Medpor porous polyethylene pivoting helix framework

This paper describes a new technique using a Medpor porous polyethylene pivoting helix framework for reconstruction of the burned auricle. The polyethylene framework is composed of two distinct components, a curved shape that represents the helical rim which pivots around a base component. This framework is covered with a temporoparietal fascia flap and a skin graft that is chosen to match the adjacent resurfaced facial burn. The porous framework then becomes rapidly vascularized with soft-tissue ingrowth and collagen deposition. The pivoting helix design can be used to create an auricle of almost any size or projection. The helix can move independently and can be compressed against the head in the event of external pressure on the ear. The resultant ear reconstruction is extremely durable and remains flexible over time. Twenty-six consecutive ear reconstructions were performed using this method over a 2-year period. Two exposures occurred which were managed without removal of the implant. All reconstructions successfully restored an ear that was both aesthetically pleasing and functional so as to provide support for a pair of eyeglasses. The Medpor porous polyethylene pivoting helix framework offers an excellent solution for a difficult reconstructive problem.