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J Cosmet Med 2021; 5(1): 45-48

Published online June 30, 2021

https://doi.org/10.25056/JCM.2021.5.1.45

Functional and esthetic reconstruction of microtia and congenital aural atresia: a case report

Sung Il Cho , MD, PhD , Ji Yun Choi , MD, PhD

Department of Otolaryngology-Head and Neck Surgery, Chosun University College of Medicine, Gwangju, Rep. of Korea

Correspondence to :
Sung Il Cho
E-mail: chosi@chosun.ac.kr

Received: August 25, 2020; Revised: October 12, 2020; Accepted: October 22, 2020

© Korean Society of Korean Cosmetic Surgery

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0), which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Reconstruction of microtia and congenital aural atresia is a challenging surgery that requires experience and thorough knowledge. The goals of auricular reconstruction and atresiaplasty are to improve the cosmetic appearance and rehabilitate the acoustic function. There are several options for reconstruction of the external ear. Here, we present a case of microtia and congenital aural atresia in an 18-year-old woman. The two-stage auricular reconstruction using autologous costal cartilage and atresiaplasty were performed. The first stage of auricular reconstruction included fabrication and placement of the costal cartilage framework in the subcutaneous pocket. The second stage of auricular reconstruction involved elevation of the cartilage framework and a split-thickness skin graft. In the third stage, atresiaplasty involved reconstructions of the external auditory canal and tympanic membrane. Autologous microtia reconstruction with atresiaplasty is a good option to achieve improving the cosmetic appearance and acoustic function in patients with microtia and congenital aural atresia.

Keywords: aural atresia, congenital microtia, hearing, reconstructive surgical procedures

Fig. 1.The first-stage operation of auricular reconstruction. (A) Preoperative photograph in an 18-year-old woman who has microtia and congenital aural atresia. (B) The remnant cartilage is removed completely. (C) A subcutaneous pocket is formed for the insertion of the costal cartilage framework, and lobule transposition is performed. (D) The cartilage framework and suction drains are inserted. (E) The appearance of the auricle after completion of the first stage is seen.
  1. Genc S, Kahraman E, Ozel HE, Arslan IB, Demir A, Selcuk A. Microtia and congenital aural atresia. J Craniofac Surg 2012;23:1733-5.
    CrossRef
  2. El-Hoshy Z, Abdel-Aziz M, Shabana M. Congenital aural atresia: transmastoid approach; an old technique with good results. Int J Pediatr Otorhinolaryngol 2008;72:1047-52.
    CrossRef
  3. Zhang TY, Bulstrode N, Chang KW, Cho YS, Frenzel H, Jiang D, et al. International consensus recommendations on microtia, aural atresia and functional ear reconstruction. J Int Adv Otol 2019;15:204-8.
    CrossRef
  4. Nagata S. A new method of total reconstruction of the auricle for microtia. Plast Reconstr Surg 1993;92:187-201.
    CrossRef
  5. Kelley PE, Scholes MA. Microtia and congenital aural atresia. Otolaryngol Clin North Am 2007;40:61-80, vi.
    CrossRef
  6. Siegert R. Combined reconstruction of congenital auricular atresia and severe microtia. Adv Otorhinolaryngol 2010;68:95-107.
    CrossRef
  7. Casale G, Nicholas BD, Kesser BW. Acquired ear canal cholesteatoma in congenital aural atresia/stenosis. Otol Neurotol 2014;35:1474-9.
    CrossRef
  8. Shonka DC Jr, Livingston WJ 3rd, Kesser BW. The Jahrsdoerfer grading scale in surgery to repair congenital aural atresia. Arch Otolaryngol Head Neck Surg 2008;134:873-7.
    CrossRef
  9. Ruhl DS, Kesser BW. Atresiaplasty in congenital aural atresia: what the facial plastic surgeon needs to know. Facial Plast Surg Clin North Am 2018;26:87-96.
    CrossRef
  10. Ali K, Mohan K, Liu YC. Otologic and audiology concerns of microtia repair. Semin Plast Surg 2017;31:127-33.
    CrossRef

Article

Case Report

J Cosmet Med 2021; 5(1): 45-48

Published online June 30, 2021 https://doi.org/10.25056/JCM.2021.5.1.45

Copyright © Korean Society of Korean Cosmetic Surgery.

Functional and esthetic reconstruction of microtia and congenital aural atresia: a case report

Sung Il Cho , MD, PhD , Ji Yun Choi , MD, PhD

Department of Otolaryngology-Head and Neck Surgery, Chosun University College of Medicine, Gwangju, Rep. of Korea

Correspondence to:Sung Il Cho
E-mail: chosi@chosun.ac.kr

Received: August 25, 2020; Revised: October 12, 2020; Accepted: October 22, 2020

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0), which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Reconstruction of microtia and congenital aural atresia is a challenging surgery that requires experience and thorough knowledge. The goals of auricular reconstruction and atresiaplasty are to improve the cosmetic appearance and rehabilitate the acoustic function. There are several options for reconstruction of the external ear. Here, we present a case of microtia and congenital aural atresia in an 18-year-old woman. The two-stage auricular reconstruction using autologous costal cartilage and atresiaplasty were performed. The first stage of auricular reconstruction included fabrication and placement of the costal cartilage framework in the subcutaneous pocket. The second stage of auricular reconstruction involved elevation of the cartilage framework and a split-thickness skin graft. In the third stage, atresiaplasty involved reconstructions of the external auditory canal and tympanic membrane. Autologous microtia reconstruction with atresiaplasty is a good option to achieve improving the cosmetic appearance and acoustic function in patients with microtia and congenital aural atresia.

Keywords: aural atresia, congenital microtia, hearing, reconstructive surgical procedures

Fig 1.

Figure 1.The first-stage operation of auricular reconstruction. (A) Preoperative photograph in an 18-year-old woman who has microtia and congenital aural atresia. (B) The remnant cartilage is removed completely. (C) A subcutaneous pocket is formed for the insertion of the costal cartilage framework, and lobule transposition is performed. (D) The cartilage framework and suction drains are inserted. (E) The appearance of the auricle after completion of the first stage is seen.
Journal of Cosmetic Medicine 2021; 5: 45-48https://doi.org/10.25056/JCM.2021.5.1.45

References

  1. Genc S, Kahraman E, Ozel HE, Arslan IB, Demir A, Selcuk A. Microtia and congenital aural atresia. J Craniofac Surg 2012;23:1733-5.
    CrossRef
  2. El-Hoshy Z, Abdel-Aziz M, Shabana M. Congenital aural atresia: transmastoid approach; an old technique with good results. Int J Pediatr Otorhinolaryngol 2008;72:1047-52.
    CrossRef
  3. Zhang TY, Bulstrode N, Chang KW, Cho YS, Frenzel H, Jiang D, et al. International consensus recommendations on microtia, aural atresia and functional ear reconstruction. J Int Adv Otol 2019;15:204-8.
    CrossRef
  4. Nagata S. A new method of total reconstruction of the auricle for microtia. Plast Reconstr Surg 1993;92:187-201.
    CrossRef
  5. Kelley PE, Scholes MA. Microtia and congenital aural atresia. Otolaryngol Clin North Am 2007;40:61-80, vi.
    CrossRef
  6. Siegert R. Combined reconstruction of congenital auricular atresia and severe microtia. Adv Otorhinolaryngol 2010;68:95-107.
    CrossRef
  7. Casale G, Nicholas BD, Kesser BW. Acquired ear canal cholesteatoma in congenital aural atresia/stenosis. Otol Neurotol 2014;35:1474-9.
    CrossRef
  8. Shonka DC Jr, Livingston WJ 3rd, Kesser BW. The Jahrsdoerfer grading scale in surgery to repair congenital aural atresia. Arch Otolaryngol Head Neck Surg 2008;134:873-7.
    CrossRef
  9. Ruhl DS, Kesser BW. Atresiaplasty in congenital aural atresia: what the facial plastic surgeon needs to know. Facial Plast Surg Clin North Am 2018;26:87-96.
    CrossRef
  10. Ali K, Mohan K, Liu YC. Otologic and audiology concerns of microtia repair. Semin Plast Surg 2017;31:127-33.
    CrossRef

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