Total Ear Reconstruction in 31 Patients Using a One-Stage Coverage Method with a Free Flap

The authors have performed total auricular reconstructions using a one–stage coverage method with contralateral temporoparietal fascial flaps in 26 patients, and omental flaps in 5 patients.

The recipient arteries and veins for the free flap were the superficial temporal arteries and veins in 10 patients; the occipital arteries and veins or external jugular veins in 14 patients; the superior thyroid arteries and external jugular veins in 5 patients; and the facial arteries and veins in 2 patients.

New auricular frameworks were made of autogenons costal cartilage. They were fabricated as highly convoluted and projected forms, and included the tragus.

The deformities had been caused by previous failure in microtia reconstructions for 14 of the patients, car accidents for 13 of the patients, and burns for 4 of the patients.

All except two cases were successful in microsurgical transplantations. Two failed due to thrombosis at the anastomosis sites, which were earlier cases.

Evaluation of the final aesthetic result in 24 patients followed for more than 3 years, included 19 patients graded as good–to–excellent, and 5 patients exhibiting fair–to–poor results.

Despite the relatively long operating time, the ear reconstruction method using one–stage coverage has proved to be encouraging and worthwhile. Free flap coverage is recommended for total ear reconstruction in patients presenting with devascularized temporoparietal regions.