Abstract
The use of a porous high-density polyethylene (pHDPE) implant for ear reconstruction is gradually gaining acceptance because it allows for a pleasing ear reconstruction in young children before they enter school. In this chapter, we discuss the rationale behind the use of pHDPE for ear reconstruction, describe the steps of this challenging procedure, and answer the common questions that surgeons have when they come to observe the surgery, or when they go back to their respective practices and start performing this procedure. The key parts of this surgery are to meticulously harvest a well-vascularized superficial temporoparietal fascia (STPF) flap and to use appropriate color-matched skin grafts. This allows for a pleasing ear reconstruction with an excellent definition, projection, symmetry and long-term viability. The use of pHDPE with a thin STPF flap coverage is our preferred method of ear reconstruction since it can be performed at an earlier age, in a single stage, as an outpatient procedure with minimal discomfort and psychological trauma for the patients and parents.
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(a) Harvesting the temporoparietal fascia flap through a single auricular incision (MP4 155236 kb)
(b) Harvested TPF flap with healthy arterial pulsations (MOV 22785 kb)
Carving of the porous high-density polyethylene implant (MP4 183159 kb)
Shrink-wrapping of the STPF flap over the implant once the suction is applied (MOV 13463 kb)
Full-thickness skin grafts are sutures over the STPF flap with 6-0 chromic catguts. These are single interrupted sutures that care close to each other. Adequate projection and definition is demonstrated in this video (MOV 67688 kb)
Postoperative ear movements 1-year after surgery (M4V 23794 kb)
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Reinisch, J.F., Tahiri, Y. (2019). Polyethylene Ear Reconstruction: A State-of-the-Art Surgical Technique. In: Reinisch, J., Tahiri, Y. (eds) Modern Microtia Reconstruction. Springer, Cham. https://doi.org/10.1007/978-3-030-16387-7_6
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DOI: https://doi.org/10.1007/978-3-030-16387-7_6
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