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CC BY-NC 4.0 · Arch Plast Surg 2013; 40(03): 209-213
DOI: 10.5999/aps.2013.40.3.209
Original Article

Onlay Rib Bone Graft in Elevation of Reconstructed Auricle: 17 Years of Experience

Authors

  • Taehoon Kim

    Department of Plastic and Reconstructive Surgery, Seoul National University College of Medicine, Seoul, Korea

  • Jihyeon Han

    Department of Plastic and Reconstructive Surgery, Seoul National University College of Medicine, Seoul, Korea

  • Yoonho Lee

    Department of Plastic and Reconstructive Surgery, Seoul National University College of Medicine, Seoul, Korea
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Background A cartilage wedge block and covering flap are standard procedures for firm elevation of the ear in microtia correction. However, using costal cartilage for elevation of the reconstructed auricle can be insufficient, and the fixed cartilage wedge block may be absorbed or may slip out. Furthermore, elevating covering flaps is time-consuming and uses up fascia, a potential source of reconstruction material. Therefore, we propose an innovative method using autologous onlay rib bone graft for auricular elevation of microtia.

Methods From February 1995 to August 2012, 77 patients received a first stage operation with a rib cartilage framework graft. In the second stage operation, a small full thickness of rib bone was harvested through the previous donor scar. The bihalved rib bone was inserted into the subperiosteal pocket beneath the cartilage framework.

Results The follow-up time ranged from 1 month to 17 years, with a mean of 3 years. All of the patients sustained the elevation of their ears very well during the follow-up period. Donor site problems, except for hypertrophic scars, were not observed. Surgery-related complications, specifically skin necrosis, infection, or hematoma, occurred in 4 cases.

Conclusions Onlay rib bone graft used to elevate the reconstructed auricle is a more anatomically appropriate material than cartilage, due to the bone-to-bone contact between the bone graft and the temporal bone. Postoperative minor correction of the elevation degree is straightforward and the skin graft survives better. Therefore, reconstructed auricle elevation using onlay rib bone graft is a useful and valuable method.

Keywords

Bone transplantation - Cartilage - Ear auricle

This article was presented at the 70th Congress of the Korean Society of Plastic and Reconstructive Surgeons on November 9-11, 2012 in Seoul, Korea.




Publication History

Received: 22 February 2013

Accepted: 09 April 2013

Article published online:
01 May 2022

© 2013. The Korean Society of Plastic and Reconstructive Surgeons. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonCommercial License, permitting unrestricted noncommercial use, distribution, and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes. (https://creativecommons.org/licenses/by-nc/4.0/)

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