Surgical Principles and Planning for Ear Reconstruction

Abstract

Surgical planning and technique selection basically depend on identification of the deformity, which is important before ear reconstruction. They are mandatory procedures because each patient has unique abnormalities that require a specific approach for adequate treatment. Whether the operation will repair a congenital or acquired deformity, it is necessary to create two anatomical structures, the a uricular cartilage skeleton and the cutaneous covering. The new auricular framework is excavated on the rib cartilage with all anatomical details. The cutaneous covering may be developed on the mastoid area combined with skin flaps from neighboring regions as well as skin grafts. Some surgical principles that are used as guidelines during the operation include:

• (a) Creation of new anatomical structures

• (b) Integrity of the skin in the mastoid area

• (c) Development of the new layer of perichondrium around the grafted cartilage

• (d) Enlargement of the cutaneous covering

• (e) Tissue distention during surgery

• (f) Assurance that the rib cartilage segments do not heal together

• (g) Performance of adequate postoperative dressing

• (h) Long-term follow-up of patients for complete recovery after operation

I always perform each operation under the preceding surgical principles, carefully paying attention to the operation as though it were my first, and deeply emotionally involved as if it were my last.