eMedicine Specialties > Otolaryngology and Facial Plastic Surgery > Reconstructive Surgery

Ear Reconstruction: Follow-up

Author: Joseph L Leach Jr, MD, Associate Professor of Otolaryngology, University of Texas Southwestern Medical School
Coauthor(s): Michael J Biavati, MD, Clinical Assistant Professor of Otolaryngology, University of Texas Southwestern; Private Practice, ENT Care for Kids, Dallas, TX
Contributor Information and Disclosures

Updated: Feb 11, 2009

Outcome and Prognosis

Under ideal conditions, a surgeon with some degree of artistic ability who uses sound judgment can expect a good result after adequately spaced stages. Nevertheless, much of the prognosis depends on factors beyond the surgeon's immediate control, such as skin pliability, scar tissue formation, and the resolution of edema.

Future and Controversies

The greatest morbidity with the rib cartilage technique is at the harvest site. The postoperative pain, the thoracic scar, and the occasional concavity produced in the chest area have motivated surgeons to seek an adequate alternative. The use of porous alloplastic material has proven to be effective, but concerns persist about its long-term viability and the propensity for exposure and infection.

Prosthetic ears, with or without osteointegrated fixation, are popular with some physicians. Although these prosthetics are remarkably natural in appearance, they have several drawbacks. These include limited longevity, lack of sensation, and unnatural feel. Prosthetics should probably not be considered a first-line remedy for microtia.

Cadaveric (homograft) or animal (xenograft) cartilage has been demonstrated to have high resorption rates that make them unacceptable for preserving the delicate architecture of the reconstructed ear. In addition, concern exists about the transmission of HIV or slow viral diseases.

Seeding autologous cartilage onto a biologic framework to grow tissue in a foreign host is now possible. An auricular cartilage framework was grown in a nude mouse, whose picture was circulated widely by the lay press. Nevertheless, problems remain with such technologies, primarily because the new cartilage lacks the skeletal strength to withstand the contracting forces of the skin pocket and the subsequent scar formation.

 


More on Ear Reconstruction

Overview: Ear Reconstruction
Workup: Ear Reconstruction
Treatment: Ear Reconstruction
Follow-up: Ear Reconstruction
Multimedia: Ear Reconstruction
References
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References

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Further Reading

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Keywords

ear reconstruction, ear, ear deformity, microtia, anotia, external ear deformity, aural atresia, external ear reconstruction, microtia repair, auricular reconstruction

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Contributor Information and Disclosures

Author

Joseph L Leach Jr, MD, Associate Professor of Otolaryngology, University of Texas Southwestern Medical School
Joseph L Leach Jr, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Cosmetic Surgery, American Academy of Facial Plastic and Reconstructive Surgery, American Academy of Otolaryngology-Head and Neck Surgery, Texas Medical Association, and Triological Society
Disclosure: Nothing to disclose.

Coauthor(s)

Michael J Biavati, MD, Clinical Assistant Professor of Otolaryngology, University of Texas Southwestern; Private Practice, ENT Care for Kids, Dallas, TX
Michael J Biavati, MD is a member of the following medical societies: American Academy of Otolaryngology-Head and Neck Surgery, American Academy of Pediatrics, American Cleft Palate/Craniofacial Association, American College of Surgeons, American Laryngological Rhinological and Otological Society, American Society of Pediatric Otolaryngology, Society for Ear, Nose and Throat Advances in Children, and Texas Medical Association
Disclosure: Nothing to disclose.

Medical Editor

John C Li, MD, Private Practice in Otology and Neurotology; Medical Director, Balance Center
John C Li, MD is a member of the following medical societies: American Academy of Otolaryngology-Head and Neck Surgery, American College of Surgeons, American Medical Association, American Neurotology Society, American Tinnitus Association, Florida Medical Association, and North American Skull Base Society
Disclosure: Nothing to disclose.

Pharmacy Editor

Francisco Talavera, PharmD, PhD, Senior Pharmacy Editor, eMedicine
Disclosure: eMedicine Salary Employment

Managing Editor

Dominique Dorion, MD, MSc, FRCSC, Program Director and Division Chair, Professor of Surgery, Division of Otolaryngology, University of Sherbrooke, Canada
Disclosure: Nothing to disclose.

CME Editor

Christopher L Slack, MD, Otolaryngology-Facial Plastic Surgery, Private Practice, Associated Coastal ENT; Medical Director, Treasure Coast Sleep Disorders
Christopher L Slack, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Facial Plastic and Reconstructive Surgery, American Academy of Otolaryngology-Head and Neck Surgery, and American Medical Association
Disclosure: Nothing to disclose.

Chief Editor

Arlen D Meyers, MD, MBA, Professor, Department of Otolaryngology-Head and Neck Surgery, University of Colorado School of Medicine
Arlen D Meyers, MD, MBA is a member of the following medical societies: American Academy of Facial Plastic and Reconstructive Surgery, American Academy of Otolaryngology-Head and Neck Surgery, and American Head and Neck Society
Disclosure: Covidien Corp Consulting fee Consulting; US Tobacco Corporation unstricted gift unknown; Axis Three Corporation Ownership interest Consulting; Omni Biosciences Ownership interest Consulting; Sentegra Ownership interest Board membership; Syndicom Ownership interest Consulting; Oxlo  Consulting; Medvoy Ownership interest Management position

 
 
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