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Ear Reconstruction Workup

  • Author: Joseph L Leach, Jr, MD; Chief Editor: Arlen D Meyers, MD, MBA  more...
 
Updated: Apr 08, 2015
 

Laboratory Studies

Unless indicated by the patient's overall medical condition, no particular laboratory studies are obtained routinely.

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Imaging Studies

Aural atresia repair requires a fine cut noncontrast axial and coronal CT scan of the temporal bones. The timing of this study is not critical and may be deferred until the otologic procedure is anticipated.

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Diagnostic Procedures

For microtia repair, no routine diagnostic procedures are necessary, unless a thorough history and physical examination reveal that particular studies are necessary.

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Histologic Findings

Because microtia consists of malformed cartilages and skin appendages, no routine histologic examination is indicated. In fact, no pathologic specimen is obtained under normal circumstances.

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Staging

Meurmann staged microtia as follows:

  • Grade 1: Malformed auricle of smaller than normal size but retaining characteristic features
  • Grade 2: Rudimentary auricle consisting of a low oblong elevation hook formed at the cranial end corresponding to the helix
  • Grade 3: A more defective auricle with a malformed lobule and the rest of the pinna being totally absent

Grade 3 is the abnormality most commonly encountered in patients desiring reconstruction. Note that anotia is not considered under the above classification.

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Contributor Information and Disclosures
Author

Joseph L Leach, Jr, MD Associate Professor of Otololaryngology, 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, Triological Society, American Academy of Facial Plastic and Reconstructive Surgery, American Academy of Otolaryngology-Head and Neck Surgery, Texas Medical Association

Disclosure: Nothing to disclose.

Coauthor(s)

Michael J Biavati, MD, FACS, FAAP Clinical Assistant Professor of Otolaryngology, University of Texas Southwestern Medical Center at Dallas, Southwestern Medical School; Private Practice, ENT Care for Kids, Dallas, TX

Michael J Biavati, MD, FACS, FAAP is a member of the following medical societies: American Academy of Otolaryngology-Head and Neck Surgery, American Society of Pediatric Otolaryngology, Society for Ear, Nose and Throat Advances in Children, American Academy of Pediatrics, American Cleft Palate-Craniofacial Association, American College of Surgeons, The Triological Society, Texas Medical Association

Disclosure: Nothing to disclose.

Specialty Editor Board

Francisco Talavera, PharmD, PhD Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Received salary from Medscape for employment. for: Medscape.

Dominique Dorion, MD, MSc, FRCSC, FACS Deputy Dean and Associate Dean of Resources, Professor of Surgery, Division of Otolaryngology-Head and Neck Surgery, Faculty of Medicine, Université de Sherbrooke, Canada

Disclosure: Nothing to disclose.

Chief Editor

Arlen D Meyers, MD, MBA Professor of Otolaryngology, Dentistry, and Engineering, 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, American Head and Neck Society

Disclosure: Serve(d) as a director, officer, partner, employee, advisor, consultant or trustee for: Cerescan;RxRevu;SymbiaAllergySolutions<br/>Received income in an amount equal to or greater than $250 from: Symbia<br/>Received from Allergy Solutions, Inc for board membership; Received honoraria from RxRevu for chief medical editor; Received salary from Medvoy for founder and president; Received consulting fee from Corvectra for senior medical advisor; Received ownership interest from Cerescan for consulting; Received consulting fee from Essiahealth for advisor; Received consulting fee from Carespan for advisor; Received consulting fee from Covidien for consulting.

Additional Contributors

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 Neurotology Society, American College of Surgeons, American Medical Association, American Tinnitus Association, Florida Medical Association, North American Skull Base Society

Disclosure: Received consulting fee from Synthes Power Tools for consulting.

References
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Grade 4 microtia (anotia). Note the absence of cartilage.
Grade 3 microtia: the most common type.
Grade 2 microtia.
Grade 1 microtia.
Framework components of porous polyethylene.
Cartilage framework carved and assembled for stage 1.
Appearance at completion of stage 1, rib technique.
Incisions for stage 2.
Postoperative appearance, stage 3. A bolster is in place over the skin graft.
Appearance after stage 4.
Early result after stage 1 reconstruction with porous polyethylene.
Early result after stage 2 reconstruction with porous polyethylene.
 
 
 
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