This is the second stage of Microtia Reconstruction, the first stage was depicted in a prior video. The ear is elevated and lateralized to take its 3-dimensional form, and this is accomplished with use of an anteriorly based mastoid fascial flap as well as costal cartilage graft and full thickness skin graft.
Editor Recruited By: Michael Golinko, MD
Stage 2 Microtia Repair
Health condition preventing the patient from undergoing general anesthesia
Head drape with complete sterile set up. Hair should be shaved around the ear prior to prepping and draping for sterility and visualization.
Physical exam and examination of skin healing over the auricular framework that was created in the first stage of surgery.
New anatomic landmarks are created after stage 1 of this surgery and these new landmarks should help guide where the new post-auricular sulcus will be. Posterior auricular incision should be made ~8mm posterior to the helix of the neo-auricle to have sufficient anteriorly based skin for a smooth transition from anterior to posterior of the ear (which will be covered with a skin graft).
Advantage is that this avoids use of a Temper-Parietal-Fascial (TPF) Flap by using mastoid fascia, thereby allowing the TPF to remain in place in case of any future necessary procedures.