Different Designs
of The Prefabricated Three Dimensional Cartilagenous Framework In Total
AuricularReconstruction By Autologous Costal Cartilage Grafts
Ahmed Gamil El-Sharkawy, M.D, Sherif
Zamer Ezzat, M.D, & Tarek Ahmed Said
The Department
of Surgery, Cairo University
Kasr El Aini Journal of Surgery,
Vol (4), No (1),January 2003: 23-35
Auricular reconstruction represents
a meticulous and aesthetic problem to the plastic surgeon. To date the
most frequently relied upon technique for auricular reconstruction is the
autologous costal cartilage grafting where the most important factor affecting
the outcome of surgery is the fabricated three-dimensional cartilagenous
framework for the reconstructed ear. In a study to compare the aesthetic
outcome of the different framework designs, 27 ears were reconstructed
in 25 patients using costal cartilage grafts. Three patterns of frame works
were used; the contour accentuated, the Tanzer's framework and a Cantilever
pinnal framework. The best results were obtained with the contour accentuated
framework which yielded good results in 100% of cases. When using the Tanzer's
framework good results were obtained in 80% of cases which further dropped
when using a cantilever pinnal framework to 76.9%. The results suggest
that contour accentuated framework is the best framework design to be used
in auricular reconstruction. As the construction of this type of framework
needs a well developed chest wall, it is recommended that auricular reconstruction
is attempted after the age of 8 years.
