[A comparative study of temporoparietal fascial flap and postauricular fascial flap in the ear elevation].

OBJECTIVE: To discuss the effects of the temporoparietal fascial flap and the postauricular fascial flap as the materials to cover the postauricular-frame during the second stage operation of the total auricular reconstruction.

METHODS: From June 2005 to May 2007, the second stage elevation of the reconstructed auricle was performed at 6-10 months after the first stage total auricular reconstruction for 72 cases (left 31, right 41), 47 males and 25 females, aged 5-28 years old (12 on average). According to the Nagata's classification, 56 cases were lobule-type microtia with no external auditory canal, and the other 16 cases were concha-type microtia with external auditory canal (narrow in 9 cases). Homolateral temporoparietal fascial flap was used to cover the postauricular-frame in 29 patients (group A), and the homolateral postauricular fascial flap was used in the other 43 patients (group B).

RESULTS: All the patients were followed up for 3-22 months. A total of 55 cases had excellent skin flap and fascial flap (22 in group A and 33 in group B). Darker epidermis could be seen in 15 cases (6 in group A and 9 in group B), and it healed within one month after the operation. Two cases (1 in group A and 1 in group B) suffering from partial grafted skin and fascial flap necrosis (< 1 cm2) healed by means of coverage of local flap transfer. All the patients' reconstructed auriculocephalic angles were close to the normal side. There existed scars of varying degrees at the area of skin graft in both groups: 47 cases had flat scars (19 in group A and 28 in group B); 18 cases had hyperplastic scars (7 in group A and 11 in group B); and 7 cases had severe scars with the auriculocephalic angles draw-off (3 in group A and 4 in group B). Furthermore, there were obvious scars in temporal region and severe hair thinning at the donor site in group A, but there were no such conditions in group B. At 6 months of follow-up, reduction of the auriculocephalic angle occurred in 3 cases of group A and obvious in 5 cases of group B (> 0.5 cm).

CONCLUSION: Both the temporoparietal fascial flap and the postauricular fascial flap can be applied to cover the postauricular-framework in the second stage reconstructed ear elevation, with superiority of the latter over the former.