Clinical efficacy of modified total auricular reconstruction technique by using reformative inflation method and remnant ear without skin grafting

BACKGROUND: As one of the most widely used methods to treat microtia, the auricular reconstruction proposed by Zhuang may have several drawbacks. This study aimed to introduce a modified Zhuang’s ear reconstruction technique by using a reformative inflation method and remnant ear to shorten therapy time and avoid skin grafting in a two-stage operation for patients with microtia. METHODS: A total of 124 patients with microtia were enrolled consecutively from 2014 to 2018. Among them, 66 patients underwent a modified Zhuang’s method, and the remaining patients underwent Zhuang’s method. The clinical and perioperative characteristics of patients, as well as complications and esthetic outcomes were analyzed. RESULTS: Compared with Zhuang’s group, our modified Zhuang’s group had better average esthetic scores according to two plastic surgeons [11.5 (IQR, 10.5–12.5) vs. 9.5 (IQR, 7.5–11.0), P<0.001], fewer hypertrophic scar cases [0% (n=0/66) vs. 10% (n=6/58), P = 0.024], shorter whole therapy duration [2.5 (IQR, 2.4–2.6) vs. 5.0 (IQR, 5.0–5.1) days, P<0.001] and shorter hospital duration after operation [5 (IQR, 5–6) vs. 6 (IQR, 5–6) days, P=0.013]. CONCLUSIONS: Our modified Zhuang’s technique is a new method to treat microtia which results in a clear contour of the reconstructed ear and matching skin color, minimal scarring, and a short treatment time.