Ear reconstruction using a porous polyethylene framework and temporoparietal fascia flap
Abstract
Ear reconstruction is a difficult procedure requiring a framework and soft tissue covering. The traditional method uses a rib cartilage framework placed beneath scalp skin. This method has been used for 50 years despite inherent problems with both harvesting rib cartilage and using scalp for coverage. The authors describe a method using a porous polyethylene (PPE) framework covered by a large temporoparietal fascia (TFP) flap raised with the underlying subgaleal fascia (SGF). The entire implant is covered by the two-layered flap, which can be raised without any scalp incision. The skin grafts applied to the covered implant lie on the SGF. The trilaminar structure of the SGF allows the skin to move independently over the implant, resisting shear forces and reducing the probability of implant exposure. Ear reconstruction using the PPE framework was performed on 786 ears over an 18-year period. Initial complications were common. With improved implant design and complete coverage of the implant with both the TPF and SGF, exposure rate dropped to 7% with a 12-year follow-up. Implant fractures decreased to less than 3%. The PPE/TPF method allows earlier ear reconstruction in children with minimal scarring and discomfort. The reconstructed ear can closely mimic the shape and projection of the natural contralateral ear in fewer stages and with a shorter learning curve.
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Osteointegrated prostheses, costochondral implants, or polyethylene Medpor implants are the preferred methods to reconstruct near-total to total ear defects.
“Osteointegrated prostheses, costochondral implants, or polyethylene Medpor (Stryker Corp., Kalamazoo, MI) implants are the preferred methods to reconstruct near-total to total ear defects.5,[34][35][36][37][38]”
From Ear Reconstruction following Mohs Micrographic Surgery (2024) · cites this paper as [35]
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Kaboodkhani, R., Mehrabani, D., Moghaddam, A., Salahshoori, I., & Khonakdar, H. A. (2024) · Journal of Biomaterials Science Polymer Edition · doi:10.1080/09205063.2024.2318822 · Cited by 5 · see citing works
Ha, N. H., Vu, D. D., Ngo, L. M., & Tran, H. T. T. (2024) · Journal of Plastic Reconstructive & Aesthetic Surgery · doi:10.1016/j.bjps.2024.01.029 · Cited by 5 · see citing works
Avoiding Complications of Microtia and Otoplasty
Romo, T., Baratelli, R., & Raunig, H. (2012) · Facial Plastic Surgery · doi:10.1055/s-0032-1312692 · Cited by 5 · see citing works
- Authors
- Reinisch, J., & Lewin, S.
- Affiliations
- Cedars-Sinai Medical Center (US)
- Venue
- Facial Plastic Surgery
- Publisher
- Georg Thieme Verlag KG
- Published
- 2009-08
- Volume
- 25
- Issue
- 03
- Pages
- 181-189
- ISSN
- 0736-6825 (ISSN-L)
- 1098-8793
- OpenAlex
- W2091166213
- Cited by
- 203
- References
- 0
- Citations by year
- 2026: 6 · 2025: 20 · 2024: 14 · 2023: 15 · 2022: 12 · 2021: 19 · 2020: 8 · 2019: 19 · 2018: 14 · 2017: 11 · 2016: 10 · 2015: 9 · 2014: 18 · 2013: 4 · 2012: 10
- FWCI
- 8.04
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Facial Plastic Surgery (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Surgery › Reconstructive Facial Surgery Techniques
- Health Sciences › Medicine › Surgery › Reconstructive Surgery and Microvascular Techniques
- Health Sciences › Medicine › Genetics › Congenital Ear and Nasal Anomalies
- Keywords
- ear reconstruction, temporoparietal fascia flap, implant exposure, implant fracture, implant design, soft tissue coverage
- MeSH terms
- Congenital Abnormalities, Ear Canal, Ear Cartilage, Ear Diseases, Ear, External, Fascia, Humans, Prosthesis Design, Surgery, Plastic, Surgical Flaps, Plastic Surgery Procedures, Prostheses and Implants, Polyethylene, Tissue Scaffolds, Ear Auricle
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