Clinical Research Article
Ear reconstruction with Ba Da Chu Method——Ten-year experiences of our team
Leren He, Qinghua Yang, Haiyue Jiang, Hongxing Zhuang, Qingguo Zhang, Yongzhen Wang, Jinxiu Yang, Yanyong Zhao, Bo Pan, Lin Lin, Hengyun Sun, Ye Zhang, Jin Qian
Published 2017-08-15
Cite as
Chin J Plast Surg, 2017, 33(Z1): 28-33. DOI: 10.3760/cma.j.issn.1009-4598.2017.S1.007
Abstract
ObjectiveTo introduce our experiences in ear reconstruction with Ba Da Chu Method during the past 10 years, and to summarize the operative skills and key points.
MethodsGenerally, Ba Da Chu Method for ear reconstruction includes 3 stages: Stage 1, skin expansion in mastoid region. Stage 2, auricular reconstruction), consisting of tissue expander removal, earlobe transposition, expanded skin flap and temporal fascia flap formation, autologous costal cartilage harvest, framework fabrication and transplantation, and the wound closure. Stage 3: tragus formation, conchoplasty, and refinement of the reconstructed ear.
ResultsFrom January, 2006 to December, 2015, we performed 5628 reconstructed ears for 5267 patients with congenital microtia. Follow-up period ranged from 1 to 10 years. Complications in stage 1 included hematoma, infection and expander exposure sporadically arising, which were treated properly and stage2 operations were carried out on time or delayed. 5202 (92.4%) reconstructed ears were demonstrated with fine substructure landmarks. 236(4.2%)reconstructed ears with poor blood circulation at the margin of skin flap, were cured completely and ended up with acceptable outcomes; 108 (1.9%) reconstructed ears, manifestedwith mild cartilage framework exposure due to partial necrosis of skin graft, were repaired in stage 3. 61 (1.1%) of them with severe exposure, needed additional operations to cover the framework with axial fascial flap immediately. 21 (0.3%) reconstructed ears lost the normal contour because of cartilage infection, which a secondary operation was needed to repair. The complications of stage 3 occurred rarely, which could be cured in the end.
ConclusionsBa Da Chu Method is well adapted to treat congenital microtia, and it is flexible to adjust surgical skills when microtia was combined with other complicated soft tissue deformities or craniofacial bone defects; Satisfactory result were achieved in 92.4% reconstructed ears in this study with fine substructures; During approximate 2-month skin expansion, great attention must be paid to ensure successful expansion, which is based on extensive clinical experiences from doctors, appropriate nursing management from nurses, and careful observation from patients or their families.
Key words:
Microtia; Ear reconstruction with Ba Da Chu method; Otoplasty; Soft tissue expander; Costal cartilage; Framework
Contributor Information
Leren He
First Center of External Ear Reconstruction, Plastic Surgery Hospital, Chinese Academy of Medical Science, Beijing 100144, China
Qinghua Yang
Haiyue Jiang
Hongxing Zhuang
Qingguo Zhang
Yongzhen Wang
Jinxiu Yang
Yanyong Zhao
Bo Pan
Lin Lin
Hengyun Sun
Ye Zhang
Jin Qian