Subscribe to RSS
![](/products/assets/desktop/img/oa-logo.png)
DOI: 10.5999/aps.2013.40.3.192
The Importance of a Conchal Bowl Element in the Fabrication of a Three-Dimensional Framework in Total Auricular Reconstruction
![](https://www.thieme-connect.de/media/10.1055-s-00051611/201303/lookinside/thumbnails/10_5999_aps_2013_40_3_192_192-1.jpg)
Background To construct a sophisticated three-dimensional framework, numerous modifications have been reported in the literature. However, most surgeons have paid little attention to the anatomical configuration of the concha and more to its deepness and hollowness, leading to unsatisfactory outcomes.
Methods For a configuration of the concha that is definitely anatomical, the author further developed and employed the conchal bowl element, which has been used by several surgeons although the results have not been published elsewhere. The author constructed the conchal bowl element in one of three patterns according to the amount of available cartilages: one block, two-pieces, or a cymba bowl element only. A total of 20 patients underwent auricular reconstruction using a costal cartilage framework between 2009 and 2012. The 8 earliest reconstructions were performed without a conchal bowl element and the latter 12 with a conchal bowl element. The patients were followed up for more than 1 year. The aesthetic results were scored by evaluating characteristics involving the stability of the crus helicis, the conchal definition, and the smoothness of the helical curve.
Results The ears reconstructed early without a conchal bowl element showed a shallow and one or two incompletely separated concha with an obliterated cymba conchal space. They also did not have a realistic or smooth curve of the helix because of an unstable crus helicis. However, ears reconstructed later with the concha bowl element showed a definite crus helicis, deep cymba conchal space, and smooth helical curve.
Conclusions The construction of the conchal bowl element is simple, not time-consuming procedure. It is suggested that the conchal bowl element must be constructed and attached to the main framework for natural configuration of the reconstructed ear.
This article was presented at the 5th International Congress on Auricular Reconstruction, March 11-13, 2012 in Sydney, Australia and the 70th Congress of the Korean Society of Plastic and Reconstructive Surgeons, November 9-11, 2012 in Seoul, Korea.
Publication History
Received: 28 November 2012
Accepted: 27 March 2013
Article published online:
01 May 2022
© 2013. The Korean Society of Plastic and Reconstructive Surgeons. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonCommercial License, permitting unrestricted noncommercial use, distribution, and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes. (https://creativecommons.org/licenses/by-nc/4.0/)
Thieme Medical Publishers, Inc.
333 Seventh Avenue, 18th Floor, New York, NY 10001, USA
-
References
- 1 Nagata S. A new method of total reconstruction of the auricle for microtia. Plast Reconstr Surg 1993; 92: 187-201
- 2 Nagata S. Modification of the stages in total reconstruction of the auricle: Part I. Grafting the three-dimensional costal cartilage framework for lobule-type microtia. Plast Reconstr Surg 1994; 93: 221-230
- 3 Nagata S. Modification of the stages in total reconstruction of the auricle: Part II. Grafting the three-dimensional costal cartilage framework for concha-type microtia. Plast Reconstr Surg 1994; 93: 231-242
- 4 Nagata S. Modification of the stages in total reconstruction of the auricle: Part III. Grafting the three-dimensional costal cartilage framework for small concha-type microtia. Plast Reconstr Surg 1994; 93: 243-253
- 5 Nagata S. Modification of the stages in total reconstruction of the auricle: Part IV. Ear elevation for the constructed auricle. Plast Reconstr Surg 1994; 93: 254-266
- 6 Kawanabe Y, Nagata S. A new method of costal cartilage harvest for total auricular reconstruction: part I. Avoidance and prevention of intraoperative and postoperative complications and problems. Plast Reconstr Surg 2006; 117: 2011-2018
- 7 Kawanabe Y, Nagata S. A new method of costal cartilage harvest for total auricular reconstruction: part II. Evaluation and analysis of the regenerated costal cartilage. Plast Reconstr Surg 2007; 119: 308-315
- 8 Cho BC, Lee JH. New technique for the fabrication of a stable cartilage framework. Plast Reconstr Surg 2012; 129: 183e-184e
- 9 Chin W, Zhang R, Zhang Q. et al. Modifications of three-dimensional costal cartilage framework grafting in auricular reconstruction for microtia. Plast Reconstr Surg 2009; 124: 1940-1946
- 10 Tanzer RC. Total reconstruction of the external ear. Plast Reconstr Surg Transplant Bull 1959; 23: 1-15
- 11 Brent B. Auricular repair with autogenous rib cartilage grafts: two decades of experience with 600 cases. Plast Reconstr Surg 1992; 90: 355-374
- 12 Brent B. Technical advances in ear reconstruction with autogenous rib cartilage grafts: personal experience with 1200 cases. Plast Reconstr Surg 1999; 104: 319-334
- 13 Brent B. Microtia repair with rib cartilage grafts: a review of personal experience with 1000 cases. Clin Plast Surg 2002; 29: 257-271
- 14 Osorno G. A 20-year experience with the Brent technique of auricular reconstruction: pearls and pitfalls. Plast Reconstr Surg 2007; 119: 1447-1463
- 15 Firmin F. Ear reconstruction in cases of typical microtia. Personal experience based on 352 microtic ear corrections. Scand J Plast Reconstr Surg Hand Surg 1998; 32: 35-47
- 16 Tolleth H. Artistic anatomy, dimensions, and proportions of the external ear. Clin Plast Surg 1978; 5: 337-345