Abstract:

BACKGROUND: Traumatic auricle defects in upper 1/2 or lower 1/2, seriously involve the auricular cartilage and skin blood vessels. The autogenic rib cartilage graft and acellular dermal matrix have good histocompatibility, and expanded flap is a kind of thin and achromatic tissue for skin defect repair. 
OBJECTIVE: To explore the application of acellular dermal matrix and expanded flap in half auricular reconstruction, and to find out the fine carving and anastomosis of autogenic rib cartilage graft as well as its similarities with the ear and clinical significance.
METHODS: Eight cases of half auricular defects were treated with expanded flap, autogenic rib cartilage graft, fine anastomosis of autogenic rib cartilage graft and residual ear for half auricular reconstruction, during which the acellular dermal matrix was used to promote residual ear docking and skull auricle angle formation. The reconstruction was performed in three stages: first, an expander (volume, 80 mL) was subcutaneously implanted at the retro-auricular area; second, the auricular defects were reconstructed with fine rib cartilage graft, acellular dermal matrix and auriculoplasty; finally, acellular dermal matrix was used to promote residual ear docking. Then the half auricular reconstruction was evaluated by objective measurement and subjective rating.
RESULTS AND CONCLUSION: Half auricular reconstruction was successful in all the eight cases without obvious complications, and the cartilage grafts were in good condition. During the follow-up, the reconstructed auricle was shaped well and formed a good involution with the residual auricle. In addition, the flange was smooth without obvious color difference and edema, and its position, size and shape were consistent with those of the contralateral one. After the follow-up of 6 months, objective indicators showed that the affected side had no significant difference from the contralateral one (P > 0.05). In conclusion, the acellular dermal matrix can obviously decrease the complications of the cartilage grafts and contribute to a good shaped auricle; and half auricular reconstruction by expanded flap, autogenic rib cartilage graft, and fine anastomosis of autogenic rib cartilage graft can achieve significant clinical effects.

中国组织工程研究杂志出版内容重点：组织构建；骨细胞；软骨细胞；细胞培养；成纤维细胞；血管内皮细胞；骨质疏松；组织工程

Key words: Dermix, Surgical Flaps, Ear Auricle