Ear Reconstruction Essay

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Ear reconstruction for microtia is an intriguing surgery in terms of clinical skill and dexterity for plastic and reconstructive surgeons. Apart from proper ratios and detailed carving of cartilage framework, the overlying skin is utmost important for the final outcome of reconstruction. A good outcome needs adherence of the skin flap and cartilaginous framework, for which purpose suction drains are used during the surgery. By creating a negative pressure, suction drains promote adherence of skin flap and cartilage framework and removes the seroma and hematoma. Usually surgeons put two drains through the infra auricular skin one behind and other beneath the cartilaginous framework. Herein, we put forward our idea of putting the drains through the hair bearing areas of scalp so as to avoid visible post-operative visible scars.
The use of autologous costal cartilage for ear reconstruction was first described by Sir Harold Gillies, in 1920(1). Later Brent described a standardized technique of four stage reconstruction of microtia (2, 3, 4). In early 90s Nagata further modified this procedure and proposed his two stage technique for
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Two silicon tube drains were inserted through the scalp skin posterior to the superficial temporal artery, one of which was placed beneath the framework with the tip lying at the concha, while the other was placed behind the framework (Figure-1). Drains were connected to 10 cc disposable syringes and continuous suction was maintained using the plunger of a 2 cc syringe as a stopper postoperatively for 3 to 5 days. Drains were removed at 3-5 days. There were no complications of drain displacement, loss of suction, collection or skin necrosis. We have modified the drain placement by placing both the drains through hair bearing area of scalp, which we feel avoids an unnecessary visible scar in the neck region without causing any problems and compromise in
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