An innovative corrective method: Reutilization of auricular fistula in microtia reconstruction

Abstract

Background

Auricular fistulas, typically excised due to infection risk, consist of intact skin and soft tissue when uninfected. A large fistula lumen with sufficient tissue coverage over cartilage and no infection during stable periods may be viable for reuse. This article explores using non-infected fistulas as soft tissue sources for microtia reconstruction.

Method

Between January 2020 and October 2023, a total of 24 patients diagnosed with concha-type microtia were enrolled in this retrospective study. The correction of ear deformities is achieved by utilizing tissue harvested from the auricular fistulas. Summarize the characteristic information of auricular fistula and the information on postoperative complications of auricular fistula. The ear morphology data(ear length and ear width) collected pre- and post-surgery, along with the Visual Analog Scale (VAS) satisfaction scores and Aesthetic Outcomes Scale(AOS) ear aesthetic evaluations, were assessed for the patients.

Results

The mean follow-up duration for this study was 13.1 months.All patients included in this study were diagnosed with concha-type microtia. The auricular fistula was situated in the upper region of the auricle and opened onto the skin surface. The skin tissue surrounding the auricular fistula was abundant, and cartilage was present within the structure of the fistula. Postoperative follow-up indicated the absence of infection, flap necrosis, or any abnormal secretions. The postoperative measurements of ear length, width, and the difference in ear length and width between the two sides were all significantly improved compared to the preoperative measurements. The average preoperative AOS score was 1.2 ± 0.4, and the average postoperative AOS score was 3.6 ± 0.4. The preoperative VAS satisfaction score was 2.1 ± 0.6, and the postoperative VAS score significantly increased to 8.0 ± 0.8.

Conclusion

The larger auricular fistula tissue in a stable, non-infected state can be used as a valuable skin source for microtia reconstruction. Utilizing auricular fistula tissue in concha-type microtia correction enhances the auricular aesthetics, reduces secondary local trauma, and improves patient satisfaction with the surgical outcome.