Shuqi Xu1, Xianlei Jia2, Yoonho Choi1, Yangbin Xu1, Qing Tang1, Ram Velamuri3 and Xiangxia Liu1,3*
1Department of Plastic Surgery, First Affiliated Hospital of Sun Yat-sen University, China
2Department of Orthopedic Surgery, Guangdong Hospital of Chinese Traditional Medicine, China
3Department of Plastic Surgery, First Affiliated Hospital, Sun Yat-sen University, China
Objective: Tissue expansion technique plays an important role in microtia reconstruction surgery by creating an abundant skin envelop which is one of the most two critical factors besides the frame structure. Currently there is no precise and objective way to evaluate how large is the surface area of the expanded remnant ear and how much skin will be needed in microtia reconstruction with tissue expansion technique. This study aimed to present our preliminary results by using 3D surface scanning technique to evaluate the surface area of the normal ear and the expanded remnant ear and help the surgeons during the decision-maker process in three microtia patients reconstructed with tissue expander and autologous cartilage.
Methods: Using the two stage procedures, three microtia patients were reconstructed by tissue expander and autologous cartilages. During the expansion, the surface area of normal ear and expanded remnant ear were measured by DH-H30 3D scanning machine. The plastic surgeons preceded the second stage procedure of autologous cartilage frame placement based on these 3D scanning measurement and other related factors such as the texture of the skin and total volume of expansion accordingly.
Results: Three congenital microtia patients were enrolled in the study. The patients’ age ranged from 8 to 28 years old. The expanders applied were 100 ml kidney-shaped. The expansion time ranged from 121 to 176 days. The total volume of expansion was 174 ml, 190 ml and 176 ml respectively. After the expansion, the 3D scanning showed the expanded surface area of remnant ear was 7119.70 mm2, 8310.93 mm2 and 8042.76 mm2, the surface area of normal ear was 3852.94 mm2, 4351.08 mm2 and 3591.27 mm2. By subtracting the base area of the expander which was 3093.16 mm2, 3094.28 mm2 and 1847.78 mm2, all the measurement indicated there was extra skin for the next stage procedure. All cases were successfully reconstructed by two-stage procedures with tissue expander and autologous cartilage without complications. After 2 years follow up, the reconstruct ear showed stable and favorable contour.
Conclusion: Tissue expansion is an effective way to obtain excess skin envelop for microtia reconstruction. 3D scanning technique helps the surgeons in decision making process by providing precise and objective information of the surface area of both the normal ear and the expanded remnant ear.
Xu S, Jia X, Choi Y, Xu Y, Tang Q, Velamuri R, et al. The Application of 3D Scanning Technique in the Congenital Microtia Reconstruction with Tissue Expander: A Preliminary Report. Clin Surg. 2019; 4: 2408.