What is auricular reconstruction?
Auricular reconstruction is a multi-staged procedure to rebuild the ear. Some children are born without one or both ears. People of any age may lose all or part of an ear in an accident. Auricular reconstruction usually takes four operations spaced about 6 months apart, so the total process can take up to two years.
Who is a good candidate for auricular reconstruction?
The best candidates for auricular reconstruction are children around 6 to 8 years old or older. At this age, the rib cartilages are large enough to carve into an adequately sized framework. People who have had radiation, extensive scarring or extensive sun damage to the area are not good candidates, and may be better suited with a prosthesis. |
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How is auricular reconstruction performed?
In the first stage, an incision is made in front of the small ear remnant, and a skin pocket is made. Rib cartilage is borrowed from the chest, and it is carved into the shape of an ear. The new ear framework is placed in the skin pocket, and the skin closed with dissolving stitches. A drain is also put in the chest, and removed after a couple of days. In the second stage, the earlobe is moved to a more normal location. In the third stage, the ear is lifted from the side of the head, and a skin graft is put behind the ear. The graft is usually taken from the leg or hip. In the fourth stage, a piece of cartilage and skin is borrowed from the other ear to make a tragus (the small flap that covers the ear canal opening). All stages of auricular reconstruction are performed under general anesthesia. Usually, only the first stage requires a stay in the hospital. This typically takes 2-3 days. The first operation takes about 3 hours, and the others take about 2 hours each.
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First Stage
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Second Stage
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Third Stage
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Forth Stage
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What is the recovery from surgery like?
Recovery from auricular reconstruction surgery involves several phases. Since general anesthesia is used, your child may experience some nausea for the first 24 hours, and he/she should avoid eating substantial amounts of food. Slight oozing may occur around the incisions. Limiting strenuous activity and keeping the head elevated will cut down on much of the swelling. It can take 3-6 months for the swelling is go down. It is important to put antibiotic ointment on skin graft sites and sutures twice a day.
When should I come back to the doctor?
Since the sutures dissolve by themselves, there is some leeway about when you may come back to the doctor for a check up. Any skin graft bolsters need to be removed after about a week.
When can I go back to work or school?
You should be able to resume any normal activity after about 7-10 days.
Will my insurance pay for this?
Most insurance companies consider auricular reconstruction a functional procedure and do provide coverage.
