Microtia Repairs Comparisons

Transcription

Microtia Repairs Comparisons
COMPLIMENTS OF
Atlanta Plastic Surgery Specialists, P.C.
Dr. Mark Mitchell Jones
2001 Peachtree Road NE, St. 630
Atlanta, GA 30309
(404) 355-3566 www.atlantaear.com
Age to begin
Opening ear canal for hearing
MR Argiogram or equivalent
Anesthesia and duration
Major complications
Natural materials
Artificial materials
Time in surgery
Hospitalizations (total)
Outpatient
Inpatient (overnight)
Infection
Exposure
Chest scar
Scar on scalp
Hair cutting for surgery
Skin grafting
Vasc. compr. & major tissue loss
Time span over surgeries
Ear flexibility
Sensation
Convenience
Longevity
Ear skin color
Ear skin texture
Rejection
Infection
Implant fracture
Nerve risk to frontal facial nerve
Exposure/extrusion
Ear detachment
After
Trauma resilience/durability
Surgery Chest scar
(Longterm) Scar on scalp
Permanent hair loss
Options for repair of damaged ear
Worry of future complications
Insect bites
Playground trauma
Other blunt trauma
Infections
Sports limitations
Time post-op in town
Retain normal ear components
Time post op. ear swelling
Time post op. to wear protective dressing
Before
Surgery
Bibliography
DRAFT 10/21/2014
Microtia Repairs Comparisons
Synthetic Plastic Grafts
Natural Rib Cartilage Grafts
External Prosthesis
Glue Attached
External Prosthesis
Dental Implant
Attached
Silicon with TP Flap
Endoscopic Reduces
Hairloss at Scalp Seam
5-6
No
No
Yes, 1-2 hours
No
None
Yes
1-2 hours
1
1
5-6
No
No
Yes, 2-3 hours
Infection, drainage
None
Yes
2-3 hours
1
1
Low risk
Low risk
No
No
No
No
No
N/A
No
No
Daily application
5 years
Changes daily
Major difference
No
None
N/A
None
No
Yes
Falls off
No
No
No
Yes
High risk
Low risk
No
No
No
No
No
N/A
No
No
Daily application
5 years
Changes daily
Major difference
No
Lifelong risk
N/A
None
No
Yes
Falls off
No
No
No
Compromised
5-6
5-6
No
Option before, not after
Yes
Yes
Yes, 3-5 hours
Yes, 3-5 hours
Flap loss
Flap loss
None
None
Yes
Yes
3-5 hours
3-5 hours
2
2
1
1
1
1
High risk
Medium risk
High risk
Medium risk
No
No
Yes
Yes, usually
Yes
Yes, usually
Yes, in front of/over ear Yes, in front of/over ear
High risk
Medium risk
6 months
6 months
Some
Stiff
Decreased to numb
Decreased to numb
Normal bathing
Normal bathing
All removed eventually
Unknown
Some difference
Some difference
Shiny-like skingraft
Shiny/like skingraft
Lifelong risk
Lifelong risk
Lifelong risk
Lifelong risk
Unknown
>3%
Yes
Yes
Lifelong risk
7% after 12 years
No
No
Poor resistance
Moderate resistance
No
No
Yes
Yes, usually
High risk
High risk
Compromised
Compromised
No
Falls off
Falls off
None
Yes
1 day
Yes
None
None
No
Falls off
Falls off
Medium risk
Yes
1 day
Sometimes
1 week
1 week
1. Dr. Mark Mitchell Jones website www.atlantaear.com
2. Dr. Francoise Firmin website
3. Dr. Burt Brent. The Art of Plastic Surgery.
4. Dr. Satory Nagata website www.microtia.jp
5. Dr. John Reinisch website www.drjohnreinisch.com
6. Dr. Sheryl Lewin website www.microtiaearsurgery.com
7. Mr. Andrew Greensmith website www.microtiaexpert.com
High risk
High risk
High risk
High risk
Yes
2-3 weeks
No
6 months
3 weeks
Medpor with TP Flap
Endoscopic Reduces
Hairloss at Scalp Seam
Medium risk
Medium risk
Medium risk
Medium risk
Yes
2-3 weeks with cup
No
6 months
3 weeks
Brent/Mark M. Jones
Classic
3-4 Stages
Japanese Nagata/Firmin
Two-Stage
Griffin TP One-Stage
Ribgraft/Medpor
(prefers rib graft)
5-6
Option, prefer after
No
Yes, 3-4 hours
Minimum rib loss
All
No
2.5-3.5 hours, 1 h, 2-3 hrs
2-4
1-3
1
Low risk
Low risk
One incision
No
No
Yes, behind ear
Low risk
2-8 months
Some
Decreased to normal
Normal bathing
Lifelong
Same as skin
Normal skin
No
Normal
None
None
<1%
No
Normal ear
One, no phys. limitations
No
No
TP flap available
10
Option, prefer after
No
Yes, 4-6 hours
More rib loss
All
No
4-6 hours, 3-5 hours
2
1
1
Low risk
Medium risk (14%)
Two incisions
Yes, 2nd stage
Yes, 2nd stage
Yes, behind ear
Medium risk
4-6 months
Some
Decreased to numb
Normal bathing
Lifelong
Same as skin
Normal skin
No
Normal
None
None
Some 8%
No
Normal ear
Two
No
Yes
Compromised
3+
Possible in some cases
Yes
Yes, 10-20 hours
Flap compromised
Yes/No
Sometimes
10-20 hours
1-3
1-2
1
Low/Medium risk
Medium/High risk
One incision/None
Yes
Yes
Yes, front of/over ear
Medium/High risk
N/A
Some
Decreased to numb
Normal bathing
Unknown
Some difference
Shiny-like skingraft
No/Lifelong risk
Mild risk/Normal
None/>3%
Yes/Yes
Mild risk/7%
No
Unknown
One/No
Yes
High risk
Compromised
Normal ear
Normal ear
Normal ear
Normal ear
No
1st 7-10 days, others 1 day
Yes
4-6 weeks
9-10 days
Normal ear
Normal ear
Normal ear
Normal ear
No
2-3 weeks
Compromised
6 months
Weeks to months
Normal ear/Medium risk
Normal ear/Medium risk
Normal ear/Medium risk
Normal ear/Medium risk
No/Yes
2-3 months
Unknown
6 months
Weeks to months
8. Dr. Arturo Banilla website www.microtia.net
9. Boston Children's Hospital website www.childrenshopsital.org
10. Reinisch J, Lewin S. Ear Reconstruction with Porous Polyethylene Implant. Facial Plastic Surgery, 2009 Aug 25 (3), pp. 181-9.
11. Bauer B. Reconstruction of Microtia. Online at Plast Reconstr Surg . 2009; 124: 14e-26e.
12. Dr. Russell Griffiths website www.earreconstructionspecialist.com
13. Shen J, Quinn F. Microtia Reconstruction. Presentation at The University of Texas Department of Otoralyncology. October 2004.
Copyright 2014. Dr. Mark Mitchell Jones and www.atlantaear.com.