PMID- 31639620 OWN - NLM STAT- MEDLINE DCOM- 20200318 LR - 20221207 IS - 1872-8464 (Electronic) IS - 0165-5876 (Linking) VI - 128 DP - 2020 Jan TI - Using an expanded scalp flap without fascial flap harvest or skin grafting for total auricular reconstruction in hemifacial microsomia with low hairline. PG - 109726 LID - S0165-5876(19)30479-3 [pii] LID - 10.1016/j.ijporl.2019.109726 [doi] AB - BACKGROUND: Total auricular reconstruction for hemifacial microsomia patients with extremely low hairline is a tough challenge in plastic surgery. In this work, a brand new technique using a singer expanded scalp flap without skin graft and combined with intense pulse light treatments (IPLT) for ear reconstruction is described in this special population. METHODS: From January 2015 to April 2019, 41 hemifacial macrosomia (HFM) patients with 70-100% low hairline were enrolled in our study. Operative treatment was performed in 3 stages: 1. Expander insertion and inflation; 2. Expander removal, costal cartilage framework fabrication and auricular reconstruction; 3. Tragus reconstruction and reconstructed auricle refinement. Several IPLTs were performed every 45 days until local area become hairless during the whole course. The first IPLT could be executed either before all the operations or during the expansion period. The flap was treated with M22 system using a filter of 695-1200 nm. Follow up ranged from 10 months to 4 years. RESULTS: During follow-up, 90.2% patients were surveyed as satisfied with the outcome, especially in the aspects of minimal scars, natural matched color and clear contour of the reconstructed ear. No serious complications happened. Patients starting the IPLT during the expansion period required less treatment times of depilation (p < 0.05). CONCLUSION: Auricular reconstruction using a single expanded scalp flap combined with intense pulse light depilation is a safe, effective and less invasive technique for hemifacial microsomia with extremely low hairline, and providing highly satisfying results. Initialing the IPLD during the expansion period is recommended. CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, IV. CI - Copyright (c) 2019 Elsevier B.V. All rights reserved. FAU - Chen, Qi AU - Chen Q AD - From the Auricular Plastic and Reconstructive Surgery Center, Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College. FAU - Wang, Bingqing AU - Wang B AD - From the Auricular Plastic and Reconstructive Surgery Center, Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College. FAU - Wang, Yue AU - Wang Y AD - From the Auricular Plastic and Reconstructive Surgery Center, Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College. FAU - Hu, Jintian AU - Hu J AD - From the Auricular Plastic and Reconstructive Surgery Center, Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College. FAU - Zhang, Qingguo AU - Zhang Q AD - From the Auricular Plastic and Reconstructive Surgery Center, Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College. Electronic address: plasticsurgern163@163.com. LA - eng PT - Journal Article DEP - 20191015 PL - Ireland TA - Int J Pediatr Otorhinolaryngol JT - International journal of pediatric otorhinolaryngology JID - 8003603 SB - IM MH - Adolescent MH - Child MH - Ear, External/*abnormalities/*surgery MH - Facial Asymmetry/congenital/*surgery MH - Female MH - Humans MH - Intense Pulsed Light Therapy MH - Male MH - Plastic Surgery Procedures/methods MH - Scalp MH - Tissue Expansion OTO - NOTNLM OT - Auricular reconstruction OT - HFM OT - Intense pulse light treatment OT - Low-hairline OT - Tissue expansion EDAT- 2019/10/23 06:00 MHDA- 2020/03/19 06:00 CRDT- 2019/10/23 06:00 PHST- 2019/08/06 00:00 [received] PHST- 2019/10/07 00:00 [revised] PHST- 2019/10/12 00:00 [accepted] PHST- 2019/10/23 06:00 [pubmed] PHST- 2020/03/19 06:00 [medline] PHST- 2019/10/23 06:00 [entrez] AID - S0165-5876(19)30479-3 [pii] AID - 10.1016/j.ijporl.2019.109726 [doi] PST - ppublish SO - Int J Pediatr Otorhinolaryngol. 2020 Jan;128:109726. doi: 10.1016/j.ijporl.2019.109726. Epub 2019 Oct 15.