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Salvage Ear Reconstruction Of The Unsatisfied Patient
John Reinisch, MD, FACS1, Youssef Tahiri, MD, MSc, FACS2.
1Cedars Sinai Medical Center and University of Southern California, Los Angeles, CA, USA, 2Cedars Sinai Medical Center, Los Angeles, CA, USA.

Purpose This study describes our large experience with secondary reconstruction of patients with unsatisfactory or failed initial ear reconstruction.
Methods A review of all consecutive patients who underwent salvage surgery for prior unsatisfactory microtia reconstruction was conducted. Demographic data and outcomes were assessed.
Results Between January 2002 and 2016, 117 patients met inclusion criteria. There were 36 females and 81 males. Patient’s age at the time of the secondary reconstruction ranged from 7 to 57 years of age. Mean follow up time ranged from 6 months to 14 years. Primary reconstructions included rib cartilage in 81, Medpor implant in 27 and prosthesis in 9 patients. Medpor implants were used for salvage in all patients. Implants were covered with a temporo-parietal fascial flap in 62 patients, occipital fascia flaps in 52 patients and 4 salvages required fascial free flaps (2 radial forearms in the same patient, 1 contralateral TPF and one lateral arm). 4 patients (3.4 %) had complications requiring a revision surgery. 115 patients reported increased satisfaction with their ear reconstruction following the secondary salvage procedure.
Conclusion This data represents the largest evaluation of salvage ear reconstructions. Representative examples of secondary procedures for prior unsatisfactory ear reconstruction will be shown.


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