Concha Type

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Left Concha Type Microtia

Concha Type,Preoperative Appecfance

Preoperative appearance

Concha Type,Post-operative Appearance

Post-operative appearance

1st stage

The second stage operation - auricular projection

1st stage

Schematic illustration of the second stage operation - auricular projection. Diagram 1: The outline for the second stage operation, auricular projection. The spindle shape outline is for the harvesting of the ultra-delicate split-thickness scalp skin [UDSTS] and the outline along the helical rim is for the release of the reconstructed auricle. The zigzag outline is the incision outline for the elevation of the temporoparietal fascia flap [TPF] with the superficial temporal artery plotted. Diagram 2 and 5: The harvested UDSTS with the area where it was harvested, and the preparation for the elevation for the TPF. Diagram 3 and 4: The method of harvesting the UDSTS with a scalpel [number 15 blades]. Diagram 6: The elevated TPF. Diagram 7: For the release of the reconstructed auricle, the area immediately adjacent to the helical rim which penetrates into the hair-bearing skin is elevated in the same manner as the UDSTS to the distance of 4 mm from the margin of the reconstructed auricle. Diagram 8: The follicular bud layer is left at the site of elevation of the UDSTS portion of the skin cover. Diagram 9: The release of the reconstructed auricle from the site of the head. Diagram 10: The layer with the follicular buds adjacent to the helical rim is to be excised. Diagram 11: The skin of the temporal and mastoid surfaces is undermined. Diagram 12: The TPF is passed through the skin tunnel and the site of elevation is closed. Diagram 13, 14: C4, C5 costal cartilage harvest. Diagram 15, 16, 17: A simplified illustration of the costal cartilage construct with the modification in the inferior portion of the construct, reversed letter L configuration to increase stability. The cartilage block construct is multi-layered, and the units are fixed with 38-gauge wire sutures. Diagram 18: The cartilage block is fixed to the soft tissue of the posterior surface of 3-D frame and to temporal and mastoid surfaces with 4-0 clear nylon. Diagram 19: The TPF covers the top of exposed helix [the UDSTS portion of the skin cover], the posterior surface of the reconstructed auricle, the cartilage block and the temporal and mastoid surfaces. Diagram 20: Skin suture line. Diagram 21: The skin of the temporal and mastoid surfaces is approximated and the excessive skin is excised in a triangular configuration in the hair-bearing skin to avoid dog ear configuration. Diagram 22: The exposed surface is covered with the UDSTS. Diagram 23: The tie-over is performed to keep the UDSTS in contact to the TPF. Diagram 24: Restone foam sponge is cut out to the reconstructed auricle to provide protection. Diagram 25: The illustrated appearance of the patient after the second stage operation.

Right Concha Type Microtia

Concha Type,Preoperative Appecfance

Preoperative appearance

Concha Type,Post-operative Appearance

Post-operative appearance

Before the operation: Another concha type microtia case which at some institution may be classified as a constricted ear instead of a microtia case.
After the second-stage operation: All the detailed features of the auricle have been reconstructed.

Left Concha Type Microtia

Left Concha Type Microtia

concha type microtia with a rather large conchal vault

Concha type microtia with a large conchal vault

Concha type microtia with a large conchal vault

Information on Microtia Surgeries

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■Information

◆Mar. 10, 2017 Updated:
Clinic Closed on the following dates:
Sep. 25 (Mon) 2017,
Oct. 4 (Wed) 2017, and
Oct. 7 (Sat) 2017.
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◆Mar. 10, 2017 Updated:
Attending the following Meetings:
ISAR (Beijing, China) from Sep. 22 to Sep 24, 2017
and ASPS (Florida, USA) from Oct. 6 to Oct. 10, 2017.
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◆Nov. 4, 2016 updated: Clinic outpatient service will be closed on Jan. 30 (Mon), Feb. 22 (Wed) and Feb. 25 (Sat), 2017.
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◆Jun. 11, 2016 updated: Clinic closed from Sep. 21 (Wed.) to Sep. 24 (Sat.) 2016 for attending ASPS meeting in the U.S.
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◆May 14, 2016 updated: Clinic closed on Oct. 8 (Sat.) 2016 for delivering a lecture at Aichi Gakuin University.
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◆Oct. 30, 2015 updated: Clinic outpatient service will be closed from Dec. 27 (Sunday), 2015 to Jan. 3 (Sunday), 2016 for year-end & new-year holidays.
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◆Aug. 7, 2015 updated: Clinic outpatient service will be closed on Sep. 14 (Mon), Oct. 14 (Wed.) and Oct. 17 (Sat.) 2015 for attending meetings in Japan and the U.S.
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◆Apr. 16, 2015 updated: Clinic closed from Oct. 14 (Wed.) to Oct. 18 (Sun.) 2015 for attending ASPS meeting in the U.S.
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Auricular
Reconstruuction Nagata Method

Accuracy evaluation on proportions of the reconstructed auricle / microtia surgery.

To reconstruct an auricle that will not melt

Microtia surgery without pain or deformity in the chest

Reconstructive Surgery

Aesthtics Surgery

Clinic Appointment

Academic exchange with doctors from overseas