Correcting Past Results with Revision Ear Surgery

Michael was born with grade III microtia on the right.  As a child he went through four separate operations at a university hospital that essentially failed. Dr. Griffiths built another ear for Michael in one operation using a cartilage graft from the other side of his chest, a TPF vascularized membrane, and skin grafts.

Terrick was born with stage 3 microtia. After 3 operations at a major metropolitan children’s hospital, he and his mother both were hoping for more. Although his previous surgeon created a nice lobule and lower portion of the tragus, the rest of his ear is a disappointment.

Several building blocks were harvested with his previous operations that would not be available for Dr. Griffiths to utilize. These building blocks include a cartilage graft from the right side of his chest, as well as skin and cartilage grafts from his other ear.

Dr. Griffiths was able to reconstruct his ear in one operation. He artistically carved a cartilage graft from the left side of Terrick’s chest into a natural shape that artistically matched details from his other ear. 

Compare the mirror image photographs of the Terrick’s ear framework to his other ear.

Dr. Griffiths then covered the cartilage framework with a vascularized membrane from underneath his scalp (TPF flap). Finally, a split thickness skin graft was harvested from his scalp and carefully sewn in place over the vascularized membrane. The skin graft harvest site on the right side of his scalp healed without a visible scar.

This is Terrick at the end of his operation. The sutures are so small you can barely see them. Three small suction catheters are used to help the vascularized membrane adhere to every detail of the cartilage framework. No scalp incision is seen from the harvest of the vascularized TPF membrane (it is hidden behind the framework). Although he was not a candidate for canalplasty, Dr. Griffiths created the external portions of the external auditory canal to complete the reconstruction. 

Please notice how well the two ears are matched in size, projection and detail.

The angle view shows the natural relationship between the helix, antihelix, tragus, antitragus and lobule.

Secondary (Re-do) Ear Reconstruction

We can only imagine how disappointed you must feel having trusted another surgeon to reconstruct your ear only to endure multiple operations and end up with a substandard result If you have had your ear reconstructed elsewhere and are disappointed with the results we may have a solution for you. It is natural to approach another reconstruction with trepidation but Dr. Griffiths has helped many people just like you.

Occasionally we can revise the other surgeon’s work but usually patients seeking our help request another complete ear. Frequently we can use the cartilage on the other side of your chest to create a new framework. The framework can then be covered with a temporoparietal fascia or an occipital fascia flap followed by skin grafts all in one procedure. We would need to know if the vascular supply to the fascia is intact. A Doppler vascular study of the superficial temporal artery and the occipital artery will be needed and can usually be performed at your local hospital. Please contact our office and we will help you obtain the necessary studies.

Although complete rib cartilage graft revisions are fairly straightforward, complete revisions of Medpor failures are very complicated and should only be attempted by the most experienced surgeons. Dr. Griffiths will also need detailed photographs to review (please see instructions on submitting photographs). Contact us and schedule your Appointment with Dr. Griffiths

• Learn more about One stage rib graft microtia reconstruction
• Learn more about One stage Medpor microtia reconstruction
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