الفهرس 
EMBRYOLOGY OF THE AURICLEOnly 14 pages are availabe for public view
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Abstract
T
he auricle is a part of the auditory organ, that transmits sound waves into the acoustic canal. It also plays an important role in an individual’s appearance. In clinical practice of Facial Plastic and Reconstructive surgery, microtia is the most common congenital ear abnormality observed. Microtia is a congenital deformity in which the auricle fails to develop or does not develop properly. During embryogenesis, the auricles are derived from the first and second branchial arches. The branchial arches transform into six auditory tissue elevations (hillock of His). The elevations then merge into the entire ear. The absence of two to five elevations results in common and typical microtia. Ear malformations may occur at any stage during development.
The aim of this study is to evaluate the satisfaction of people with microtia after auricular reconstruction & asses the quality of life postoperative. This assessment of patient reported experience and outcome in the future can be used as a means of targeted quality improvement and to benchmark care nationally.
After approval of local ethical committee of faculty of medicine, Ain Shams University, this cross-sectional study will target the patients with unilateral microtia who underwent first and second stage of auricular reconstruction 4 months at least postoperative. A Written informed consent explaining the whole procedure under study in this research has been obtained from all patients and absolute confidentiality as regard the patients „names and addresses was given special care and attention.
In this current study, 1st stage auricular reconstruction was done by harvesting 6th, 7th, 8th costal cartilage from contralateral chest wall to create framework. Scoring of cartilage was done with matress suturing and placing it in the created subcutaneous pocket of microtia side. Then, 2nd stage auricular reconstruction took place 3-5 months postoperative by creating posterior aurcilar sulcus and insetting a skin graft from thigh of the patient.
In present study, forty-four of patients with unilateral microtia have been operated at El Dmerdash hospital by the senior author were included in this study having fulfilled the inclusion criteria of this study and their satisfaction of auricular reconstruction (two-step modified Nagata’s technique) 4 months postoperative via questionnaire form was conducted.
In this conducted study, there were 28 female cases (63.6%) and 16 male cases (36.4%), with their ages ranging from 5 to 27 years old with median of (8) years old. Right sided microtia cases were 30 (68.2%) and left sided cases were 14 (31.8%). According to Habitat, most cases were in the Capital (Cairo, Giza, Qalioubia) (45.5%),18 Cases came from Upper Egypt (40.9%) and the fewest cases came from lower Egypt (13.6%). Most of cases were third degree type of microtia (lobule type).
In this present study, we found a greater number of female patients with microtia.
Regarding results of satisfaction of the surgical outcomes, most of the people were satisfied with the entire auricle and distributed as (45.5%) were satisfied and (45.5%) were very satisfied while (9.1%) were acceptable results. However, all people were satisfied with the ear fitting with face as (54.5%) were very satisfied and (45.6%) were satisfied.
As regards auricular subunits, Helix and lobule showed the highest scores of satisfaction while concha and antihelix were the least items that pleased most of patients.
Regarding separation of the auricle from scalp and creating of posterior auricular sulcus, 26 patients were very satisfied (59.1%),16 cases were satisfied (36.4%) and 2 cases were unsatisfied (4.5%).
CONCLUSION
H
elix and lobule of reconstructed auricle get the highest level of satisfaction regarding reconstructed auricle while antihelix and concha still need more continuous work and follow up to enhance their aesthetic outcome with utilizing the 3D modern technique