Porous polyethylene material is a biocompatible polymer that natural tissue grows through. Ear reconstruction with porous polyethylene first started in the early 1990s, but the material had already been in use for decades prior to that in other maxillofacial, craniofacial, and orthopedic reconstruction surgeries. The two common polyethylene materials used for reconstructing an ear are Medpor and OmniPore. Medpor implants have been used successfully in over 250,000 reconstructive, cranial, and cosmetic surgeries since the 1990s, and OmniPore is a newer ear framework that has been used for the past decade. Both allow for newly reconstructed ears to be created in one stage of surgery, with a second stage sometimes needed depending on how the patient heals or if the ear lobe needs to be smoothed out.
3D Printing for Porous Polyethelyne (PPE) ear frameworks – Vanderbilt University Medical Center partners with MatrixSurgical and other companies to produce 3D printed PPE implants that are customized for each patient using the data found in the CT scan of the shape of their opposite ear.
During this single stage surgery, Dr. Stephan creates the ear framework from the polyethelne material and shapes it to match the shape of the other ear (or makes two matching ears if the patient has bilateral Microtia…two ears would require two separate surgeries). Utilizing a flap of skin from the head (called the TPF flap or the Temporoparietal Fascia flap), Dr. Stephan covers the newly shaped ear framework and attaches the ear to the head. Since the polyethelene material is a porous material, the ear becomes completely vascularized as the blood vessels of the tissue flap become integrated throughout the tiny holes of the porous implant, making the ear become a living ear. A newly reconstructed Medpor or OmniPore ear quickly begins healing and begins showing definition within just a few weeks following surgery. The body does not reject the polyethelene implant. The minimum age that Dr. Stephan performs Medpor and OmniPore is around 4 years of age.
Medpor and OmniPore have several advantages:
- the reconstruction is often a single stage procedure
- often no donor site scarring is visible like for other types of reconstruction
- a great option for a patient that has bilateral Microtia and Atresia for fewer surgeries
- the procedure causes minimal pain
- the procedure causes minimal scarring
- can be performed at an earlier age
- the polyethelene material is biocompatible and is not rejected by the body
Medpor and OmniPore has disadvantages:
- the Medpor/OmniPore ear can be stiff
- it is possible for the ear to break (fracture) or have an exposure (area where the ear framework can become exposed), but these are rare and occur at less than 5% of the time.
As a facial plastic and reconstructive surgeon, Dr. Stephan loves creating ears for his pediatric patients who were born with microtia and atresia. Dr. Stephan also enjoys teaching his surgical technique for making Medpor and Omnipore ears to medical students around the world.
It is important for Dr. Stephan to help as many children feel more comfortable about their appearance as possible, but if they can not come to him for help, he will find a way to go to them with his mission trips. For the past six years, Dr. Stephan and a team travel to Guatemala with the FINN Foundation, an organization in conjunction with the Face To Face Foundation (the humanitarian division of the American Academy of Facial Plastic and Reconstructive Surgery (AAFPRS), to help children with cleft lip, palate, cleft rhinoplasty deformities and… microtia!
Below are some images from some of the mission trips that Dr. Stephan is proud to have been a part of when helping children receive beautiful reconstructed ears.
To make an appointment, e-mail us at: MicrotiaAtresiaClinic@VUMC.org or call ph: 615-343-6166.