Microtia surgery without postoperative pain at Nagata Microtia and Reconstructive Plastic Surgery Clinic
With the conventional method of microtia surgery, patients after the surgery stay in bed for about a week due to the pain in the chest. Patients in Nagata Microtia and Reconstructive Plastic Surgery Clinic, however, walk and go to the bathroom without help from the day after the surgery. No patients cry after the surgery. These are because the anesthesia is provided based on a new theory of less postoperative pain. A patient, of course, has no pain during the microtia surgery under general anesthesia. The problem is how to reduce the pain related to the costal cartilage harvest after awaking from anesthesia.
In this clinic, local anesthesia is applied into the intercostal nerve in the patient’s harvest site during general anesthesia, by which the chest does not remember the pain at the incision and at the costal cartilage harvest during the surgery. In other words, a temporary intercostal nerve block is performed.
After the microtia surgery and right before the patient recovering from the general anesthesia, additional local anesthesia is applied in the same manner into the intercostal nerve, by which the patient has no pain even after awaking from general anesthesia. If the patient after the surgery does not feel pain for about 6 hours after awaking from anesthesia, that means almost postoperative pain goes away and thus he/she is able to walk and go to the bathroom without help from the day after the surgery.
A method of costal cartilage harvest adopted in this clinic also contributes to less postoperative pain. Costal cartilage is surrounded by perichondrium. With the conventional method, the costal cartilage is harvested with such perichondrium, which damages intercostal nerve that runs right under the perichondrium and causes intense pain, which results the patient cannot walk for a week after the surgery. In addition, the conventional method causes indentation deformity in the chest after the costal cartilage harvest.
However, at Nagata Microtia and Reconstructive Plastic Surgery Clinic, the costal cartilage is harvested with perichondrium left intact, that means intercostal nerve is not damaged at all and thus the patient feels less pain.
Also, the remaining costal cartilage from fabricating ear framework is cut into pieces and put back into the perichondrium, where the regeneration of costal cartilage occurs resulting in no chest deformity.
And furthermore, bleeding is minimized through the use of hypotensive general anesthesia.