Auricular reconstruction surgery in cases of microtia is a two-step procedure performed by plastic surgeons in Japan. We performed active middle ear implant (Vibrant Soundbridge®: VSB) surgery for congenital aural atresia prior to auricular reconstruction, and a new surgical procedure is proposed for skin incision and temporal muscle flap preparation. The surgical procedure is to make a 10-cm skin incision at 5 cm from the posterior edge of the temporomandibular joint capsule, then make an incision from the skin to the deep temporal fascia at once, and peel off the skin flap to the posterior edge of the temporomandibular joint on the temporal fascia. Furthermore, this is a method in which the temporalis muscle is incised 1 cm anterior to the skin incision site to create a temporalis muscle flap with upper and lower stalks. This procedure is associated with a scarce possibility of interfering with future auricular reconstruction, and we propose a further study to establish it as a standard procedure.
