Aesthetic surgery for microtia

Abstract

We describe here a technique for reconstruction of the external ear based upon an autogenous costal cartilage graft which is inserted into a cutaneous pocket dissected in the auricular area. Three subsequent procedures are then performed: rotation of the ear-lobe; reconstruction of the tragus; and elevation of the auricle. The ideal age for reconstruction is about 7 years. This technique was originally described by Brent, who has a very extensive experience with this kind of surgery. Skin deficiencies can be overcome by using either a temporo-parietal fascial flap or a skin expander.

Complication Rate of Autologous Cartilage Microtia Reconstruction

“…One early article mentioned the start of the serial ear reconstruction before 4 years old. 47 Most of the others start to perform the surgery at the age older than 7 years in average, 3,4,9,10,12,14,15,18,20,22,24,27,28,31,34–36,39–41,43,45,48–54 which is consistent with the US national survey published in 2013 1 and the international survey on the fourth International Ear Reconstruction Congress in Edinburgh. 55 …”

“…24,26,35 Authors of twelve articles reported their experiences of simultaneously external and mid-ear reconstruction. 10–12,15,17,27,36–40 Sixteen articles reported the technique of using fascia to cover the framework, including temporoparietal fascia 4,5,7,10,36,41–44 or mastoid fascia. 3,17,25,30,34,45,46 Table 3 is the list of different surgical methods and the overall complication incidence.…”

“…Techniques of microtia reconstruction varied among different surgeons. Tissue expander was first reported to be used in ear reconstruction in 1989 41 and 1990 35 and then followed by the only attractable data in the report by Park 18 in 2000. While from 2007 to 2012, doctors from China and only from China published 11 articles that met the inclusion criteria with large case series.…”

“…The salvage procedures included local flap coverage 34,49 or temporoparietal fascia transfer and skin graft 41,46,54 for frame exposure, cartilage removal, 39,48 or expander removal 18,27,43 due to infection and wire or suture removal after exposure. 34,52,54 Using temporoparietal fascia in the first stage of microtia reconstruction is controversial as it is a useful salvage procedure to cover the exposed cartilage frame.…”