Auricular Framework Construction Using Cadaveric Costal Cartilage in Type III Microtia: Preliminary Results

Abstract

Purpose: Non/minimally irradiated Cadaveric Costal Cartilage (NCCC) is commonly used for grafts in nasal reconstruction; however, no information exists on its use in total ear reconstruction for type III microtia. In this case series we describe preliminary results from the novel use of NCCC for auricular framework construction in 7 ear reconstructions. Methods: Patients requiring total ear reconstruction from August 2020 to October 2021 were eligible and underwent ear reconstruction using NCCC from MTF Biologics (Edison, NJ). Patients were evaluated for surgical site infection, skin necrosis, cartilage exposure, warping, and resorption during regular follow up visits. Results: Seven ears were reconstructed using NCCC across 5 patients with type III microtia. Patients ranged from 5 to 51 years old at the time of surgery. Follow up time ranged from 12 to 78 weeks (mean: 46 wk). No patients experienced surgical site infections or significant cartilage resorption. All procedures were done outpatient, total time under anesthesia was <90 minutes in 5/7 cases and postoperative narcotics for pain management were not needed in 5/7 cases. Complications included minor skin necrosis that was repaired via primary closure, construct exposure in the immediate postoperative period, which was successfully salvaged with a local flap, and explantation of one construct after reconstruction for a complicated revision surgery involving a previous temporoparietal fascial flap. Conclusion: NCCC serves as an immediately available alternative to alloplastic and autologous materials for construction of auricular frameworks during ear reconstruction. Longer follow up times and a larger sample size will further elucidate long-term efficacy.

Bilateral Costal Cartilage Harvest for Auricle Reconstruction: A New Technique to Prevent Postoperative Thoracic Deformity

“…Cadaveric costal cartilage (CCC) is a promising alternative to autologous costal cartilage for ear reconstruction. 24,25 The main benefits of CCC include the elimination of donor site morbidity and a shorter anesthesia time. As an immediately available material, CCC can also offer pediatric patients an earlier surgical option.…”

Update on Total Auricular Construction

“…To withstand the thicker skin envelope used in reconstructive surgery, a stronger framework synthesized from block rib cartilage or PPE is needed. Other less popular options include cadaver rib cartilage 13 or silicone, where the latter is rarely used. 1015e…”