Three Techniques for Reconstruction of Congenital Microtia: Porous Implant Ear Reconstruction, Auricular Reconstruction Using Autologous Rib, and Osseointegrated Craniofacial Implants with Auricular Prosthesis

Seminars in Plastic Surgery: Pediatric Ear Anomalies and Reconstruction

Congenital ear anomalies affect 15 to 20% of neonates and can be categorized as either auricular deformations or malformations. Deformations involve a fully developed, albeit abnormally shaped, chondrocutaneous framework, which makes them amenable to correction with ear molding within the first few months of life. Malformations involve hypoplastic or fully absent auricular structures that require augmentation with alloplastic and/or autogenous reconstruction. The goal of this article is to outline the various auricular deformities and malformations, followed by a description of the latest clinical management options, both nonsurgical and surgical, by auricular anomaly.

A Novel Method for Making an Auricle Framework Like Lego Building Blocks

OBJECTIVES

The traditional Tanzer-Brent method, which uses the integral engraving of costal cartilage, provides insufficient three-dimensional sensation and is characterized by poor firmness of the auricle framework. This tends to cause the absorption deformation of the auricle framework after surgery. In order to reduce the absorption deformation as well as make the reconstructed auricle more three-dimensional and the ear shape more realistic, our ear reconstruction team invented a novel method to make an auricle framework with autologous costal cartilage. The auricle framework made by this novel method has been applied to auricle reconstruction and has achieved excellent surgical results.

PATIENTS AND METHODS

Clinical data and postoperative data were collected for patients with unilateral microtia who received auricle reconstruction using the novel method of auricle framework construction in Plastic Surgery Hospital from January 2020 to June 2022. The therapeutic effect of this novel method was evaluated by the satisfaction rate of patients and their families and by the prevalence of postoperative complications.

RESULTS

A total of 60 patients were enrolled in this study. The average age was (10.95 ± 2.97) years old. The mean follow-up time was 24.02 ± 1.52 months. The satisfaction rate of patients and their families was 96.7%. In terms of postoperative complications, two patients had postoperative infection, one patient had framework exposure, no patients had framework absorption and deformation, two patients had postoperative hematoma, and three patients had scar hyperplasia.

CONCLUSION

This novel method of making the auricle framework is more standardized, easier to master for plastic surgeons, and more conducive to the clinical application of plastic surgery. Through this study, we believe that this novel method offers significant therapeutic advantages and can be used as a unified standard for construction of an auricle framework using autologous costal cartilage.