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Published on: May 23, 2021
Auricular reconstruction: indications for autogenous and prosthetic techniques.
C H Thorne1, L E Brecht, J P Bradley
1Institute of Reconstructive Plastic Surgery, New York University Medical Center, NY 10021, USA. ct322@aol.com
Plastic and Reconstructive Surgery
|May 25, 2001
Summary
Autogenous reconstruction is preferred for most pediatric microtia cases. Prosthetic reconstruction is ideal for acquired total ear defects in adults, though both methods require significant expertise and long-term care.
Area of Science:
- Plastic Surgery
- Otolaryngology
- Biomedical Engineering
Background:
- Established indications for auricular reconstruction (autogenous vs. prosthetic) were published in 1994.
- Extraoral osseointegrated implants gained FDA approval in 1995, necessitating updated guidelines.
- A US surgical unit had not yet examined these updated indications.
Purpose of the Study:
- To present an evolving algorithm for auricular reconstruction.
- To analyze experiences with 98 patients over a 10-year period.
- To compare autogenous and prosthetic reconstruction methods.
Main Methods:
- Retrospective review of 98 patients undergoing auricular reconstruction.
- Analysis of cases involving both autogenous and prosthetic techniques.
- Development of an algorithm based on patient outcomes and indications.
Main Results:
- Autogenous reconstruction is the primary choice for most pediatric microtia cases.
- Prosthetic reconstruction is indicated for failed autogenous reconstruction, severe hypoplasia, or unfavorable hairlines in pediatric patients.
- Prosthetic reconstruction is ideal for acquired total/subtotal auricular defects, typically in adults.
Conclusions:
- Autogenous reconstruction presents surgical challenges but is often preferred for pediatric microtia.
- Prosthetic reconstruction, while technically less demanding, requires extensive expertise and lifelong monitoring for complications.
- This study offers the first American series comparing both methods by a single team.
