Reconstruction of congenital microtia by using a tissue expander

In the conventional reconstruction of microtia, skin grafting is an absolute necessity because of the scantiness of the skin tissue at the affected site. As the result, color- and texture- matching as well as sensory preservation remain to be improved. To solve these problems, we developed a surgical procedure for reconstruction of microtia by using a tissue expander, which allowed us to reconstruct the erect auricle without the need for skin grafting. In this paper, we introduce and discuss our method using the tissue expander with a review of the literature. We operated on a total of 38 patients with microtia. Most of the patients were around 10 years of age, but 3 were adults. Autogenous cartilage was used, and the helix, antihelix, concha, and tragus were reproduced. Initially, 70 ml custom-made expanders were used; after that, 75 ml or 95 ml ready-made expanders were used. The erect auricle was reconstructed by the primary procedure in 33 patients. The reconstructed auricle was satisfactory in color- and texture-matching and had nearly normal sensation. No major absorption of the cartilage has been noted for 15 years, although a slight retraction of the expanded skin was observed in each patient. In conclusion, microtia repair by using a tissue expander is superior to that by conventional procedures in color- and texture- matching and sensory preservation of the reconstructed auricle.