[Auricular reconstruction for severe microtia. Schedule of treatment, operative strategy, and modifications]

The incidence of microtia in Germany is 100-150 per year. These cases require a specific and challenging therapy. All patients need audiologic consultation. If desired plastic reconstruction is performed, which is aiming at achieving a lifelike as possible appearance corresponding to the shape of the opposite ear including an excellent skin color. The present paper describes background information, the interdisciplinary schedule of treatment, and the results of our operative strategy in two to three steps using autologous rib cartilage. Furthermore we expand on anomalous cases of microtia which require a modified procedure. In dystopic microtia, repositioning of the rudiment is necessary before reconstruction. In cases of excessive scar tissue due to injuries or previous operations, a one-step reconstruction using an axial fascia flap can be useful.