Comparison of microtia reconstructive surgery with autograft versus homograft

Microtia is a congenital abnormality with low incidence but considerable morbidities. Reconstruction of the microtia deformity is a complex and difficult process that requires a proper planning. The primary technique of reconstruction employs patient's own rib cartilage. Irradiated homograft cartilages previously have been used in facial reconstruction but its application in microtia surgery has not been reported yet. This study is designed to compare the results of autograft versus homograft auriculoplasty.

Between 1992 - 2002, 23 patients underwent auricular reconstructive surgery by the senior author in our department. Autograft implantation was performed in one stage but homograft auriculoplasty was done in two stages.

Auricular deformity was right-sided in 13, left-sided in 8, and bilateral in 2 cases. Implanted graft was autograft in 9 patients and homograft in 14 patients. During mean follow-up of 4 years, cartilage graft resorption was detected in two cases, one in autograft and one in homograft group (P > 0.05). No postoperative infection was observed. Status of postauricular sulcus was optimal in 85.7% of homograft and 77.8% of autograft groups (P > 0.05). The satisfaction score of the patients and/or parents was excellent in 66.7% of autograft and 92.9% of homograft groups (P < 0.01).

Based on better satisfaction score, equivalent aesthetic appearance, and absence of complications such as scaring and pain on the chest wall, homograft auriculoplasty is an appropriate option for reconstructive surgery in patients with microtia.