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Cranial Bones: Lateral View01:27

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Endoscopic Cholesteatoma Surgery
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Ear elevation using 2-tiered costal cartilage on the same side as the reconstructed framework.

Shinji Kobayashi1, Jiro Maegawa

  • 1Department of Plastic and Reconstructive Surgery, Kanagawa Children's Medical Center, Yokohama City University Hospital, Yokohama, Kanagawa, Japan. skobayashi@kcmc.jp

The Journal of Craniofacial Surgery
|October 1, 2011
PubMed
Summary

This study reports a novel ear elevation technique for microtia reconstruction using costal cartilage. The method successfully elevated constructed auricles by 32 degrees, maintaining results for up to 10 years.

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Area of Science:

  • Plastic Surgery
  • Otolaryngology
  • Regenerative Medicine

Background:

  • Ear elevation in microtia reconstruction is challenging, often underestimated.
  • Limited costal cartilage availability from the ipsilateral side can complicate ear framework and elevation.
  • A technique using unilateral costal cartilage for both framework and elevation base was developed.

Purpose of the Study:

  • To describe a novel method for ear elevation in microtia reconstruction.
  • To address the challenge of insufficient costal cartilage for ear framework and elevation.
  • To report the outcomes of this technique in patients with unilateral microtia.

Main Methods:

  • A 2-stage surgical approach was employed for 28 patients with unilateral microtia.
  • Stage 1 involved framework assembling of the auricle.
  • Stage 2 focused on the ear elevation of the constructed auricle using a base carved from the same unilateral costal cartilage source.

Main Results:

  • All patients achieved acceptable ear contours post-reconstruction.
  • No instances of cartilage absorption or infection were observed over 6 to 10 years.
  • Auricular projections and cephaloauricular angles remained stable and comparable to healthy ears, with a mean elevation of 32 degrees.

Conclusions:

  • Costal cartilage from the ipsilateral side can be used for both the ear framework and elevation base.
  • The described method allows for significant ear elevation (mean 32 degrees) in microtia reconstruction.
  • This technique provides a viable and durable option for elevating constructed auricles in microtia patients, with long-term stability observed.