An investigation of the fixation materials for cartilage frames in microtia

When performing auriculoplasty for microtia surgery, wires are typically used to fix the costal cartilage frames. However, cases in which such wires become exposed during a long-term follow-up were frequently observed at our facility. Hence, using various materials, we conducted an investigation of the materials most suitable for fixation.

The subjects consisted of 122 cases in which auriculoplasty by costal cartilage graft surgery was performed and the postoperative course was traceable, within approximately 24 years from January 1984 to March 2007. Regarding the fixation materials used in the 84 cases in which wire was used, 5 cases used monofilament non-absorbable sutures (Nylon(®)), 5 cases used monofilament absorbable sutures (PDS(®)), and 28 cases used braided absorbable sutures(VICRYL(®)).Their postoperative course was investigated, and the presence of auricular deformities caused by a loosening of the fixation materials and the exposure of the fixation materials was examined.

An exposure of the wire was observed in 19 cases (22.6%) of the 84 cases that used wires. An exposure of nylon was observed in 2 (40%) of 5 the cases that used nylon, and of those, a mild deformation was observed in the lower helix in one case that was suspected to have been caused by a loosening of the surgical suture. Regarding the 33 cases in which absorbable sutures were used (5 cases used monofilament absorbable sutures and 28 cases used braided absorbable sutures), neither any auricular deformities nor exposure of the fixation materials was observed in any of the cases.

Whether using monofilament or braided sutures, absorbable sutures are therefore believed to be the most suitable material for the fixation of cartilage.