Modification in the technique of ear framework fabrication for congenital microtia

Ear framework fabrication with autologous costal cartilage is considered to be one of the important factors for successful auricular reconstruction. Congenital microtia in adults has many particular physiological characteristics different from that in children. The authors report an effective ear framework-fabricating technique in congenital microtia in adults. Technical points regarding the reduction of the amount of costal cartilage harvested and the increase of the flexibility of the cartilage are discussed.

One hundred three adult patients diagnosed with unilateral congenital microtia were treated with skin expansion method for a 2-year period. The ear framework was fabricated using splicing method. The seventh costal cartilage was harvested from 74 patients (with 35 lobular and 39 conchal types) for fabricating the ear framework. For the remaining 29 patients (with 19 lobular and 10 conchal types), both the seventh and eighth cartilages were harvested for fabrication.

Eighty-four patients (81.55%) were satisfied with the outcome of the reconstructed ear. Fourteen patients (13.60%) found the result acceptable, whereas 5 patients (4.85%) found the result unacceptable. Six patients (5.82%) showed different levels of absorption and cartilage deformation. Five patients (4.85%) were found to have the steel wire extruded. There were no postoperative complications related to chest wall deformity or that affected normal physical function. Ninety-three patients (90.29%) had good recovery of the chest wall. Ten patients (9.71%) had increased chest scar.

Compared with traditional methods, the technique proposed is a simple approach that can effectively treat adult patients with congenital microtia. This kind of cartilage-harvesting and ear framework-fabricating technique is an appropriate management choice for congenital microtia in adults.