Correction of congenital microtia using the tissue expander

Congenital microtia presents a challenge in reconstructive surgery due to the underdeveloped external ear structures. Prior research has shown that autologous rib cartilage is commonly used for auricular frameworks, but the skin coverage and expansion techniques remain areas of uncertainty. That uncertainty drove the exploration of alternative methods for skin expansion. No prior work had resolved the optimal shape and volume of tissue expanders for auricular reconstruction. The complete hypoplastic and constricted types of microtia require tailored approaches for skin and framework integration. The rotated semiellipse shape of expanders had not been systematically tested in pediatric patients. The success of reconstruction depends on achieving both structural and aesthetic outcomes. Mild complications and shrinkage have been reported in prior studies, but long-term cartilage resorption remains a concern.

This study aimed to evaluate the effectiveness of Radovan-type inflatable silicone expanders in auricular reconstruction for patients with congenital microtia. The specific problem addressed was the need for a reliable skin expansion method that supports the structural integrity of the reconstructed ear. The motivation was to determine whether this approach could reduce the need for additional procedures like ear elevation. The study focused on three types of microtia: complete hypoplastic, conchal remnant, and constricted. The goal was to assess both functional and aesthetic outcomes. The study also aimed to track complications and long-term cartilage stability. The framework was designed to mimic normal auricle anatomy. The study sought to confirm whether this method could be applied successfully in both pediatric and adult patients.

The study involved seven patients with congenital microtia, including six children and one adult. Radovan-type inflatable silicone expanders were used for skin expansion. The expander was shaped into a rotated semiellipse based on the surface area of a normal adult auricle. Each expander was expanded with 70 cc of saline. Autologous rib cartilage was used to construct the ear framework. The helix, anthelix, concha, and tragus were included in the framework design. Auricular reconstruction was completed at the time of expander insertion in four patients. Postoperative outcomes were evaluated for color, texture, sensation, and complications.

Auricular reconstruction was completed at the time of expander insertion in four of the seven patients. The reconstructed auricles were satisfactory in color and texture, with nearly normal sensation. Mild complications were observed in three patients, but no major issues were reported. No resorption of the inserted rib cartilage was noted up to 2 years and 5 months post-surgery. Slight shrinkage of the expanded skin was observed in all patients. The rotated semiellipse shape of the expander was successfully adapted to the auricle's surface area. The 70 cc saline volume provided adequate expansion without overstretching the skin. The study demonstrated that this method can achieve both structural and aesthetic outcomes.

The authors suggest that the use of Radovan-type inflatable silicone expanders can support auricular reconstruction in patients with congenital microtia. The rotated semiellipse shape and 70 cc saline volume appear to provide effective skin expansion. The study proposes that this method reduces the need for additional procedures like ear elevation. The authors suggest that the reconstructed auricles achieved satisfactory aesthetic and functional outcomes. The study indicates that rib cartilage remains stable over time, with no resorption observed. The authors propose that slight skin shrinkage is a predictable outcome of this technique. The authors suggest that this approach is suitable for both pediatric and adult patients. The findings support the use of this method as a viable option for auricular reconstruction.