Modified 2-Stage Method for Auricular Reconstruction

Auricular reconstruction is one of the most challenging procedures in the field of plastic surgery. The aims of this study were to apply the modified 2-stage method to perform auricular reconstruction and to summarize the clinical experience in the past 10 years.

Auricular reconstruction was performed in 243 patients (total 254 ears) of congenital microtia using autologous costal cartilage. The whole procedure is divided into 2 stages. Stage I: the individualized framework fabricated with autologous costal cartilage is inserted into subcutaneous pocket in the mastoid region, and then the earlobe was transposed backward to connect with the lower part of the framework. The second-stage surgery mainly includes the following main contents: ear elevation, fixing the bracket behind the reconstructed ear framework, harvesting the retroauricular fascial flap to cover the bracket, and closing the defect with free skin grafts.

A total of 243 patients (254 ears) of congenital microtia underwent ear reconstruction. The follow-up time ranged from 6 months to 4 years; 220 patients were satisfied with the results. Surgery-related complications such as infection, partial skin graft necrosis, flap necrosis, bad projection of the constructed auricle, and extrusion of cartilage occurred in 24 cases, and hypertrophic scars occurred in 16 patients.

This modified 2-stage method for auricle reconstruction can receive acceptable results and fewer complications; furthermore, it is relatively simple and easy to master. The 10-year experience validates that this modified method is an ideal method in auricular reconstruction.