Simultaneous Bilateral Microtia Reconstruction Using Single-Expanded Postauricular Flap Without Skin Grafting.

Area of Science:

• Plastic Surgery
• Craniofacial Surgery
• Otolaryngology

Background:

• Congenital microtia often requires auricular reconstruction to restore craniofacial balance, particularly in bilateral cases.
• Existing techniques frequently involve skin grafting, leading to potential color mismatch and scarring.
• Separate reconstruction of each ear prolongs surgery and patient suffering.

Purpose of the Study:

• To introduce a modified technique for simultaneous bilateral auricular reconstruction.
• To avoid skin grafting by utilizing single expanded flaps.
• To improve outcomes and reduce patient suffering in microtia repair.

Main Methods:

• A total of 54 patients with bilateral microtia underwent a 3-stage simultaneous reconstruction using expanded single flaps.
• Tissue expanders were used for bilateral postauricular skin expansion, followed by cartilage framework fabrication and insertion.
• Minimal incisions were used for rib cartilage harvesting and framework placement, with subsequent ear trimming and lobule/tragus reconstruction.

Main Results:

• Over 50 patients reported high satisfaction with the size, shape, location, detailing, and symmetry of their reconstructed bilateral ears.
• Only 4 patients experienced postoperative complications, with no instances of skin necrosis, cartilage exposure, or infection.
• No postoperative chest deformities were reported.

Conclusions:

• Simultaneous bilateral auricular reconstruction using single expanded flaps and a modified 3-layer cartilage framework is effective.
• This technique offers a viable solution for patients with bilateral microtia, minimizing complications and improving aesthetic outcomes.
• The described method enhances craniofacial harmony without the drawbacks of traditional skin grafting techniques.