Strategies for Surgical Refinement of the Antihelical Complex Using Autologous Costal Cartilage in Auricular...

In microtia reconstruction, surgeons must identify the various qualities of costal cartilage that can be used to create the nuances of the antihelical complex of the new auricular construct.

To compare the techniques for antihelical complex fabrication among microtia patients undergoing two-stage ear reconstruction with autogenous cartilage based on different characteristics of autologous cartilage, as measured by photograph analysis and patient survey.

This is a retrospective chart of patients undergoing microtia reconstruction using autogenous rib cartilage from 2017 to 2023. Reconstructed auricles were evaluated by three blinded expert graders using a satisfaction rating of 1-10. Patient surveys were collected (ear size, location, symmetry, and duplication of the reconstructed ear and possible complications).

Overall, 529 patients were included with a male preponderance (n = 357/529, 68%) with a mean age of 13.91 ± 6.34 (range: 6-39 years). Mean follow-up was 18.28 ± 7.53 months (range: 10-36 months). Complications (n = 36) were reported, which included flap congestion (n = 12), skin necrosis, and cartilage exposure (n = 9). Photograph review showed a mean score of 9.01 ± 0.42 (range: 8.51-9.53). Patient satisfaction scores were 9.47 ± 0.31 (range: 8.90-9.81).

Surgeons can properly create the antihelical complex in autologous costal cartilage framework.