Postoperative Cutaneous Sensory Recovery After Different Surgical Approaches for Microtia and Ear Reconstruction

The most common means of ear reconstruction include a cutaneous flap (CF) or a fascial flap with skin graft (FSG). Each approach has advantages and disadvantages; however, sensory outcomes have yet to be compared. This study aimed to compare sensory outcomes between these 2 ear reconstruction approaches.

Pediatric and adult patients with microtia or who underwent ear reconstruction were included. Sensory recovery was assessed using a 5-filament Semmes-Weinstein monofilament test sensory score before reconstruction, when available, and after single- or 2-stage reconstruction. When available, the ear remnant and the contralateral ear were used as controls.

Sensory data were collected from 2022 to 2024. Twenty-eight patients (32 reconstructed ears) were analyzed. Eighteen patients (20 ears) underwent autologous single- or 2-stage CF reconstruction using the Nagata technique (or a modification). Ten patients (12 ears) underwent FSG reconstruction with either porous polyethylene or cartilage constructs. Intragroup comparison of CF patients demonstrated clinically comparable sensation between pre- (ear remnant) and postoperative measurements of the reconstructed ear (as well as when compared with the contralateral ear). Intragroup comparison of FSG patients demonstrated significantly reduced sensation postoperatively when compared with the contralateral ear. The least sensitive regions after surgery included the helix/antihelix and conchal bowl. Intergroup comparison between CF and FSG patients revealed significantly improved sensation in the CF group.

CF-based reconstruction demonstrates improved sensation over FSG-based reconstruction. These results add to the list of advantages and disadvantages of each approach and should be considered when treating patients with ear differences.