Allogeneic Microtia Reconstruction as a Step in the Auricular Reconstructive Ladder: Personal Technique Using...

Area of Science:

• Pediatric Plastic Surgery
• Craniofacial Reconstruction
• Biomaterials in Surgery

Background:

• Microtia reconstruction is a complex pediatric plastic surgery procedure.
• Traditional autologous rib cartilage reconstruction has limitations including operator dependency and donor-site morbidity.
• Allogeneic cartilage offers an alternative, but framework fabrication is challenging.

Purpose of the Study:

• To describe a novel technique for auricular framework construction using 3D interlocking templates and allogeneic cartilage.
• To present allogeneic auricular reconstruction as a potential first step in a reconstructive ladder.
• To improve reproducibility and efficiency in microtia reconstruction.

Main Methods:

• A standardized technique for stage I microtia reconstruction using frozen cadaveric rib cartilage.
• Utilized in-house designed 3-dimensional, interlocking carving templates to guide framework geometry and subunit proportionality.
• Preoperative framework production followed by established implantation principles.

Main Results:

• Template-guided construction ensured consistent auricular subunit reproduction.
• The interlocking design simplified framework planning and assembly.
• Allogeneic cartilage use eliminated donor-site morbidity and reduced operative time, with wider frameworks aiding skin coverage.

Conclusions:

• A novel 3D interlocking template technique offers an efficient alternative to manual carving for auricular framework construction.
• Allogeneic cartilage is proposed as a viable option in the auricular reconstructive ladder.
• This approach provides a biological reconstructive pathway, avoiding autologous harvest morbidity and alloplastic risks.