Reconstruction of Concha-Type Microtia Using a Crescent Costal Framework and Residual Auricular Cartilage

ImportanceThe technique combining a crescent-shaped costal framework with the biomechanical properties of residual auricular cartilage is expected to enhance the structural stability and aesthetic outcomes of the reconstructed ear in mild conchal-type microtia.ObjectiveTo present a technique that integrates a crescent-shaped costal framework with the biomechanical properties of residual auricular cartilage to reconstruct mild conchal-type microtia, aiming to improve structural stability and aesthetic outcomes.DesignRetrospective study.SettingAuricular Reconstruction Center, Plastic Surgery Hospital, Peking Union Medical College, between January 2023 and January 2024.ParticipantsPatients with grade I or II conchal-type congenital microtia underwent auricular reconstruction using this refined technique. The procedure integrates a crescent-shaped costal framework with residual auricular cartilage to achieve single-stage ear reconstruction.InterventionThe surgery technique combining a crescent-shaped costal framework with the biomechanical properties of residual auricular cartilage was used.Main Outcomes and MeasuresPostoperative outcomes were assessed based on the integrity of auricular subunit structures, bilateral symmetry, scar visibility, complication rates, Ear-Q (Appearance), and patient satisfaction.ResultsThe study included 26 unilateral microtia cases (20 right ears and 6 left ears) with a mean follow-up period of 9.43 ± 3.57 months. According to aesthetic evaluations, 23 patients (88.46%) received 4 points (indicating an excellent aesthetic effect). Patient satisfaction was high, with 24 patients (92.31%) and their families reporting favorable outcomes. The mean Ear-Q (Appearance) score was 62.23 ± 18.68. Aesthetic results were rated as the highest score in 23 cases (88.46%). There were no significant dimensional differences between the reconstructed and unaffected ears, and no significant changes between immediate postoperative and final follow-up measurements.Conclusions and RelevanceThe combination of a crescent-shaped costal framework with residual auricular cartilage offers a reliable, aesthetically-refined, and technically-efficient approach for the repair of mild conchal-type microtia.