A New Supra-auricular Incision in Single-flap Auricular Reconstruction: A Retrospective Study

Microtia is a common congenital craniofacial malformation, and auricular reconstruction with expansion method is one of the primary surgical treatments. This research introduces a novel technique involving a supra-auricular incision during the second stage of single-flap auricular reconstruction.

A total of 86 patients with unilateral microtia who underwent auricular reconstruction between June 2023 and August 2024 were included in this retrospective analysis. All 86 patients progressed to the second stage of single-flap auricular reconstruction 2-3 months after the first stage of retro-auricular expander implantation. Among them, 40 cases were operated on using previous retro-auricular incision (Group A), and 46 cases were operated on using new supra-auricular incision (Group B). Postoperative outcomes, patient satisfaction, and complications were monitored during follow-up.

The mean follow-up time was 11 ± 3.3 months. Immediately after the operation, the cranioauricular angles of Group A and Group B were 28.64° ± 2.49° and 31.06° ± 1.84°, respectively. At the final follow-up (mean duration: 11 ± 3.3 months), the cranioauricular angles of Group A and Group B were 27.83° ± 2.27° and 30.69° ± 1.87°, respectively. Differences were observed between the two groups (p < 0.001). Additionally, the appearance of other subunits, such as the helix and scapha, showed improvement. Functional assessments indicated better performance in glasses and mask wear in Group B, with higher patient satisfaction scores (average 1.87 vs. 1.775). Complications included flap necrosis and hypertrophic scarring in Group A (2 cases each), and one case each of infection and hypertrophic scarring in Group B.

In the second-stage operation of single-flap auricular reconstruction, a novel supra-auricular incision for the placement of the auricular scaffold can be employed to achieve improved esthetic and functional surgical outcomes. This approach demonstrates clinical superiority over conventional methods and suggests broader applicability in auricular reconstruction.

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