A Ten-Year Retrospective Cohort Study on Auricular Reconstruction: Comparative Analysis of Three Surgical Techniques

Microtia significantly impacts patients' quality of life due to physical, financial, and psychological burdens. Auricular reconstruction, the main treatment for microtia, is considered a significant challenge, given its high demand, complex nature, and need for meticulous precision. This study conducted a retrospective analysis of three widely used techniques for auricular reconstruction within our clinical practice over a 10-year period, providing substantial comparative insights and experiences into the customization of auricular reconstruction.

From January 2015 to January 2025, our center performed auricular reconstruction on 1677 microtia patients. Of these, 1582 completed follow-up and joined the study. In the patient cohort, 402 received the modified two-step method, 462 had the expanded two-flap technique, and 718 underwent the single-expanded flap procedure. The cumulative operative time, total length of postoperative hospital stays, duration of therapy, and incidence of postoperative complications across all surgical stages within three distinct groups were analyzed. Additionally, patients' satisfaction with surgical outcomes was assessed.

The patients were followed up for between 6 months and 10 years. The single-expanded flap technique achieved the highest satisfaction score. The modified two-step method group demonstrated the shortest cumulative operative time, and duration of therapy. The benefits, limitations, and distinct attributes of each method's application were subsequently examined and synthesized.

Auricles reconstructed using the single-expanded flap technique exhibit minimal scarring, uniform color, and greater patient satisfaction. However, no single approach can be universally suitable for every patient. Thorough preoperative assessments and careful selection of indications ultimately yield positive outcomes in auricle reconstruction procedures.

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