25. Short Term Maintenance of Cadaveric Costal Cartilage Integrity in Ear Reconstruction

Abstract

PURPOSE: Cartilage allografts are widely used in orthopedic and reconstructive surgery. Concerns over resorption and warping have limited their use in ear reconstruction. Newer sterilization methods forgo high dose radiation yielding high quality allografts with reliable longevity. In this study, we evaluate the use of this non/minimally irradiated cadaveric costal cartilage (NCCC) for primary ear reconstruction in congenital type III microtia. METHODS: Patients who underwent ear reconstruction using NCCC between August 2020 and August 2022 were included. Demographics, complications, and outcomes were recorded. Pre and post implantation cartilage samples from four patients stained with H&E and safranin-O were analyzed qualitatively using light microscopy. RESULTS: 12 ears were reconstructed for 11 patients (six male, five female) with congenital type III microtia. Average age was 10.7 years (range 4 - 25) and average follow up time post stage I reconstruction was 11.1 months (range 1.5-25.3). Two instances of surgical site infection were recorded as well as two instances of 1cm x 1cm construct exposure which were successfully salvaged. All patients required less than 90 minutes of anesthesia and were discharged home same day with over-the-counter analgesics for pain. Histologic analysis revealed repopulation of empty lacuna at stage II with cells and absence of lymphocytic infiltration. CONCLUSION: Ear reconstruction with NCCC shows short term maintenance of cartilage integrity with evidence of integration on histology. Advantages over current options include significantly reduced anesthesia time, reduced post operative pain, same day discharge, and reconstruction as early as 4 years old. Longer follow up times will reveal long-term reliability.