A novel method for costal cartilage framework fabrication in full expansion ear reconstruction technique without skin grafts

Abstract

Objective This study aimed to present our clinical experience using a novel method for autologus costal cartilage framework fabricationin fully expansion technique ear reconstruction without skin graft. Methods During Steptember 2016 to Steptember 2017, autologus costal cartilage framework with expansion technique were performed for 63 patients with microtia. Autologous costal cartilage was stacked up to form the structure and height, the natural appearance of auriculocephalic angle was achieved at the same stage, so the second-stage elevation of ear and postauricular skin graft was unnecessary. The delicate structure of the reconstructed ear and ideal bilateral symmetry were achieved by the optimized cartilage stack-up. Results Three patients out of total 63 patients had cartilage frame work exposure, and were treated with superficial temporal fascia transfer combined with skin graft. The rest 60 patients had satisfied results. Follow-up ranged from 8 months to 18 months and 12 months follow-up was on average. The novel frame work fabrication method was based on the sufficient full pre-expansion procedure. The ideal structure, bilateral symmetry, and excellent definition of the framework, as well as the natural dorsal appearance of the reconstructed auricular were achieved. Conclusions The cartilage stack-up method is essential for the full expansion without skin grafts ear reconstruction technique. The combination of the cartilage stack-up framework fabrication and full pre-expansion provide a well-defined, well-projected and bilateral symmetrical ear. Key words: Microtia; Soft tissue expansion; Ear reconstruction; Costal cartilage framework