Auricular reconstruction of congenital microtia by using the modified Nagata method: Personal 10-Year experience with 1350 cases

Abstract

BackgroundTotal auricular reconstruction is currently one of the most challenging plastic surgery procedures. Herein, we present our 10-year experience with 1350 cases of ear reconstruction by using Nagata method with necessary improvement. MethodsFactors related to ear reconstruction, namely, remnant ear, mastoid skin, adjacent scalp, rib cartilages, normal ear, and mastoid process, were carefully evaluated before operation. An individualized design and precise framework fabrication were performed for each patient. Necessary modifications in fabricating base frame, helix, tragus, and antihelix were introduced to achieve a stable and individualized framework. These efforts also reduced the quantity of cartilage required for ear reconstruction. ResultsFollow-up time ranged from 1 month to 5 years, and 1217 (90.1%) patients were satisfied with the reconstructed ears, which showed appropriate color, texture, size, and location. The modifications made conferred a harmonious and individualized contour of the reconstructed ears. Incidence of all complications such as hematoma, skin necrosis, and framework absorption was very low. ConclusionsBased on preoperative assessment, individualized design, and precise sculpting, a harmonious and individual auricle with detailed anatomical structures was achieved by using our modified Nagata method in which a stable and sophisticated framework can be fabricated with less cartilage requirement.