Lifting the reconstructed ear using remnant ear cartilage in lobule-type microtia

Abstract

One of the cardinal principles in microtia reconstruction is to achieve an acceptable projection of the ear, symmetrical with the normal contralateral ear, especially for patients with eyeglasses. Following the method of Brent's microtia reconstruction, the third stage involved elevation of the reconstructed ear, initially described without additional cartilage block for framework projection, 1 Boudard P. Benassayag C. Dhillon R.S. et al. Aesthetic surgery for microtia. Arch Otorhinolaryngol. 1989; 246: 349-352 Crossref PubMed Scopus (4) Google Scholar , 2 Meyer R. de Goumöens R. Derder S. Combined aesthetic and functional treatment of microtia. Aesthetic Plast Surg. 1997; 21: 159-167 Crossref PubMed Scopus (8) Google Scholar , 3 Staffenberg D.A. Microtia repair. J Craniofac Surg. 2003; 14: 481-486 Crossref PubMed Scopus (13) Google Scholar , 4 Brent B. Technical advances in ear reconstruction with autogenous rib cartilage grafts: personal experience with 1200 cases. Plast Reconstr Surg. 1999; 104 ([discussion 335–8]): 319-334 Crossref PubMed Scopus (303) Google Scholar but now applied with a similar approach to Nagata's technique for second stage surgery. 5 Yoshimura K. Asato H. Nakatsuka T. et al. Elevation of a constructed auricle using the anteriorly based mastoid fascial flap. Br J Plast Surg. 1999; 52: 530-533 Abstract Full Text PDF PubMed Scopus (24) Google Scholar , 6 Ou L.F. Yan R.S. Tang Y.W. Firm elevation of the auricle in reconstruction of microtia with a retroauricular fascial flap wrapping an autogenous cartilage wedge. Br J Plast Surg. 2001; 54: 573-580 Abstract Full Text PDF PubMed Scopus (32) Google Scholar The advantage of Nagata's technique was that good projection was maintained, because the cartilage framework was supported at its posterior surface by the cartilage wedge. However, using costal cartilage can damage the integrity of the chest wall. 5 Yoshimura K. Asato H. Nakatsuka T. et al. Elevation of a constructed auricle using the anteriorly based mastoid fascial flap. Br J Plast Surg. 1999; 52: 530-533 Abstract Full Text PDF PubMed Scopus (24) Google Scholar In cases of insufficient or unavailable costal cartilage wedge graft, it was difficult to acquire a firm elevation.