The importance of costal cartilage framework stabilization in microtia reconstruction: Anthropometric comparison based on 216 cases

Abstract

This study explored anthropometric changes in the reconstructed auricle and the contralateral normal ear in a series of 216 microtia patients using different stabilization methods. Our main personal modifications concerning the preparation of the framework were the following: 1. The individualized framework grafting was based on patients with different ages and different degrees of the strength and thickness of the rib cartilage. 2. The framework was stabilized as a "C" shape by using a piece of cartilage or suture to reinforce the two end points of the "C". In group A (the thickness of cartilage was more than 5 mm), a block of residual cartilage fixed by wire was added between the tragus and the base frame of the inferior crus by the modified method but was not applied in the original method. In group B (the thickness of cartilage was less than 5 mm), a 4-0 braided suture was used to reinforce the two structures but was not used in the original method. No significant differences were found in the height or width measurements of the cartilage framework and the contralateral normal side in either group at the time of implantation. At the follow-up, the height and width measurements were obviously increased in both groups operated on by the original method compared with the initial implanted or contralateral normal measurements. There were no significant differences in the height or width measurements by the modified method in either group. The authors' techniques produced acceptable results and generated some useful parameters for the growth study of the reconstructed auricle and the contralateral normal ear. The modifications in framework stabilization allow a harmonious outline of the reconstructed auricle to be attained, which is almost symmetrical to the contralateral normal auricle.