Auricular Reconstruction for Microtia: Personal 6-Year Experience Based on 350 Microtia Ear Reconstructions in China

Background: Favorable results in auricular reconstruction are difficult to achieve. The authors report 350 patients with different types of microtia who underwent total ear reconstruction. The youngest was aged 5.5 years and the oldest was aged 50 years. Methods: The authors performed auricular reconstruction using autologous costal cartilage with the combination of the Brent and Nagata methods, with some modifications. At the first stage, an individualized framework fabrication based on different degrees of strength and thickness of the rib cartilages was performed. One piece of cartilage was added vertically under the reconstructed tragus to enhance conchal depth to provide a more prominent appearance. At the second stage, the elevated reconstructed ear was supported by bone cement with a special shape that was 2 mm wider at the end of two poles, giving the reconstructed ear more projection on the upper and lower poles. This external ear morphology occurs quite often in China. Results: In this series, the follow-up time in 322 patients ranged from 8 months to 6 years. Two hundred eighty-eight patients were satisfied with the results, including good shape, accurate size, right orientation, and duplication of more than 10 well-detailed structures. Surgery-related complications such as broken helix, skin necrosis, infection, blunted convolution, and extrusion of cartilage occurred in 13 cases and hypertrophic scars occurred in 21 patients. Conclusions: The authors' techniques produce acceptable results and fewer complications. This 6-year experience confirms the reliability, versatility, and reproducibility of this type of combined technique in auricular reconstruction, especially for Asian patients. (Plast. Reconstr. Surg. 123: 849, 2009.)