The Challenges and Considerations with Autologous Rib Microtia Reconstruction

Abstract

Microtia encompasses a spectrum of congenital pinna malformation. Autologous rib reconstruction is a widely utilized surgical reconstruction technique for microtia. The surgery presents various challenges that can impact surgical outcomes and patient satisfaction. Sculpting and shaping the cartilage into a detailed auricular framework poses is a technically difficult surgery due to the complexity of the ear's anatomy. Postoperative complications such as scar formation, infection, and framework resorption may lead to poor aesthetic outcomes like asymmetry of the reconstructed ear and inadequate projection. Patient-related factors, such as age, rib cartilage quality and quantity, and psychological expectations, also play critical roles in determining success. Additionally, the surgeon's experience and expertise heavily influence the reconstruction's quality.

This paper explores the challenges microtia surgeons face during the reconstruction process, emphasizing technical, patient-specific, and postoperative challenges. It underscores the importance of comprehensive preoperative planning, advanced surgical training, and ongoing research to mitigate these challenges and optimize outcomes in autologous rib microtia reconstruction.

Keywords

microtia - autologous rib microtia reconstruction - auricular reconstruction - microtia surgery

Publikationsverlauf

Artikel online veröffentlicht:
13. Februar 2025

• References

• 1 Luquetti DV, Leoncini E, Mastroiacovo P. Microtia-anotia: a global review of prevalence rates. Birth Defects Res A Clin Mol Teratol 2011; 91 (09) 813-822
• 2 Tanzer RC. Microtia. Clin Plast Surg 1978; 5 (03) 317-336
• 3 Brent B. Auricular repair with autogenous rib cartilage grafts: two decades of experience with 600 cases. Plast Reconstr Surg 1992; 90 (03) 355-374 , discussion 375–376
• 4 Yamada A. Autologous rib microtia construction: Nagata technique. Facial Plast Surg Clin North Am 2018; 26 (01) 41-55
• 5 Firmin F. [Microtia. Reconstruction by Brent's technique]. Ann Chir Plast Esthet 1992; 37 (01) 119-131
• 6 Zanje SS, Kamat NV, Taware KK, Rokade ML, Bhumkar AC. Utility of 3D CT rib study in presurgical planning of autologous ear graft for pinna reconstruction in microtia. Indian J Radiol Imaging 2021; 31 (03) 586-595
• 7 Fu YY, Gao XL, Li CL, Zhang TY. Ultrasonographic evaluation of costal cartilage for microtia reconstruction surgery. Int J Pediatr Otorhinolaryngol 2020; 137: 110234
• 8 Thomson HG, Kim TY, Ein SH. Residual problems in chest donor sites after microtia reconstruction: a long-term study. Plast Reconstr Surg 1995; 95 (06) 961-968
• 9 Ohara K, Nakamura K, Ohta E. Chest wall deformities and thoracic scoliosis after costal cartilage graft harvesting. Plast Reconstr Surg 1997; 99 (04) 1030-1036
• 10 Fu Y, He A, Xie Y, Zhu Y, Li C, Zhang T. The effect of fixation materials on the long-term stability of cartilage framework for microtia reconstruction. Facial Plast Surg Aesthet Med 2023; 25 (02) 126-131
• 11 Sakamoto A, Kiyokawa K, Rikimaru H, Watanabe K, Nishi Y. An investigation of the fixation materials for cartilage frames in microtia. J Plast Reconstr Aesthet Surg 2012; 65 (05) 584-589
• 12 Driscoll DN, Walker ME, D'Achille J. Salvage of a costochondral graft for microtia after postoperative infection. Ann Plast Surg 2014; 72 (01) 56-58
• 13 Badawy MS, Elshahat A. Retroposition of the vestigial cartilage in patients with microtia: a novel technique to enhance projection of the reconstructed ear. J Craniofac Surg 2022; 33 (04) 1197-1200
• 14 Abel RR. Postoperative (pressure) alopecia. Anesthesiology 1964; 25: 869-871