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CC BY-NC-ND 4.0 · Indian J Plast Surg 2023; 56(02): 130-137
DOI: 10.1055/s-0043-1762907
Original Article

Microtia Reconstruction: Our Strategies to Improve the Outcomes

Mohit Sharma
1   Department of Plastic and Reconstructive Surgery, Amrita Hospital, Faridabad, Haryana, India
,
Srilekha Reddy G.
2   Amrita Institute of Medical Sciences, Kochi, Kerala, India
,
Shruti Kongara
2   Amrita Institute of Medical Sciences, Kochi, Kerala, India
,
Vasundhara Jain
2   Amrita Institute of Medical Sciences, Kochi, Kerala, India
,
Shravan Rai K.S
3   Tara Healthcare, Jayanagar, Bengaluru, Karnataka, India
,
Ankita Harijee
2   Amrita Institute of Medical Sciences, Kochi, Kerala, India
,
Abhinandan Badam
2   Amrita Institute of Medical Sciences, Kochi, Kerala, India
,
Nirav G. Maharaja 
2   Amrita Institute of Medical Sciences, Kochi, Kerala, India
,
Thomas Joseph
4   Department of Plastic and Reconstructive Surgery, KMC Hospital, Mangalore, Karnataka, India
,
Janarthanan R.
2   Amrita Institute of Medical Sciences, Kochi, Kerala, India
,
Subramania Iyer 
2   Amrita Institute of Medical Sciences, Kochi, Kerala, India
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Abstract

Introduction: Autologous costal cartilage framework placement is currently the gold standard in patients with microtia. In this article, we present the modifications developed by the author, generally following the principles established by Nagata, and discuss the technical details that have led us to achieve consistently stable and good long-term outcomes for auricular reconstruction in microtia.

Materials and Methods: A retrospective review of microtia reconstruction performed from 2015 to 2021 was done. Those who underwent primary reconstruction for microtia and with a minimum follow-up of 6 months with documented photographs were included. Those who underwent secondary reconstruction for microtia and those who did not follow-up for a minimum period of 6 months were excluded. Outcomes were assessed with regard to appearance, and durability of the result. Influence of certain changes like delaying reconstruction until 15 years of age, use of nylon for framework fabrication, etc. over the outcome were assessed.

Results: Of 11 ears reconstructed at less than 15 years of age, only one patient (9%) had a good long-term outcome, whereas of the 17 ears reconstructed at greater than 15 years of age, nine patients (53%) had a good long-term outcome. In our experience, infections and wire extrusions were the significant events related to severe cartilage resorption.

Conclusion: In our experience, delaying the first stage to 15 years or later, using double-armed nylon sutures, and reducing the projection of the third layer of the framework in select cases have helped to improve our outcomes. Second stage of reconstruction can be avoided if patient is satisfied with the projection achieved in the first stage.

Keywords

microtia reconstruction - single-stage ear reconstruction - ear framework fabrication - wire extrusion - improving outcomes of ear reconstruction


Publication History

Article published online:
28 February 2023

© 2023. Association of Plastic Surgeons of India. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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