Individual auricular reconstruction with autologous costal cartilage framework for degree I microtia

Objective To discuss the individual auricular reconstruction utilizing remnant auricle and autologous costal cartilage framework for congenital degree Ⅰ microtia.Methods From Oct.2000 to Jul.2006,167 patients(167 ears) with degree Ⅰ microtia underwent two-or three-stage operation of auricular reconstruction with individual expansion and autologous costal cartilage framework.In the first stage(expander implanting stage),the dorsal skin of remnant auricle was separated sufficiently and the expander was implanted in.The upper part of remnant auricle with higher location was separated from the cranial wall.In the second stage(auricular reconstructing stage),the remnant auricle of microtia was utilized sufficiently and the autologous costal cartilage frame was fabricated individually to supply the absent structure.The costal cartilage frame was wrapped by dorsal skin of remnant auricle and the expanded flap.In the third stage(repair operation of the reconstructed auricle),if the cavity of concha was smaller than normal side,it could be enlarged by Z-plasty of local skin combining with free skin transplantation after some cartilage of the cavity of concha near antihelix was excised.Results The operative effects were satisfied for 167 patients and no complication was observed.Seventy-eight patients were followed up for 1 to 6 years(2.5 years in average),the fine structures of reconstructed auricles were clearly and similar to the normal side,and the patients and their family members were satisfied with results.Conclusion Individual auricular reconstruction with autologous costal cartilage framework is an economical and ideal therapeutic method for degree Ⅰ microtia.