Optimal surgical timing for ear reconstruction with autologous cartilage: Analysis of the computed tomography scan characteristics of the ribs

BACKGROUND The approach to the construction of the cartilage framework for ear reconstruction is sufficiently established. However, there is still no consensus about the age of initiation of surgical treatment. This study aims to assess the development and growth of the costal cartilage to determine the best age to perform ear reconstruction surgery. METHODS: Data of 107 patients: 40 - patients before surgical treatment, 67 - archival materials aged 5 to 40 years. CT scans were performed and average parameters were calculated (length, width, thickness, cartilage density, and standard deviation in Hounsfield units) of the cartilaginous part of 6th, 7th, 8th, 9th ribs. RESULTS: The needed values were reached at the age of 9-10 years. CONCLUSION: The criteria for starting surgical treatment in the Russian population was determined by the width of the 6th-7th ribs synchondrosis that must be equal to the width of a healthy auricle, and the length of eighth rib that must be longer than 9 cm. Therefore, the optimal age for ear reconstruction with autologous costal cartilage is 10 years and older. Although, reconstruction can be made earlier in specific cases according to height and weight, and the preoperative CT scan.