“Hybrid Auricular Framework of Autologous Rib and Ear Cartilage for Microtia Reconstruction via a Preauricular Incision”

Background: Fabrication of the auricular framework is a key aspect of ear reconstruction. The use of autologous rib cartilage, which is considered an ideal grafting material, can minimize harvesting damage and optimize its use. This study introduces a method that combines both rib and ear cartilages to reconstruct the auricular framework using an anterior auricular approach, which can help achieve optimal results. Methods: Between 2020 and 2024, 153 patients with microtia underwent ear reconstruction using a hybrid framework of autologous rib and ear cartilage. Reconstruction was performed through a preauricular incision. Postoperative evaluations focused on the morphology and aesthetics of the reconstructed ears, as well as patient satisfaction. Results: The average follow-up period for this study was 28.94 ± 5.42 months. Plastic surgeons assessed the morphology of the reconstructed ears, and the results were as follows: 90 (58.8%), 60 (39.2%), and three (1.9%) ears had excellent, good, and fair morphologies, respectively. The preoperative visual analog scale (VAS) satisfaction score was 0.17 ± 0.38, which significantly improved to 8.45 ± 0.94 postoperatively. All the patients expressed satisfaction with their reconstructed ears. There were no significant differences in ear length, width, or circumference between the reconstructed ears and their contralateral counterparts postoperatively (P = 0.080, P = 0.054, and P = 0.051, respectively). Conclusions: Ear reconstruction using hybrid frameworks of autologous rib and ear cartilage performed via preauricular incisions optimally utilizes the residual ear tissue, minimizes tissue damage, and results in aesthetically favorable reconstructed ears with well-defined substructures and high patient satisfaction.