Aesthetic auricular reconstruction with autologous rib cartilage grafts in adult microtia patients

• Published in: Journal of plastic, reconstructive & aesthetic surgery reconstructive & aesthetic surgery, 2015-08, Vol.68 (8), p.1085-1094
• Main Authors: Han, So-Eun, Lim, So-Young, Pyon, Jai-Kyung, Bang, Sa-Ik, Mun, Goo-Hyun, Oh, Kap Sung
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Aesthetic auricular reconstruction; Cartilage - transplantation; Child; Congenital Microtia - surgery; Ear Auricle - surgery; Female; Humans; Male; Microtia; Middle Aged; Patient Satisfaction; Plastic Surgery; Reconstructive Surgical Procedures; Retrospective Studies; Rib cartilage calcification; Rib cartilage grafts; Ribs; Tissue Expansion; Transplantation, Autologous; Young Adult
• ISSN: 1748-6815; 1878-0539
• DOI: 10.1016/j.bjps.2015.04.016

Summary Background Cartilage calcification is an important factor in aesthetic auricular reconstruction using autologous rib cartilage grafts in adults, a technique that involves difficult manipulation and unexpected absorption. As a result, artificial implants or prosthetics are considered for auricular reconstruction in adult patients despite the limitations of artificial material. In this article, we present our experience with auricular reconstruction using autologous rib cartilage grafts in adult microtia patients with reliable aesthetic results and minimal complications. Methods A retrospective chart review was performed for 84 microtia patients ranging in age from 21 to 56 (average: 29.9) years who underwent auricular reconstruction using autologous rib cartilage grafts from March 2001 to March 2013. To validate our acceptable reconstructive results, two independent observers performed postoperative photographic evaluation of two groups (adults and children) using non-inferiority tests in addition to patient questionnaires. Results The mean operation time for rib cartilage grafts was 3 h and 53 min, and the follow-up time for all patients ranged from 6 months to 8 years. Surgery-related complications occurred in only three cases. On objective photographic evaluation, the adult group was not inferior to the child group in auricular shape, location, or symmetry. The subjective patient satisfaction evaluation reported a high satisfaction rate. Conclusions As this study shows, aesthetic auricular reconstruction using rib cartilage grafts in adult microtia patients is possible even in cases with advanced cartilage calcification. Modification of the fabricating framework, well-preserved flap vascularity, and complete understanding of physiological aspects of rib cartilage are essential for aesthetic auricular reconstruction.