Bilateral microtia reconstruction

Summary 

Background

Ear reconstruction for congenital microtia is a challenge for the plastic and reconstructive surgeon. Ten percent of microtia cases are bilateral. However, the published literature contains relatively little information about auricular reconstruction in bilateral microtia. Some authorities prefer to reconstruct each side at different stages. In this article, we introduce an operative method to reconstruct both sides simultaneously. This is completely feasible, and saves time and cost. Furthermore, this method allows comparison between sides during surgery, and facilitates carving of bilateral ear frameworks of equal size and shape.

Methods

From March 2007 to June 2008, 21 cases of congenital bilateral microtia were treated by post-auricular skin flap expansion, autogenous rib cartilage framework implantation, post-auricular fascial flap lifting, followed by split-thickness free skin grafting to reconstruct bilateral external ears during the same stage.

Results

With a follow-up duration of 6 months to 1 year, two cases in a total of 21 showed different levels of absorption and cartilage deformation. The rest (19 cases) of the bilateral reconstructed ears showed good symmetry in size, shape and location. The bilateral reconstructed ears looked symmetrical and similar in outline, with well-defined structures.

Conclusion

Simultaneous bilateral congenital microtia reconstruction is feasible and effective. The authors recommend it as the treatment of choice for bilateral microtia reconstruction.

Keywords: Congenital bilateral microtia, Soft-tissue expansion, Autologous cartilage framework, Ear reconstruction, Simultaneous surgery