Reconstruction of Microtias with Constricted Ear Features: A 22-Year Experience

Background: The surgical correction of microtias with constricted ear features has remained a challenge because of the variable shape and large volume of the remnant cartilage and skin involved. To clarify how this remnant cartilage and skin should be treated, the authors have reviewed and analyzed cases operated on at their center. Methods: A total of 167 cases of microtia with constricted ear features, operated on from 1992 to 2014, were included in the study. They were reviewed through medical records and photographs, analysis of surgical methods, and postoperative outcomes. Results: A total of 141 cases (84 percent) were followed for 2 months to 13 years (average, 28 months). The average score given for the aesthetic outcomes, rated on a four-point Likert scale (i.e., 1 = poor, 2 = fair, 3 = good, and 4 = excellent), was 3.1. For framework construction, the authors used remnant cartilage-saving methods ( n = 37) or remnant cartilage-replacement methods ( n = 104). The average scores for the aesthetic outcome for these methods were 2.56 (median, 3) and 3.36 (median, 4), respectively. The difference in these scores was statistically significant ( p < 0.001). For the coverage of new frameworks, various flap techniques were used. Conclusion: To correct microtias with constricted ear features with consistent postoperative results, the deformed cartilage remnant should be completely replaced with a costal cartilage framework, and the remnant skin should be maximally saved.