Auricular reconstruction of congenital microtia using autogenous costal cartilage: report of 27 cases.

BACKGROUND Total auricular reconstruction in congenital lobule type microtia is one of the most challenging problems faced by a reconstructive surgeon as it demands precise surgical technique combined with artistic creativity. Ear reconstruction requires carefully planned procedures. METHODS We present a simple method for auricular reconstruction consisting of three stages. The first stage is carving the cartilage framework from the costal cartilages of 6th, 7th and 8th ribs, lobule transposition and insertion in a skin pocket. The second stage is performed 5 months later to elevate the ear framework using a full thickness skin graft and a cartilage spare part. The third stage is done after 3-4 months later to give finer detail to the reconstructed ear. This method was used in 27 patients with lobule type microtia. RESULTS The results of the reconstructed auricles in 27 patients were satisfactory with good aesthetic balance. The complications ranged from small localized skin infection treated with topical and oral antibiotics to catastrophic loss of the skin pocket and the framework. CONCLUSION Although various donor sites have been used for harvesting the cartilage, only costal cartilage provides a substantial source for fabricating total ear framework. The cosmetic outcome and least complication results in our series support this conclusion.