Establishment of a Standardized Technique for Concha-type Microtia―How to Incorporate the Cartilage Frame into the Remnant Ear

Abstract

Background: We have already reported surgical procedures for lobule-type microtia that provide an excellent contour and shape of the ear with minimum sacrifice of the donor. We have succeeded in establishing a standard surgical technique for almost all types of concha-type microtia that effectively uses the remnant ear and can use a unified costal cartilage frame. Methods and Results: The concept of our technique is that remnant cartilage should be used maximally but that the deformed area should be completely replaced by the costal cartilage frame. The differences between the cartilage frame for lobule-type microtia and that for concha-type microtia are that the lower half beneath the antihelical area and the concha cymba in the base frame are omitted in concha-type microtia. The area from the tragus to the incisura of the tragus in the antihelical-tragal frame is also omitted. The area of the helical crus in the helical frame and the lower half in the antihelix are not immobilized in the base frame and are free edges. On the other hand, the remnant cartilage outside the concha is removed, but the antitragus is preserved. When the cartilage frame and the remnant are incorporated, all of the components of the ear can be provided. Conclusion: The ears created by our technique have a natural appearance and clear contour.

Vibrant Soundbridge Implantation prior to Auricular Reconstruction with Unilateral Microtia-Atresia

“…Plastic reconstruction of the auricle follows a standard procedure with autologous rib cartilage in two operative steps based on the technique of Nagata 13 . Although some modifications have been reported 9,14,15 , these operations predominantly include (1) costal cartilage harvest and implantation of the sculpted framework in a subcutaneous pocket and (2) elevation of the auricle with skin grafting. When performing VSB implantation in advance of the auriculoplasty, otologists must ask plastic surgeons to design the proposed ear preoperatively.…”

Vibrant soundbridge implantation prior to auricular reconstruction with unilateral microtia‐atresia

“…Plastic reconstruction of the auricle follows a standard procedure with autologous rib cartilage in two operative steps based on the technique of Nagata. 13 Although some modifications have been reported, 9 , 14 , 15 these operations predominantly include (a) costal cartilage harvest and implantation of the sculpted framework in a subcutaneous pocket and (b) elevation of the auricle with skin grafting. When performing VSB implantation in advance of the auriculoplasty, otologists must ask plastic surgeons to design the proposed ear preoperatively.…”

Microtia Ear Reconstruction with Patient-Specific 3D Models—A Segmentation Protocol

“…He differentiated between the cartilage frame and template for lobule-type microtia and that for concha-type microtia, omitting in the latter one the lower half beneath the antihelical area and the concha cymba in the base frame while keeping the antitragus. The idea behind this is that non-deformed cartilage should be used to its fullest extent [7].…”