Fabrication of three-dimensional cartilaginous framework in auricular reconstruction.

OBJECTIVE: One of the greatest challenges in facial plastic surgery is total auricular reconstruction, as it demands precise technique as well as artistic creativity. The crucial step to reconstruct satisfactory auricles is sculpting a three-dimensional cartilaginous framework, which determines the success of surgery. In this paper we describe our new techniques in fabricating the three-dimensional auricular framework.

METHODS: To assemble satisfactory auricular frameworks, we designed four different methods according to the number of rib cartilages used. (1) Method I, the framework was made from the entire 6th, 7th and 8th rib cartilages; (2) method II, the framework was made from the partial 6th, the entire 7th and 8th rib cartilages; (3) method III, the framework was made from the entire 7th and 8th rib cartilages; (4) method IV, the framework was made only from the entire 7th rib cartilage.

RESULTS: 332 patients, ranging in age from 5 to 33 years old, were operated on using autogenous costal cartilage between 2004 and 2006. All the reconstructed ears had a satisfactory three-dimensional configuration. The cranioauricular angle of the reconstructed ears was also similar to that of the opposite ears.

CONCLUSIONS: According to the status of the normal ear and the development of the cartilage in each patient, we have developed four methods to harvest and fabricate cartilage. Our operations on 332 patients with microtia suggest that our new technique is effective in fabricating cartilaginous framework. Our new technique facilitates the operation procedure and minimises the usage of cartilage.