Assessment of limited stage reconstruction of auricular deformities using autogenous costal cartilage

ObjectiveTo evaluate the results of ear reconstructions in cases of auricular dysplasia utilizing autogenous costal cartilage graft, using two-stage versus three-stage technique of auricular reconstruction.BackgroundTotal reconstruction of the absent auricle because of congenital microtia is a complex topic that can be carried out either by alloplastic material or by autogenous material such as costal cartilage.Patients and methodsThis prospective study evaluated 22 patients with auricular deformities who were presented to ENT and Plastic Surgery Departments. Patients are assessed preoperatively by history, general and local examination. Esthetic assessment, photo documentation, audiological and radiologic evaluation were carried out. The patients were divided into two groups according to the stages of reconstruction: two-stage (using temporalis fascia and skin graft) and three-stage (using tissue expander) reconstruction. Patients were assessed postoperatively according to doctor and patient satisfaction. The latter was measured by Glasgow benefit inventory questionnaire.ResultsThe surgical outcome was good to fair for the majority of the patients in terms of size, texture and shape of the ear, according to doctor satisfaction, with no significant difference between the two techniques (P > 0.05). Regarding patient satisfaction, there were no significant differences between both the techniques (P > 0.05). There was a significant difference between the two techniques regarding postoperative skin texture and the rate of development of postoperative complications in favor of group II, using tissue expander (P = 0.002).ConclusionThe microtic ear can be satisfactorily reconstructed using autogenous costal cartilage graft either by two-stage technique (using temporalis fascia flap and skin graft) or three-stage technique (using tissue expander), with no significant difference between the two techniques regarding doctor and patient satisfaction.