Published: 2019-10-24

A clinical study of external ear reconstruction: a study of 20 cases

Priyank K. Katwala, Vishal A. Pawar, Palak P. Katwala, Ketan H. Parmar


Background: Auricular defects pose one of the most difficult challenges in reconstructive surgery of the head and neck. The reason is the unique three-dimensional anatomical architecture of the auricle, with its multiple concavities and convolutions of the cartilage and the thin, delicate skin cover. Acquired auricular deformities commonly result from traumatic injuries, burn trauma or tumour extirpation. These vary in severity from simple lacerations to complete auricular avulsions. Congenital ear deformity (microtia) occurs in every 1 out of 6000 live births. The goal of reconstruction is the precise duplication of the missing anatomical part with regard to size, orientation and anatomical landmarks.

Methods: Range from healing by secondary intention to complete replacement with autologous rib cartilage and/or auricular prosthesis. Total auricular reconstruction was done by two methods: (1) Nagata and (2) Brent’s method. Nagata’s technique is commonly performed in this study. The present study aimed to evaluate the reconstruction of auricular defects using autologous rib cartilage graft with or without temperoparietal fascia flap covered by split-thickness skin graft.

Results: Excellent cosmetic result can be obtained with adequate skills and training in carving the cartilage for auricular framework. This improves confidence and gives psychological support to microtia patients.

Conclusions: With training and method, results in ear reconstruction using autologous rib cartilage are excellent and reproducible.


Ear reconstruction, Microtia, Rib cartilage, Auricular deformities

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Warren R, Neligan PC. Plastic Surgery (third edition), Volume 3, Saunders: 2012.

Kasrai L, Snyder-Warwick AK, Fisher DM. Single-Stage Autologous Ear Reconstruction for Microtia. Plast Reconstr Surg. 2014;133(3):652-62.

Khondoker MS, Awwal R, Sarker MM, Khundkar SH. Microtia reconstruction: our experiences of first 10 cases in Bangladesh. Bangladesh J Plastic Surg. 2010;1(2):14-9.

Nagata S. A new method of total reconstruction of the auricle for microtia. Plast Reconstr Surg. 1993;92:187-201.

Nagata S. Modification of the stages in total reconstruction of the auricle: Part I. Grafting of the three-dimensional costal cartilage framework for lobule-type microtia. Plast Reconstr Surg. 1994;93:221-30.

Nagata S. Modification of the stages in total reconstruction of the auricle: Part II. Grafting the three-dimensional costal cartilage framework for concha-type microtia. Plast Reconstr Surg. 1994;93:231-42.

Nagata S. Modification of the stages in total reconstruction of the auricle: Part III. Grafting the three-dimensional costal cartilage framework for small concha-type microtia. Plast Reconstr Surg. 1994;93:243-53.

Nagata S. Modification of the stages in total reconstruction of the auricle: Part IV. Ear elevation for the constructed auricle. Plast Reconstr Surg. 1994;93:254-66.

Brunelli A, Bottini DJ, Cervelli V, Cervilli G, Grimaldi M. Reconstructin of partially amputated external ear with costal cartilage graft: case report. Acta Otorhinolaryngologica Italica. 2004;24(3):150-6.

Thorne CH, Brecht LE, Bradley JP, Levine JP, Hammerschlag P, Longaker MT. Auricular Reconstruction: Indications for Autogenous and Prosthetic Techniques. Plastic Reconstr Surg. 2001;107:1241.

Chauhan DS, Guruprasad Y. Auricular Reconstruction of Congenital Microtia using autogenous costal cartilage: Report of 27 cases. J Maxillofac Oral Surg. 2012;11(1):47-52.

Pavuluri S, Vangimalla SRR, Gangavarapu PH. Auricular reconstruction of congenital microtia using autogenous costal cartilage: Report of 25 cases. IOSR J Dent Med Sci. 2015;14(8):38-44.

Helal HA, Mahmoud NAS, Hanafy AAA. Reconstruction of post-traumatic full-thickness defects of the upper one-third of the auricle. Plast Surg (Oakv). 2014;22(1):22-5.

Elasonnbathy M, Abdelrahiem M, Fekrey M. Partial Ear Reconstruction Using the Eighth Costal Cartilage after Multiple Chondrotomies. Egypt J Plast Reconstr Surg. 2014;38(2):123-7.

Liu X, Zhang Q, Quan Y, Xie Y, Shi L. Bilateral microtia reconstruction. J Plast Reconstr Aesthet Surg. 2010;63(8):1275-8.

Firmin F, Marchac A. A novel Algorithm for Autologous Ear Reconstuction. Semin Plastic Surg. 2011;25:257-64.

Ottat MR. Partial reconstruction of the external ear after a trauma- simple and efficient techniques. Braz J Otorhinolaryngol. 2010;76(1):7-13.