New strategies for base frame fabrication in microtia reconstruction.

The base frame provides a stable support for the helix, antihelix, and tragus-antitragus complex in microtia reconstruction, and this support is vital to attain a highly defined outline for a reconstructed auricle. The success of base frame sculpting depends on appropriate treatment of the cartilage, mainly the sixth and seventh costal cartilages, which may have different characteristics. The aim of this study was to demonstrate the relevant details for base frame fabrication under various scenarios. Between 2016 and 2019, a total of 352 patients with microtia underwent autologous auricular reconstruction. Concerning the different sizes and characteristics of the costal cartilage used for the base frame reconstruction, we describe the related methods for fabrication and introduce corresponding strategies for proper management. We found that 90% of the patients responded at follow-up, and 76% of them were satisfied with the cosmetically refined auricle with harmonious integrity. The elaborate design and appropriate utilization of costal cartilage for base frame sculpting is one of the most significant and fundamental processes in microtia reconstruction. It contributes to achieving a clearly defined outline of the auricle with harmonious integrity, which is as important as the other projected subunits.

Li Y ，Li D ，Xu Z ，Zhang R ，Zhang Q ，Xu F ，Chen X ... -  《Scientific Reports》

A New Classification of Helix Fabrication Methods with Autogenous Costal Cartilage in Microtia Reconstruction.

Xu Z ，Xu F ，Zhang R ，Zhang Q ，Li D ，Li Y ... -  《-》

New Strategies for Tragus and Antitragus Complex Fabrication in Lobule-Type Microtia Reconstruction.

Xu Z ，Zhang R ，Zhang Q ，Xu F ，Li D ，Li Y ... -  《-》

Different Methods of Fabricating Cartilaginous Ear Framework in Children With Microtia According to the Length of the Eighth Costal Cartilage Intraoperatively.

Yan H ，Zhang G ，Liu W ，Wang N ，Liu Z ... -  《-》

Ear reconstruction stage I: Minor modifications in sculpting the auricle support using the 7th and 8th costal cartilages.

The verisimilitude of the reconstructed auricle and its long-term stability largely depends on the framework sculpting. This study described three kinds of minor modifications based on Firmin's way of sculpting the auricle framework and reported the clinical outcomes achieved with them. We conducted a retrospective study of congenital microtia patients undergoing detail-improved auricular reconstruction from June 2016 to June 2020. The three kinds of minor modifications included: (1) fabricating the base frame using the 7th costal cartilage, (2) fabricating the helix and the antihelix complex using the 8th costal cartilage, and (3) fabricating the helix using the combination of the 8th and 9th costal cartilage. Ninety-eight patients (aged 9-27 years, 62.2% male) were included. Ninety-five patients (97.0%) adopted minor modifications 1, 2, and 3 patients (3.0%) adopted minor modifications 1, 2, and 3. All patients achieved an excellent auricle appearance and a well-laid foundation for subsequent operations. During the follow-up period, 89 patients (90.8%) were satisfied with the reconstructed auricles, 6 (6.1%) complained of hypertrophic scars in the retroauricular sulcus or pigmentation in the skin graft area, and 3 (3.1%) developed surgery-related complications. Three minor modifications of the auricle framework sculpting can make more satisfactory use of cartilage and adjust with the flexibility of the reconstructed auricle in different situations, making it similar to the contralateral auricle, thus, improving patients' satisfaction.

Luo K ，Chen Z ，Jiang Z ，Cai S ，Zhou Y ，Cui W ，Sheng Y ，Lin Y ，Chen Y ，Cai Z ... -  《-》