Reconstruction of Concha-Type Microtia Using a Delayed Postauricular Skin Flap.

SUMMARY: Understanding how to remove and retain the relatively large residual auricle is important in concha-type microtia reconstruction. The authors present a method for concha-type microtia reconstruction using a delayed postauricular skin flap. A total of 40 patients with concha-type microtia who underwent ear reconstruction using a delayed postauricular skin flap were retrospectively examined. Reconstruction was performed in three stages. The first stage consisted of preparing a delayed postauricular skin flap and dealing with the residual auricle including removal of the upper residual auricular cartilage. In the second stage, an autogenous rib cartilage framework was placed and covered with a delayed postauricular skin flap, postauricular fascia flap, and autologous medium-thickness skin graft. The ear framework was carefully articulated and secured with the retained residual auricular cartilage to achieve a smooth junction between the two. The third stage involved modification of the reconstructed ear. Patients were followed up for 12 months after ear reconstruction. All reconstructed auricles had a good appearance, and there was a smooth connection between the reconstructed auricle and the residual ear, with similar color as well as a flat and thin scar. All patients were satisfied with the results.

CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, IV.