Other Techniques for Microtia Management

Abstract

There are many patients with microtia who never seek consultation for reconstruction, either having accepted the deformity or having resorted to camouflage of the malformed vestigial remnant with hair. Although osseointegrated prosthetic reconstruction is more readily considered in adults, its use in primary reconstruction in the pediatric population remains an area of contention, particularly in cases of microtia. In children, a prosthesis is more commonly regarded as a salvage option following failed secondary reconstruction where costal cartilage or soft tissue coverage remains insufficient for consideration of additional autogenous or alloplastic reconstructive efforts. Pre-lamination of a composite auricular flap with subsequent microsurgical transfer has been used for auricular reconstruction when regional options for secondary reconstruction have been expended, and transfer of a free fascial flap is considered a lesser option. In recent years, there has been considerable interest in generating a prefabricated cartilaginous ear framework from autogenous chondrocytes; however, these initiatives have not been fully realized.