title: Ear elevation using 2-tiered costal cartilage on the same side as the reconstructed framework.
abstract: BACKGROUND
  Ear elevation for the constructed auricle in patients with microtia is more difficult than total reconstruction of the auricle, although this procedure tends to be underestimated. Using costal cartilage for ear elevation may sometimes be difficult owing to its insufficient availability when it is harvested from the ipsilateral costal cartilage for the ear framework. We made both the ear framework and the base for elevation using only the unilateral sixth, seventh, and eighth costal cartilages to solve this problem. Our method for ear elevation is reported.
  
  
  METHODS
  The ear elevation procedure was performed in 28 patients with unilateral microtia. A 2-stage method was used, with framework assembling of the auricle in the first stage and ear elevation of the constructed auricle in the second stage. The technique was designed to make the entire constructed framework and base cartilage for elevation using only the unilateral sixth, seventh, and eighth costal cartilages
  
  
  RESULTS
  All patients displayed an acceptable ear contour after the ear reconstruction procedure. There was no cartilage absorption or infection for 6 to 10 years after surgery. The auricular projections were well maintained, and the cephaloauricular angles of the constructed auricles were similar to the healthy ears at 6 to 10 years after surgery. Mean elevation was 32 degrees.
  
  
  CONCLUSIONS
  The constructed auricle, which was made from only the costal cartilage ipsilateral to the framework, could be elevated to a mean angle of 32 degrees, and it could be maintained for 6 to 10 years. This method is an option for elevating the constructed auricle.
authors.affiliation: Department of Plastic and Reconstructive Surgery, Kanagawa Children's Medical Center, Yokohama City University Hospital, Yokohama, Kanagawa, Japan. skobayashi@kcmc.jp
authors.forename: Shinji
authors.initials: S
authors.lastname: Kobayashi
authors.forename: Jiro
authors.initials: J
authors.lastname: Maegawa
mesh_terms: D002356:Cartilage / Q000637:transplantation*; D002648:Child; D004431:Ear, External / Q000002:abnormalities* / Q000601:surgery*; D004954:Esthetics; D005260:Female; D006801:Humans; D008297:Male; D019651:Plastic Surgery Procedures / Q000379:methods*; D012272:Ribs; D016896:Treatment Outcome