Autologous microtia reconstruction combined with ancillary procedures: a comprehensive reconstructive approach.
BACKGROUND
Autologous microtia reconstruction is generally performed in two stages. The second stage presents a unique opportunity to carry out other complementary procedures. The present study describes our approach to microtia reconstruction, wherein the second stage of reconstruction is combined with final refinements to the ear construct and/or additional procedures to enhance facial contour and symmetry.


METHODS
Retrospective analysis of patients who underwent two-stage microtia reconstruction by a single surgeon (NWB) was conducted in order to ascertain those that had ancillary procedures at the time of the second stage. Patient and operative details were collected.


RESULTS
Thirty-four patients (male, 15, median age and age range at second stage, 11 and 10-18 years, respectively) who had complementary procedures executed during the second stage of auricular reconstruction were identified. Collectively, these included centralizing genioplasty (n = 1), fat transfer (n = 22), ear piercing (n = 7), and contralateral prominauris correction (n = 7). Six patients had correction for unilateral isolated microtia and in the remaining 28 patients, auricular reconstruction for microtia associated with a named syndrome. All patients reported a high rate of satisfaction with the result achieved and the majority (85%) reported no perceived need for additional surgical refinements to the ear or procedure(s) to achieve further facial symmetry. No peri- or post-operative complications were noted.


CONCLUSIONS
Combining the final stage of autologous microtia reconstruction with other ancillary procedures affords a superior aesthetic outcome and decreased patient morbidity.
Department of Plastic Surgery, Great Ormond Street Hospital for Children NHS Trust, Level 7, Paul O'Gorman Building, Great Ormond Street, London WC1N 3JH, United Kingdom. Electronic address: sabrina.cugno@gosh.nhs.co.uk.
S
S
Cugno
R D
RD
Farhadieh
N W
NW
Bulstrode
D000273:Adipose Tissue / Q000637:transplantation; D000293:Adolescent; D046288:Body Piercing; D002648:Child; D000013:Congenital Abnormalities / Q000601:surgery*; D065817:Congenital Microtia; D019465:Craniofacial Abnormalities / Q000601:surgery*; D004423:Ear / Q000002:abnormalities* / Q000601:surgery; D054644:Ear Auricle / Q000002:abnormalities / Q000601:surgery*; D005146:Facial Asymmetry / Q000151:congenital / Q000601:surgery*; D005260:Female; D063172:Genioplasty; D006801:Humans; D008297:Male; D017060:Patient Satisfaction; D019651:Plastic Surgery Procedures / Q000009:adverse effects / Q000379:methods*; D012189:Retrospective Studies
Hemi-facial microsomia; Microtia reconstruction