title: Correction of lobule-type microtia: I. The first stage of costal cartilage grafting.
abstract: BACKGROUND
  Recently, auriculoplasty with costal cartilage grafting has been successfully used for correcting microtia and creating a clearly refined contour and a natural appearance of the ear. However, several important problems remain unsolved in these techniques. The authors describe an improved technique for harvesting costal cartilage with minimal morbidity and a new procedure for fabricating a cartilage frame that ensures a refined shape and rigid structure of the constructed ear.
  
  
  METHODS
  Costal cartilage is harvested directly with a chisel. This technique enables some of the cartilage at the chest wall to remain intact. The base frame is fabricated by two cartilage blocks partly overlapped on the area of the antihelix. The thickness in the overlapping area emphasizes the contour between the antihelix and the helical crus. To prevent absorption of the cartilage, helical and antihelical parts are created using the outer rigid layer of the harvested cartilage and are covered as much as possible by perichondrium.
  
  
  RESULTS
  A total of 137 ears in 121 patients were corrected with the authors' technique and followed up for at least 3 years. Almost all of the patients could walk within 2 days after the operation. The structure and contour of the constructed ear were well maintained.
  
  
  CONCLUSIONS
  Attention should be given not only to successful outcomes of construction of the ear but also to minimal morbidity for the patients. Our technique made it possible to construct a cosmetically refined ear that could be maintained for a long period and minimize the pain and deformity of the donor's chest.
authors.affiliation: Sapporo, Hokkaido, Japan From the Department of Plastic and Reconstructive Surgery, Sapporo Medical University School of Medicine.
authors.forename: Takatoshi
authors.initials: T
authors.lastname: Yotsuyanagi
authors.forename: Ken
authors.initials: K
authors.lastname: Yamashita
authors.forename: Makoto
authors.initials: M
authors.lastname: Yamauchi
authors.forename: Asuka
authors.initials: A
authors.lastname: Sugai
authors.forename: Musashi
authors.initials: M
authors.lastname: Kayama
authors.forename: Ayako
authors.initials: A
authors.lastname: Gonda
authors.forename: Arisa
authors.initials: A
authors.lastname: Kita
mesh_terms: D002356:Cartilage / Q000637:transplantation*; D002648:Child; D000013:Congenital Abnormalities / Q000473:pathology / Q000601:surgery*; D065817:Congenital Microtia; D004423:Ear / Q000002:abnormalities* / Q000473:pathology / Q000601:surgery; D004425:Ear Cartilage / Q000002:abnormalities / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D011183:Postoperative Complications / Q000517:prevention & control; D019651:Plastic Surgery Procedures / Q000379:methods*; D012272:Ribs / Q000601:surgery*; D020858:Tissue and Organ Harvesting / Q000379:methods; D016896:Treatment Outcome