title: Aesthetic auricular reconstruction with autologous rib cartilage grafts in adult microtia patients.
abstract: BACKGROUND
  Cartilage calcification is an important factor in aesthetic auricular reconstruction using autologous rib cartilage grafts in adults, a technique that involves difficult manipulation and unexpected absorption. As a result, artificial implants or prosthetics are considered for auricular reconstruction in adult patients despite the limitations of artificial material. In this article, we present our experience with auricular reconstruction using autologous rib cartilage grafts in adult microtia patients with reliable aesthetic results and minimal complications.
  
  
  METHODS
  A retrospective chart review was performed for 84 microtia patients ranging in age from 21 to 56 (average: 29.9) years who underwent auricular reconstruction using autologous rib cartilage grafts from March 2001 to March 2013. To validate our acceptable reconstructive results, two independent observers performed postoperative photographic evaluation of two groups (adults and children) using non-inferiority tests in addition to patient questionnaires.
  
  
  RESULTS
  The mean operation time for rib cartilage grafts was 3 h and 53 min, and the follow-up time for all patients ranged from 6 months to 8 years. Surgery-related complications occurred in only three cases. On objective photographic evaluation, the adult group was not inferior to the child group in auricular shape, location, or symmetry. The subjective patient satisfaction evaluation reported a high satisfaction rate.
  
  
  CONCLUSIONS
  As this study shows, aesthetic auricular reconstruction using rib cartilage grafts in adult microtia patients is possible even in cases with advanced cartilage calcification. Modification of the fabricating framework, well-preserved flap vascularity, and complete understanding of physiological aspects of rib cartilage are essential for aesthetic auricular reconstruction.
authors.affiliation: The Department of Plastic Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
authors.forename: So-Eun
authors.initials: SE
authors.lastname: Han
authors.affiliation: The Department of Plastic Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
authors.forename: So-Young
authors.initials: SY
authors.lastname: Lim
authors.affiliation: The Department of Plastic Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
authors.forename: Jai-Kyung
authors.initials: JK
authors.lastname: Pyon
authors.affiliation: The Department of Plastic Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
authors.forename: Sa-ik
authors.initials: SI
authors.lastname: Bang
authors.affiliation: The Department of Plastic Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
authors.forename: Goo-Hyun
authors.initials: GH
authors.lastname: Mun
authors.affiliation: The Department of Plastic Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea. Electronic address: kapsung.oh@samsung.com.
authors.forename: Kap Sung
authors.initials: KS
authors.lastname: Oh
mesh_terms: D000293:Adolescent; D000328:Adult; D002356:Cartilage / Q000637:transplantation*; D002648:Child; D065817:Congenital Microtia / Q000601:surgery*; D054644:Ear Auricle / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D019651:Plastic Surgery Procedures; D012189:Retrospective Studies; D012272:Ribs; D015626:Tissue Expansion; D014182:Transplantation, Autologous; D055815:Young Adult
keywords: Aesthetic auricular reconstruction; Microtia; Rib cartilage calcification; Rib cartilage grafts