title: Satisfactory surgical option for cartilage graft absorption in microtia reconstruction.
abstract: BACKGROUND
  We routinely perform auricular elevation at least 6 months after implantation of framework in microtia reconstruction using costal cartilage. However, in a few cases, cartilage graft absorption has occurred, which has led to contour irregularity with unfavorable long-term results. In the present study, we recount the details of using additional rib cartilage augmentation to achieve an accentuated contour in cartilage graft absorption cases.
  
  
  METHODS
  The cartilage graft absorption was defined as contour irregularity or cartilage graft deformation as evaluated by the surgeon and patient. Depending on the extent of cartilage graft absorption, another rib cartilage framework was added to the previously implanted framework, targeting the absorption area. We used banked cartilage or harvested new cartilage based on three-dimensional rib computed tomography.
  
  
  RESULTS
  Additional recontouring of framework was conducted in eight patients who were examined for cartilage graft absorption from 1.5 to 5 years after implantation of the framework. Four patients received additional rib cartilage augmentation and tissue expander insertion simultaneously prior to auricular elevation. Two patients underwent auricular elevation simultaneously. In another two patients, additional rib cartilage augmentation was performed before auricular elevation. The mean follow-up period was 18 months, and in all cases reconstructive results were acceptable.
  
  
  CONCLUSIONS
  Although further follow-up evaluation is required, additional rib cartilage augmentation is an attractive surgical option for cartilage graft absorption cases.
authors: Department of Plastic Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea.
authors: So-Eun
authors: SE
authors: Han
authors: Department of Plastic Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea. Electronic address: kapsung.oh@samsung.com.
authors: Kap Sung
authors: KS
authors: Oh
mesh_terms: D002356:Cartilage / Q000601:surgery / Q000637:transplantation; D065817:Congenital Microtia / Q000601:surgery*; D004431:Ear, External / Q000601:surgery*; D006801:Humans; D019637:Orthopedic Procedures; D017060:Patient Satisfaction; D019651:Plastic Surgery Procedures; D012272:Ribs / Q000601:surgery
keywords: Canaloplasty; Cartilage graft absorption; Microtia reconstruction; Rib cartilage grafts