Microtia Reconstruction: Stage 1

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Author: Joseph Rousso
Published:
Specialties: Neurotology Otology, Otolaryngology, Pediatric Otolaryngology, Plastic Surgery
Schools: The New York Eye & Ear Infirmary of Mount Sinai
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Basic Info

Stage 1 Microtia Repair using rib cartilage and modifications to the Nagata method of auricular formation.

DOI#: http://dx.doi.org/10.17797/cquv22l7p3

Advanced

Procedure

Stage 1 microtia reconstruction

Indications

congenital microtia, auricular avulsion, auricular loss

Contraindications

none

Instrumentation

Setup

Plastic set, rib harvest instrumentation, medium dissection set.

Preoperative Workup

temporal bone CT scan, renal ultrasound, full physical exam with particular attention to chest wall deformities and rib anomalies.

Anatomy and Landmarks

Rib harvest: ribs 6 and 7 with synchondrosis, rib 8 and rib 9.
unaffected auricle with measurement and template delineating helix, anti helix, scaphoid fossa, fossa triangular, cymba and caves concha, tragus, anti tragus. Additionally, template measurements to lateral cants, alar base, and oral commissure.

Advantages/Disadvantages

Advantages: gold standard for microtia reconstruction, autologous grafting material
Disadvantages: donor site morbidity,

Complications/Risks

pneumothorax, hemothorax, infection, bleeding.

Disclosure of Conflicts

pneumothorax, hemothorax, infection, bleeding.

Acknowledgements

References

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