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Volume 42 Issue 1
Jan.  2026
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Article Navigation >  CHINESE JOURNAL OF BURNS AND WOUNDS  > 2026  >  42(1): 41-48
Xu ZC,Zhang Q,Xu F,et al.Clinical efficacy of two-stage ear reconstruction using autologous rib cartilage in the correction of congenital microtia[J].Chin J Burns Wounds,2026,42(1):41-48.DOI: 10.3760/cma.j.cn501225-20250902-00384.
Citation: Xu ZC,Zhang Q,Xu F,et al.Clinical efficacy of two-stage ear reconstruction using autologous rib cartilage in the correction of congenital microtia[J].Chin J Burns Wounds,2026,42(1):41-48.DOI: 10.3760/cma.j.cn501225-20250902-00384.
shu

Clinical efficacy of two-stage ear reconstruction using autologous rib cartilage in the correction of congenital microtia

doi: 10.3760/cma.j.cn501225-20250902-00384

  • Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200011, China

Funds:

Shanghai Science and Technology Plan Project 22MC1940300

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    Abstract
  •   Objective  To explore the clinical efficacy of two-stage ear reconstruction using autologous rib cartilage in the correction of congenital microtia.  Methods  The study was a retrospective cohort study. From January 2000 to February 2025, 3 050 patients (1 992 males and 1 058 females, aged 6 to 52 years) with congenital microtia who met the inclusion criteria were admitted to the Department of Plastic and Reconstructive Surgery of Shanghai Ninth People's Hospital of Shanghai Jiao Tong University School of Medicine. All of them were corrected by the two-stage ear reconstruction. The first stage operation involved harvesting of the 6th to 8th autologous rib cartilages (the 9th autologous rib cartilage was harvested if necessary) for ear framework fabrication. Depending on the amount and location of residual ear tissue, the transverse, longitudinal, "V"-shaped, "U"-shaped, or "W"-shaped incisions were designed, and then fabricated frameworks were implanted, and the wounds were closed. The second stage operation was performed 3 to 6 months after operation. The reconstructed ear was first lifted, the reserved cartilage or titanium plate was used as supporting material to construct the cranio-auricular angle, and then the wound was closed with retroauricular fascial flap and split-thickness scalp skin graft. The wound at the donor site of the skin graft was packaged and fixed. After operation, the incidence of complications was recorded, and the occurrence rate was calculated. During the follow-up, the appearance of the reconstructed ear was observed, and the patients' satisfaction or reasons for dissatisfaction were counted.  Results  The complications, such as venous congestion, flap necrosis, and cartilage exposure, etc. occurred in the first stage operation, and the occurrence rate was 6.59% (201/3 050); partial skin graft necrosis, fascial flap necrosis, and cartilage exposure, etc. occurred in the second stage operation, and the occurrence rate was 9.18% (280/3 050). The complications were all controlled effectively after adopting treatment measures such as acupuncture and bloodletting combined with wet compress using gauze soaked in heparin solution, debridement and drainage, hyperbaric oxygen therapy, rational application of antibiotics, and repair with fascial flaps and skin grafts. During the follow-up of 6 months to 15 years after the second stage operation, the morphology of each sub-unit of the reconstructed ear appeared, the proportion was coordinated, and the structure was soft and natural. 89.02% (2 715/3 050) of the patients and their families were satisfied with the shape contour, position, and size of the reconstructed ear. The reasons for the dissatisfaction of the remaining patients were local structural defects of the reconstructed ear caused by postoperative complications, asymmetry in the position of the reconstructed ear due to factors such as hemifacial microsomia and ectopic auditory meatus.  Conclusions  Two-stage ear reconstruction using autologous rib cartilage in the correction of congenital microtia is a reliable surgical technique, characterized by a low incidence of postoperative complications, natural anatomical structure of the reconstructed ear, and high patient satisfaction.

     

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