I have not seen any microtia cases in my practice. Most of these, appropriately so, are sent to Children's Hospitals so that a team (ENT, Plastic Surgeons, Audiologist, Speech Therapist, etc) can take care of them. I do find it amazing that this reconstruction can be done so well by those like Dr. Charles Thorne who has a great website on Microtia. I suggest you visit his site.
II. Complete hypoplasia (microtia)
A. With atresia of external auditory canal
B. Without atresia of external auditory canal
III. Hypoplasia of middle third of auricle
IV. Hypoplasia of superior third of auricle
A. Constricted (cup or lop) ear
C. Hypoplasia of entire superior third
V. Prominent ear
Nagata’s technique involves two stages. It was first introduced in 1993 and has undergone several possible technical refinements, depending on the type of microtia present (ie lobular, small concha, anotia, low hairline).In the first stage, the rib cartilage framework, which incorporates a tragal component, is placed in a subcutaneous pocket and the lobule is transposed. This first stage thus roughly corresponds to the first three stages in Brent’s sequence. Nagata uses the skin of the posterior lobule and mastoid to cover the conchal aspect of the construct. By converting the V-shaped posterior lobule incision used by Tanzer into a “W,” he also increases the surface area of skin available to cover the framework. Six months later the second stage is done. The construct is elevated and symmetry adjustments made.
- Surgical Procedures of the External Ear Canal and Ear; Dept. of Otolaryngology, UTMB, Grand Rounds; May 5, 1993; Kathleen McDonald M.D., Jeff Vrabec M.D., Melinda McCracken, M.S.
- Total reconstruction of the auricle: The evolution of a plan of treatment; Plast. Reconstr. Surg. 47: 523, 1971; Tanzer, R. C.
- Autogenous Rib Cartilage Reconstruction of Congenital Ear Defects: Report of 110 Cases with Brent's Technique; Plastic & Reconstructive Surgery. 104(7):1951-1962, December 1999; Osorno, Gabriel M.D.
- Auricular Reconstruction: Indications for Autogenous and Prosthetic Techniques; Plastic & Reconstructive Surgery. 107(5):1241-1251, April 15, 2001; Thorne, Charles H. M.D.; Brecht, Lawrence E. D.D.S.; Bradley, James P. M.D.; Levine, Jamie P. M.D.; Hammerschlag, Paul M.D.; Longaker, Michael T. M.D.
- Auricular Reconstruction for Microtia: Part II. Surgical Techniques; Plastic & Reconstructive Surgery. 110(1):234-251, July 2002; Walton, Robert L. M.D.; Beahm, Elisabeth K. M.D.
- Refinements in the Elevation of Reconstructed Auricles in Microtia; Plastic & Reconstructive Surgery. 117(7):2414-2423, June 2006; Tai, Yoshiaki M.D.; Tanaka, Shinsuke M.D.; Fukushima, Junichi M.D.; Kizuka, Yuichiro M.D.; Kiyokawa, Kensuke M.D.; Inoue, Yojiro M.D.; Yamauchi, Toshihiko M.D.