There is a nice article on a 2-stage ear reconstruction for microtia (full reference below) in the current issue (May/June 2011) of the Archives of Facial Plastic Surgery journal.
I am in awe of the surgeons who can carve the 3-dimensional cartilage framework fabricated in the first stage. This is not something I mastered but continue to read to learn (while referring this patients to others).
In the article, Yanyong Zhao, MD and colleagues describe the 2-stage procedure they used to reconstruct the ears of 68 patients (ages ranged from 5 to 17 years). The surgeries were done between January 1, 2006, to December 31, 2008. Forty-eight patients were boys, and 20 were girls. Unilateral microtia was present in 66 patients and bilateral microtia was present in 2 patients.
The authors clearly describe the procedure and have added nice photos such as this one to make it even more clear (photo credit).
The first stage involves elevating the skin flap and retroauricular fascial flap in the mastoid area, then the cartilage framework is wrapped by the fascial flap from behind and covered by the skin flap from front.
In the second stage the crus, the tragus, and the conchal cavity are reconstructed. So almost all of the fine structures of ear are reconstructed.
Here is one of the photos which shows their results (photo credit)
The article is worth reading, especially for students and residents. Even experienced surgeons may find it useful.
REFERENCE
Original Article A 2-Stage Ear Reconstruction for Microtia; Haiyue Jiang, Bo Pan, Yanyong Zhao, Lin Lin, Lei Liu, Hongxing Zhuang; Arch Facial Plast Surg. 2011;13(3):162-166; doi:10.1001/archfacial.2011.30
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