Reconstructive sequence with autologous costal cartilage for reconstruction of patients with microtia: case report.

Abstract

Introduction:

Microtia is a congenital malformation of the auricle that ranges from mild morphological alterations to complete absence (anotia). It can occur in isolation or as part of a syndrome. Its global prevalence ranges from 1 to 10 per 10,000 live births, being more common in Hispanic, Asian, and Native American populations.

Reconstruction with autologous cartilage has been the go-to technique since the first reconstruction procedures due to its durability, accessibility, immunological compatibility, reproducibility, and low cost.

Objective: To describe the reconstructive surgical sequence with autologous costal cartilage in a patient with unilateral microtia, using the technique described by Nagata.

Methodology: We present the case of an 18-year-old male with Tanzer IIA left microtia. The patient underwent surgical reconstruction using the Nagata technique. During this initial phase, ipsilateral costal cartilage (ribs 6 to 9) was harvested, and the auricular framework was constructed using this cartilage. The auricular lobe was then transposed, the previously assembled cartilaginous framework was implanted, and the ear was covered with a skin pocket created at the beginning of the surgery. The patient was discharged 72 hours later with satisfactory progress and was followed up as an outpatient.

Results: Adequate progress was observed, with integration of the costal cartilage graft and healing of the surgical site. Furthermore, a notable aesthetic improvement was shown, with acceptable asymmetry in relation to the contralateral ear. The patient reported improved self-esteem and social relationships during follow-up.

Conclusions: The use of autologous costal cartilage for reconstruction in patients with microtia remains a cornerstone of treatment due to its favorable aesthetic results, low cost, biocompatibility, and accessibility. Proper planning of the surgical sequence and a comprehensive approach to the patient are essential for successful treatment.