Growth of ears reconstructed from autologous rib cartilage
Received: 4 May 2015 /Accepted: 15 May 2015 /Published online: 30 May 2015
Springer-Verlag Berlin Heidelberg 2015
Background Microtia is a congenital abnormality characterised
by a deformed or absent auricle, which can be reconstructed
surgically using autologous rib cartilage. Long-term symmetry
in size is an important goal. The optimal age for surgery and
sizing of the framework is still under debate, as it has not been
clearly shown if the reconstructed ear grows. Our objective was
to determine if the reconstructed ear grows and to compare the
growth with the normal ear.
Methods Twenty-two patients were selected in this retrospec-
tive study. Digital morphometry was used to measure the
length of the reconstructed and normal ears. An initial photo-
graph had been taken after the reconstruction at a median of
11.2 years (range 8.0–12.5 years) of age and a second photo-
graph at a median of 16.3 years (range 14.5–21.6 years). The
median follow-up time was 5.6 years (range 2.1–10.6 years).
The differences in length in the first and second photograph
were calculated, and paired Student’s t tests and Mann–Whitney
U tests were used for the analysis.
Results The mean growth of the reconstructed ears was
0.62 cm (95 % CI 0.43–0.81) and that of the normal ears
was 0.53 cm (95 % CI 0.38–0.68). There was no significant
difference between the growth of the normal and the recon-
structed ears (p=0.26).
Conclusions The reconstructed ears grew during the studied
time-interval, and this was most likely due to growth of the
actual cartilage. There was no significant difference between
the growth on the reconstructed and normal sides.
Level of evidence: Level III, risk/prognostic study.
Autologous ear reconstruction
Microtia is a congenital abnormality characterised by a
deformed or absent auricle, which is unilateral in about
90 % of cases . Microtia is often associated with
hemifacial microsomia, which can be seen as a spec-
trum of malformations where an isolated microtia would
beamildform. The prevalence in Sweden is 2.35
per 10,000 births . The microtia classification system
used divides the malformation into the concha type,
small concha type, lobular type and anotia depending
on the appearance of the ear .
The ears grow rapidly during the first 3–6monthsandthen
grow slower until adulthood . The age at which the
length is mature varies slightly between studies due to,
for example, the ethnicity of the study population and
the measurement method, but has been estimated to be
between 11 and 14 years [5–7].
The deformed ear can be reconstructed surgically by using
autologous rib cartilage to create the framework of a new ear.
This is a three- to four-stage procedure originally developed
by Tanzer  and altered by Brent [9, 10]. There is also
another technique developed by Nagata where only two
sessions are needed . At our unit, we have developed
a three-stage technique inspired both by Nagata and Brent.
* Emma Roos
Lund University, Malmö, Sweden
Department of Plastic and Reconstructive Surgery, Skåne University
Hospital, Malmö, Sweden
Eur J Plast Surg (2015) 38:443–448