New concept in microtia repair.

Reconstruction of the severely deformed external ear has been a frustrating experience for many patients and surgeons alike. Until recently, children with microtia (1:10,000 births) have been subjected to multiple procedures with frequently ungratifying results. Because of the rarity of this deformity, most surgeons have had little personal experience with the common problems encountered in microtia reconstruction. The problems of (1) proper location of the reconstructed ear, (2) size and shape, and (3) durability of the implanted graft can be prevented by adherence to newer principles and techniques. When the four-stage reconstruction is begun at 5 years of age, an adequate and durable costal cartilage framework can be sculptured and implanted. Over the past four years, the use of these principles and techniques in 13 patients has resulted in gratifying results.