Category: Microtia

Microtia Defect Repair using Costal Grafts

12/4/2021

Microtia Defect Repair using Costal Grafts

This gentleman was born with microtia of the right ear. Microtia is the congenital deformity of the external ear. Reconstructive surgery is performed in two stages. He presented to our hospital for surgical correction of his microtia ear deformity.

A template was first made using the left ear to ensure that the reconstructed right ear was symmetrical to the normal left ear. Costal rib graft with perichondrium was then harvested from the patient. The graft was crafted using the template for reconstruction of the right ear. Markings were made in the region of the deformed right ear and a subcutaneous pocket was created. The crafted cartilaginous graft was placed in the pocket and the incision was closed with sutures.

The second stage was performed in four months with lifting up of the cartilaginous graft along with placement of a skin graft in the postauricular region. This resulted in reconstruction of a symmetrical right external ear.

Surgery Video

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Microtia ear deformity correction

16/4/2020

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Patient born with a congenital right microtia ear deformity

The patient is a 14-year-old boy who was born with a deformed right external ear. There was just a rudimentary structure in place. He had faced significant bullying in school. One of his greatest wishes in life was to be able to wear sunglasses like his father. His parents’ widespread enquiries for the best surgeon to address this issue led them to our hospital.

Treatment planning explained to the parents in detail

Dr SM Balaji, microtia ear deformity surgeon, examined the patient and obtained detailed measurements of his normal left ear. He explained to the parents that the surgery needed to be performed in two stages. It was further explained that cartilaginous grafts needed to be harvested for the procedure. The parents consented to the procedure

First stage of cartilaginous recreation of external ear structure

Under general anesthesia, a costochondral graft with an intact synchondrosis was first harvested from the patient. This was in the form of an ‘E’ in order to recreate the cartilage of the external ear. Using a template created from the measurements obtained from the normal ear, the graft was carved to recreate the external ear form.
Attention was next turned to placement of the costochondral graft at the site of the deformed right ear. A subcutaneous pocket was created followed by insertion of the graft into the pocket. The incision was closed and a period of three months was allowed to elapse before the second stage.

Second stage of raising the cartilaginous graft to recreate the perfect external ear

A full thickness skin graft was harvested from the patient’s inguinal (groin) region. This was followed by incising around the cartilaginous graft and raising up the entire superstructure of the recreated right ear. The skin graft was then sutured to cover the exposed tissue behind the recreated pinna. A period of one month was allowed for full healing of the surgical site.

Patient expresses complete satisfaction at the results of the surgery

The patient and his parents were very happy with the results of the surgery. He was now able to realize his long-cherished dream of wearing sunglasses like his father. His earlobe had also been perfectly recreated. They expressed their profuse gratitude to the surgical team before final discharge from the hospital.

Surgery Video

Microtia ear deformity correctionhttps://t.co/tq7u0ocdW0 #Microtia #EarReconstruction #DrSMBALAJI #BalajiDental pic.twitter.com/4EYmcFANrU
— Balaji Dental and Craniofacial Hospital (@balajidental) April 16, 2020

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Ear reconstruction for microtia

4/6/2016

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A 24-year old female from Mumbai born with a deformed right ear, sought the expertise of Maxillofacial Surgeon Dr. S.M. Balaji for reconstruction of her ear defect. Previously, in some other hospital elsewhere, multiple attempts to reconstruct the ear were done but she was not satisfied with the results. Hearing was normal.
Dr. Balaji employed the Limberg’s flap to successfully reconstruct the ear lobule. Followed which stage wise complete ear lobe reconstruction done using costochondral rib graft. Costal cartilage was harvested; external framework was carved and tunneled to reconstruct the external ear.
After suction, the skin was seen getting adhered to the cartilage. This was followed by the second-stage surgery to elevate the newly formed ear from the side of the head using split skin graft obtained from right thigh region. Thus, entire shape and size of the ear was reconstructed with enhanced appearance without much visible scars.

Appearance of right ear deformity

Cartilage graft harvested and carved to form ear framework

Framework placed beneath the skin to reconstruct the ear

Limberg flap raised

Earlobe reconstruction using Limberg flap

Immediately after suturing

Skin graft used to complete the elevation giving the ear a normal, raised appearance

Postoperative view following complete ear reconstruction giving enhanced appearance

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Microtia - Ear Creation/Reconstruction Surgery - Dr. S.M Balaji

31/1/2016

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Microtia is a congenital malformation of variable severity of the external and middle ear. This condition is corrected by staged ear reconstruction using autogenous costal cartilage.
Shown here is a case of pediatric external ear reconstruction. The girl’s left microtic auricle had remnants of disorganized cartilage with an earlobe. This surgery is normally performed at about 14-15 years of age but it was done at a younger age in this 10-year-old because she was facing psychological problems as a result of being teased a lot for her ear defect by other children at school.
A template of the normal side was designed to recreate the key elements of the ear shape on the affected side. Costal cartilage was harvested; external framework was carved and tunneled to reconstruct the external ear. After suction, the skin is seen getting adhered to the cartilage. This will be followed by the second-stage surgery to elevate the newly formed ear from the side of the head.
Ear reconstruction surgeries are a demanding undertaking and must be performed with skill, precision & artistry.