eMedicine Specialties > Otolaryngology and Facial Plastic Surgery > Reconstructive Surgery

Ear Reconstruction: Workup

Author: Joseph L Leach Jr, MD, Associate Professor of Otolaryngology, University of Texas Southwestern Medical School
Coauthor(s): Michael J Biavati, MD, Clinical Assistant Professor of Otolaryngology, University of Texas Southwestern; Private Practice, ENT Care for Kids, Dallas, TX
Contributor Information and Disclosures

Updated: Feb 11, 2009

Workup

Laboratory Studies

Unless indicated by the patient's overall medical condition, no particular laboratory studies are obtained routinely.

Imaging Studies

Aural atresia repair requires a fine cut noncontrast axial and coronal CT scan of the temporal bones. The timing of this study is not critical and may be deferred until the otologic procedure is anticipated.

Diagnostic Procedures

For microtia repair, no routine diagnostic procedures are necessary, unless a thorough history and physical examination reveal that particular studies are necessary.

Histologic Findings

Because microtia consists of malformed cartilages and skin appendages, no routine histologic examination is indicated. In fact, no pathologic specimen is obtained under normal circumstances.

Staging

Meurmann staged microtia as follows:

  • Grade 1: Malformed auricle of smaller than normal size but retaining characteristic features
  • Grade 2: Rudimentary auricle consisting of a low oblong elevation hook formed at the cranial end corresponding to the helix
  • Grade 3: A more defective auricle with a malformed lobule and the rest of the pinna being totally absent

Grade 3 is the abnormality most commonly encountered in patients desiring reconstruction. Note that anotia is not considered under the above classification.

More on Ear Reconstruction

Overview: Ear Reconstruction
Workup: Ear Reconstruction
Treatment: Ear Reconstruction
Follow-up: Ear Reconstruction
Multimedia: Ear Reconstruction
References
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References

  1. Brent B. Auricular repair with autogenous rib cartilage grafts: two decades of experience with 600 cases. Plast Reconstr Surg. Sep 1992;90(3):355-74; discussion 375-6. [Medline].

  2. Aguilar EF 3rd. Auricular reconstruction of congenital microtia (grade III). Laryngoscope. Dec 1996;106(12 Pt 2 Suppl 82):1-26. [Medline].

  3. Bhandari PS. Use of triamcinolone acetonide injection in ear reconstruction. Ann Plast Surg. Oct 2000;45(4):458-61. [Medline].

  4. DellaCroce FJ, Green S, Aguilar EF 3rd. Framework growth after reconstruction for microtia: is it real and what are the implications?. Plast Reconstr Surg. Nov 2001;108(6):1479-84; discussion 1485-6. [Medline].

  5. Eavey RD. Microtia and significant auricular malformation. Ninety-two pediatric patients. Arch Otolaryngol Head Neck Surg. Jan 1995;121(1):57-62. [Medline].

  6. Eavey RD. Microtia repair: creation of a functional postauricular sulcus. Otolaryngol Head Neck Surg. Jun 1999;120(6):789-93. [Medline].

  7. Eavey RD, Ryan DP. Refinements in pediatric microtia reconstruction. Arch Otolaryngol Head Neck Surg. Jun 1996;122(6):617-20. [Medline].

  8. Kamil SH, Vacanti MP, Aminuddin BS, Jackson MJ, Vacanti CA, Eavey RD. Tissue engineering of a human sized and shaped auricle using a mold. Laryngoscope. May 2004;114(5):867-70. [Medline].

  9. Leach JL Jr, Jordan JA, Brown KR, Biavati MJ. Techniques for improving ear definition in microtia reconstruction. Int J Pediatr Otorhinolaryngol. Apr 25 1999;48(1):39-46. [Medline].

  10. Mastroiacovo P, Corchia C, Botto LD, Lanni R, Zampino G, Fusco D. Epidemiology and genetics of microtia-anotia: a registry based study on over one million births. J Med Genet. Jun 1995;32(6):453-7. [Medline].

  11. Nagata S. A new method of total reconstruction of the auricle for microtia. Plast Reconstr Surg. Aug 1993;92(2):187-201. [Medline].

  12. Nagata S. Secondary reconstruction for unfavorable microtia results utilizing temporoparietal and innominate fascia flaps. Plast Reconstr Surg. Aug 1994;94(2):254-65; discussion 266-7. [Medline].

  13. Romo T 3rd, Presti PM, Yalamanchili HR. Medpor alternative for microtia repair. Facial Plast Surg Clin North Am. May 2006;14(2):129-36, vi. [Medline].

  14. Thomson HG, Correa A. Unilateral microtia reconstruction: is the position symmetrical?. Plast Reconstr Surg. Oct 1993;92(5):852-7. [Medline].

  15. Thorne CH, Brecht LE, Bradley JP, Levine JP, Hammerschlag P, Longaker MT. Auricular reconstruction: indications for autogenous and prosthetic techniques. Plast Reconstr Surg. Apr 15 2001;107(5):1241-52. [Medline].

  16. Uppal RS, Sabbagh W, Chana J, Gault DT. Donor-site morbidity after autologous costal cartilage harvest in ear reconstruction and approaches to reducing donor-site contour deformity. Plast Reconstr Surg. Jun 2008;121(6):1949-55. [Medline].

  17. Walton RL, Beahm EK. Auricular reconstruction for microtia: Part II. Surgical techniques. Plast Reconstr Surg. Jul 2002;110(1):234-49; quiz 250-1, 387. [Medline].

  18. Watson RM, Coward TJ, Forman GH. Results of treatment of 20 patients with implant-retained auricular prostheses. Int J Oral Maxillofac Implants. Jul-Aug 1995;10(4):445-9. [Medline].

  19. Wilkes GH, Wolfaardt JF. Osseointegrated alloplastic versus autogenous ear reconstruction: criteria for treatment selection. Plast Reconstr Surg. Apr 1994;93(5):967-79. [Medline].

  20. Williams JD, Romo T 3rd, Sclafani AP, Cho H. Porous high-density polyethylene implants in auricular reconstruction. Arch Otolaryngol Head Neck Surg. Jun 1997;123(6):578-83. [Medline].

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Further Reading

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Keywords

ear reconstruction, ear, ear deformity, microtia, anotia, external ear deformity, aural atresia, external ear reconstruction, microtia repair, auricular reconstruction

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Contributor Information and Disclosures

Author

Joseph L Leach Jr, MD, Associate Professor of Otolaryngology, University of Texas Southwestern Medical School
Joseph L Leach Jr, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Cosmetic Surgery, American Academy of Facial Plastic and Reconstructive Surgery, American Academy of Otolaryngology-Head and Neck Surgery, Texas Medical Association, and Triological Society
Disclosure: Nothing to disclose.

Coauthor(s)

Michael J Biavati, MD, Clinical Assistant Professor of Otolaryngology, University of Texas Southwestern; Private Practice, ENT Care for Kids, Dallas, TX
Michael J Biavati, MD is a member of the following medical societies: American Academy of Otolaryngology-Head and Neck Surgery, American Academy of Pediatrics, American Cleft Palate/Craniofacial Association, American College of Surgeons, American Laryngological Rhinological and Otological Society, American Society of Pediatric Otolaryngology, Society for Ear, Nose and Throat Advances in Children, and Texas Medical Association
Disclosure: Nothing to disclose.

Medical Editor

John C Li, MD, Private Practice in Otology and Neurotology; Medical Director, Balance Center
John C Li, MD is a member of the following medical societies: American Academy of Otolaryngology-Head and Neck Surgery, American College of Surgeons, American Medical Association, American Neurotology Society, American Tinnitus Association, Florida Medical Association, and North American Skull Base Society
Disclosure: Nothing to disclose.

Pharmacy Editor

Francisco Talavera, PharmD, PhD, Senior Pharmacy Editor, eMedicine
Disclosure: eMedicine Salary Employment

Managing Editor

Dominique Dorion, MD, MSc, FRCSC, Program Director and Division Chair, Professor of Surgery, Division of Otolaryngology, University of Sherbrooke, Canada
Disclosure: Nothing to disclose.

CME Editor

Christopher L Slack, MD, Otolaryngology-Facial Plastic Surgery, Private Practice, Associated Coastal ENT; Medical Director, Treasure Coast Sleep Disorders
Christopher L Slack, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Facial Plastic and Reconstructive Surgery, American Academy of Otolaryngology-Head and Neck Surgery, and American Medical Association
Disclosure: Nothing to disclose.

Chief Editor

Arlen D Meyers, MD, MBA, Professor, Department of Otolaryngology-Head and Neck Surgery, University of Colorado School of Medicine
Arlen D Meyers, MD, MBA is a member of the following medical societies: American Academy of Facial Plastic and Reconstructive Surgery, American Academy of Otolaryngology-Head and Neck Surgery, and American Head and Neck Society
Disclosure: Covidien Corp Consulting fee Consulting; US Tobacco Corporation unstricted gift unknown; Axis Three Corporation Ownership interest Consulting; Omni Biosciences Ownership interest Consulting; Sentegra Ownership interest Board membership; Syndicom Ownership interest Consulting; Oxlo  Consulting; Medvoy Ownership interest Management position

 
 
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