Enhancement of Aesthetic Outcomes in Patients with Bilateral Microtia

Document Type : Research article

Authors

1 Department of Plastic, Burn and Maxillofacial Surgery, Faculty of Medicine, Ain- Shams University,Cairo, Egypt.

2 The Department of Plastic, Reconstructive and Maxillofacial Surgery, Faculty of Medicine, Ain Shams University

Abstract

Background: Microtia is a complex and challenging
condition for plastic surgeons, especially when it is bilateral,
due to lack of a standard contralateral ear that could be used
as a guide to achieve proper size and position of the newly
reconstructed ear. Usually in bilateral cases each side is
operated separately in two stages, with an overall four operative
times for both sides.
Objective: In the current study, we aim at reconstruction
of bilateral ears in only three stages, taking into consideration
the aesthetic outcomes, similarity of both sides, and overall
patient satisfaction.
Patients and Methods: In the current study, 12 patients
with bilateral microtia underwent bilateral total ear reconstruction
in three stages. The first and second stages are completed
separately, one side at a time with one month interval. Then,
the third stage is performed for both sides at the same time,
three to six months after the second stage. According to the
length of a line between the eyebrow and tip of the nose, a
3D model of a patient with a previously reconstructed ear will
be selected, with the model length that should match the length
of this line. This model will be used as a template in total
auricular reconstruction. In the first stage reconstruction of
one side was done. Then, in the second stage reconstruction
of the other side was performed. In the third stage separation
of both sides was done simultaneously. The aesthetic outcome,
similarity of both sides, cost saving, postoperative complications
and patient satisfaction were assessed.
Results: The patients were followed-up for 1 year postoperatively.
The aesthetic outcome shows good patient satisfaction
and similarity of frameworks between both sides.
There was a decrease in the number of surgical stages without
an increase in the rate of complications or donor site morbidity.
Also, reduction in the surgical cost is considered one of the
advantages.
Conclusion: Management of patients with bilateral microtia
is feasible and effective in a three stages reconstruction.
It is considered both time and cost-effective treatment modality
with a significant aesthetic outcome, and high patient satisfaction.

Main Subjects

References

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