An update on auricular reconstruction: three major auricular malformations of microtia, prominent ear and cryptotia.

PURPOSE OF REVIEW: Microtia, prominent ear, and cryptotia are the most common types of auricular malformations. This review provides updated information on these types of reconstructions, in addition to recalling previously accepted surgical methods. RECENT FINDINGS: Autogenous costal cartilage is still considered as an ideal material for framework fabrication in microtia reconstruction. Many surgeons have adopted the Nagata approach, the Brent approach, or variations of the two, in their work. With these employed techniques, auricles reconstructed by experienced surgeons have proven to be aesthetically promising. However, with regards to the harvesting of the costal cartilage, the underdevelopment of the chest wall donor site, alopecia of the scalp, and scarring of the postauricular-mastoid region are still considered problematic aspects of these approaches. Some articles have described attempts to solve these problems, whereas some experiments in cartilage production using tissue engineering techniques have shown promise in their initial stages of development.It is generally accepted that prominent ears should be corrected through a combination of sculpting and suture techniques, according to the individual shape and the quality of the ear prominence.Most of the cryptotia malformations show not only embedded upper auricles, but also associated adhesions of the upper auricular cartilage. Their correction should therefore resolve both deformities. SUMMARY: A number of articles highlighting clinical experiences with auricular reconstructions for microtia, prominent ear, and cryptotia have been included in this review. We believe that the information synthesized here will become a basis for further development of auricular reconstruction techniques.

An analysis of the bacterial flora found in the external auditory canals of microtia patients: results and clinical applications.

During the process of auricular reconstruction in cases of microtia patients with external auditory canals (EAC), bacterial contamination from the EAC can cause cartilage infection. In this article, we retrospectively analyzed the data on bacterial flora present in the EAC of these patients.Preoperatively, in 91 microtia patients, culture samples were obtained, and isolates were tested for in vitro susceptibility to antibiotics. One hundred volunteers with no ear abnormalities were also evaluated as part of the control group.Seventy-nine specimens in 91 microtia patients showed growth of bacteria (86.8%): a total of 97 organisms were isolated. Dominating bacteria were of the staphylococci species (85.6%). Fourteen Staphylococcus isolates were resistant to methicillin. The percentage of microtia patients showing a presence of methicillin-resistant staphylococci isolates (15%) was significantly higher than the percentage in the "normal" volunteer group showing a presence of methicillin-resistant staphylococci isolates (2%; P = 0.0009).To decrease the complications that occurred due to cartilage infection during auricular reconstruction in the cases of microtia with EAC, we suggest that bacterial floras of the EAC be routinely examined and the patients be treated with appropriate antibiotics preoperatively.