Wang Chenglong, Gao Dejin, Luo Pan, Wang Yue, Zhang Qingguo
From the Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College.
Plast Reconstr Surg. 2025 Jul 1;156(1):130-137. doi: 10.1097/PRS.0000000000011853. Epub 2024 Nov 5.
Microtia with constricted ear features represents a challenging congenital deformity characterized by the variable shape and large volume of the remnant cartilage and skin involved. This study aimed to evaluate the efficacy and safety of a method using helix costal cartilage scaffold and postauricular flap advancement for the correction.
This prospective study analyzed the clinical and postoperative data of 121 patients diagnosed with microtia and constricted ear features, treated at the authors' institution between January of 2020 and January of 2023. All patients underwent helix reconstruction using the eighth or ninth costal cartilage combined with postauricular flap advancement. Outcomes were assessed based on the incidence of postoperative complications and auricular aesthetic scores. The aesthetic evaluation of the reshaped auricle was based on a 4-point Likert scale (ie, 1 = poor, 2 = fair, 3 = good, and 4 = excellent).
The postoperative follow-up period ranged from 12 months to 3 years (mean, 18.5 months). All patients achieved successful helix expansion, with reconstructed ears showing improved symmetry and shape comparable to the contralateral normal ears. The average aesthetic score was 3.4 of 4. Complications included suture exposure in 8.3% of cases and cartilage protrusion in 4.1%, both managed without significant issues. There were no instances of skin necrosis, costal cartilage exposure, or infection.
The combination of helix costal cartilage scaffold and postauricular advancing flap offers a reliable and effective method for correcting microtia with constricted ear features, providing satisfactory aesthetic outcomes with minimal complications.
CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, IV.
小耳畸形合并耳郭狭窄是一种具有挑战性的先天性畸形，其特征是残余软骨和皮肤的形状各异且体积较大。本研究旨在评估使用耳轮肋软骨支架和耳后皮瓣推进法进行矫正的疗效和安全性。
这项前瞻性研究分析了2020年1月至2023年1月在作者所在机构接受治疗的121例诊断为小耳畸形合并耳郭狭窄患者的临床和术后数据。所有患者均使用第八或第九肋软骨结合耳后皮瓣推进进行耳轮重建。根据术后并发症发生率和耳郭美学评分评估结果。对重塑耳郭的美学评价基于4分李克特量表（即1 = 差，2 = 一般，3 = 好，4 = 优）。
术后随访期为12个月至3年（平均18.5个月）。所有患者均成功实现耳轮扩张，重建后的耳朵对称性和形状改善，与对侧正常耳朵相当。平均美学评分为4分中的3.4分。并发症包括8.3%的病例出现缝线外露，4.1%的病例出现软骨突出，均未出现严重问题。未发生皮肤坏死、肋软骨外露或感染情况。
耳轮肋软骨支架和耳后推进皮瓣相结合为矫正小耳畸形合并耳郭狭窄提供了一种可靠有效的方法，可提供令人满意的美学效果且并发症最少。
临床问题/证据水平：治疗性，IV级。
