Chaudhry Aneeq S, Shtanko Yulia, Wolfe S Anthony, Lewin Sheryl, Mejia Martha
Plastic and Reconstructive Surgery, Florida International University, Herbert Wertheim College of Medicine, Miami, USA.
Plastic and Reconstructive Surgery, Nicklaus Children's Hospital, Miami, USA.
Cureus. 2025 Mar 27;17(3):e81275. doi: 10.7759/cureus.81275. eCollection 2025 Mar.
This case report describes a unique approach to reconstructing microtia in a patient with microtia and craniofacial microsomia. Microtia is a congenital outer ear deformity that can vary in severity, from minor abnormalities to complete absence of the ear. The traditional methods for microtia reconstruction are autologous reconstruction using the patient's rib cartilage or alloplastic reconstruction using porous polyethylene. Autologous reconstruction typically begins around age six to 10 years of age when the rib cage is sufficiently large enough, while alloplastic reconstruction may be performed as young as three years of age. In this case, the surgeons used ear molding in infancy to alter the shape of the existing skin and cartilage, thus creating a larger surface area for the ear. This approach, which is not commonly used, aims to create a more favorable shape for the microtia remnant to assist in the eventual reconstruction. A subsequent procedure to elevate the microtic ear was performed at the time of the surgical repair of macrostomia (lateral cleft lip). Using ear molding in infancy for microtia reconstruction has several potential benefits. It can lead to a more natural ear appearance as the child ages, which can have positive psychological and social implications. By starting the reconstruction process early, the child may grow up with a less noticeable deformity. Finally, ear molding can also improve the shape of the newborn microtia ear leading to more favorable anatomy prior to surgery. This case report highlights the advantage of early intervention with ear molding for selective patients with grade I or grade II microtia in preparation for their future reconstruction, particularly in patients with associated syndromes who may have more unique anatomy.
本病例报告描述了一种针对患有小耳畸形和颅面短小畸形患者进行小耳畸形重建的独特方法。小耳畸形是一种先天性外耳畸形，严重程度各不相同，从轻微异常到耳朵完全缺失。传统的小耳畸形重建方法是使用患者的肋软骨进行自体重建，或使用多孔聚乙烯进行异体材料重建。自体重建通常在胸廓足够大时，大约在6至10岁开始，而异体材料重建则可在低至3岁时进行。在本病例中，外科医生在婴儿期采用耳模塑形来改变现有皮肤和软骨的形状，从而为耳朵创造更大的表面积。这种不常用的方法旨在为小耳畸形残端塑造更有利的形状，以辅助最终的重建。在修复大口畸形（外侧唇裂）手术时，进行了后续的抬高小耳的手术。在婴儿期使用耳模塑形进行小耳畸形重建有几个潜在的好处。随着孩子长大，它可以使耳朵外观更自然，这可能具有积极的心理和社会影响。通过尽早开始重建过程，孩子长大后畸形可能不那么明显。最后,耳模塑形还可以改善新生儿小耳的形状，在手术前形成更有利的解剖结构。本病例报告强调了对于I级或II级小耳畸形的选择性患者，早期采用耳模塑形进行干预以准备未来重建的优势，特别是对于具有相关综合征且解剖结构可能更独特的患者。
