Facial plast Surg 2008; 24(1): 120-128
DOI: 10.1055/s-2008-1037453
© Thieme Medical Publishers

Aesthetic Microtia Reconstruction with Medpor

Thomas Romo1  III , Shari D. Reitzen2
  • 1Division of Facial Plastic & Reconstructive Surgery, Lenox Hill Hospital, New York, New York
  • 2Department of Otolaryngology-Head & Neck Surgery, New York University Medical Center, New York, New York
Further Information

Publication History

Publication Date:
20 February 2008 (online)

ABSTRACT

The complex architecture of the auricle makes it one of the most challenging structures for the reconstructive surgeon to re-create. Overlying the ear’s unique cartilage framework are layers of varied soft tissues forming a three-dimensional organ, which is distinctively positioned on the head. Arguably, the most challenging auricle to reconstruct is third-degree microtia due to a near-total absence of native tissue and a need for lifelong durability of the reconstruction. Many methods of reconstruction have been studied; autogenous costal cartilage reconstruction has been one of the more traditional methods, with favorable long-term results reported by several surgeons. However, this technique requires tremendous artistic and technical skill on the part of the surgeon-sculptor to construct a realistic-appearing ear. High-density porous polyethylene (Medpor) is a stable, alloplastic implant that can integrate with host tissues, is resistant to infection, and has been successfully applied to reconstruction of the head and neck. For auricular reconstruction, Medpor-enveloped in a temporoparietal fascial flap with full-thickness skin graft coverage-is a durable and aesthetically gratifying alternative in microtic patients. This alternative surgical technique reduces surgical time and morbidity, standardizes results among surgeons, and facilitates an aesthetic, natural-appearing reconstruction of the auricle.