Psychological effects of an ear deformity and age of external ear maturity play a significant role in the timing of reconstruction. We prefer to initiate treatment when the patient is 10 years of age. This allows for sufficient rib growth to provide the quantity of cartilage needed for adequate framework fabrication.

Our Technique involves two stages. It is based on an Ear Reconstruction technique developed by Dr Francoise Firmin from Paris.

The First Surgical Stage - Fabrication of Auricular Frame work from ipsilateral costal cartilage, tragus reconstruction, lobule transposition.

Modelling of the New Framework

Planning the Auricular Framework

1. Mark axis of normal ear and nose and transfer to affected side                                                       

2. Trace template from normal ear

3. Create cartilage framework templates

4. Doppler superficial temporal artery

5. Mark donor incision 1 cm above ipsilateral costal margin

6. Ipsilateral 6th, 7th, and 8th costochondral ribs junction harvested

10. The Auricular Framework shows all the anatomical details of future ear

11. Pocket Preparation

12. Insertion of Framework

Before                                                                After

13. The Final Result of First Stage

The Second Surgical Stage - Six months after the first stage, the second stage of ear reconstruction is performed.

Elevation of the Framework

2. The constructed cartilage is undermined and elevated. Another costal cartilage block is inserted to support the elevation of the ear

1. The Design for Incision Lines

3. A temporal parietal flascial flap is then transposed to provide soft-tissue coverage

4. The wound is closed with split thickness scalp skin graft

5. Dressing of the wound with one drain inserted

Surgical Techniques

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