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Using a child's rib cartilage to carve an ear framework has been the standard of care for more than 40 years. Rib cartilage reconstruction for microtia patients is an invasive technique that requires between two to four surgeries. The surgeries start when the child has grown big enough to provide enough cartilage to make an adult-sized ear, typically between six and 10 years of age.
First, the cartilage from several ribs is removed through an incision on the child's chest. The cartilage is then meticulously carved and pieced together to form an ear framework. This framework is buried under the scalp and after the ear has healed, more surgeries are required to complete the reconstruction: bringing the ear away from the scalp, repositioning the earlobe and other adjustments.
Advantages of Rib Cartilage Ear Reconstruction
The advantages of rib cartilage ear reconstruction for microtia patients are:
- The technique uses the body's own tissue exclusively
- It is a well-proven standard technique for ear reconstruction
- In expert hands, the patient may have an excellent, long-lasting result
- After surgery, rib cartilage ears are able to withstand the rigors of most sports. Protective helmets are recommended for contact sports such as wrestling or football.
Disadvantages of Rib Cartilage Ear Reconstruction
The disadvantages of rib cartilage ear reconstruction for microtia patients are:
- Removing rib cartilage is painful and requires one or two nights of hospitalization, intravenous pain medication and a permanent chest scar.
- Removal of rib cartilage may cause a chest wall deformity
- Atresia (ear canal) surgery cannot begin until the ear reconstruction is complete, often delaying hearing restoration for years
- The normal ear may have to be surgically "pinned back" to match the reconstructed ear more closely
- Since the cartilage frame is placed under the existing scalp, a low scalp hairline results in a "hairy" ear
- As with any surgery, an inexperienced microtia surgeon may produce poor results or loss of the reconstruction