Auricular Reconstruction of Congenital Microtia Using Modified Nagata Method: Personal 10-Year Experience with 1350 Cases

Publication date: Available online 19 June 2018
Source:Journal of Plastic, Reconstructive & Aesthetic Surgery
Author(s): Qiang Li, Xu Zhou, Yue Wang, Jin Qian, Qingguo Zhang
BackgroundTotal auricular reconstruction is currently one of the most challenging plastic procedures. Herein, we present our 10-year experience with 1350 cases of ear reconstruction using Nagata method with necessary improvement.MethodsBefore operation, factors related to ear reconstruction were carefully evaluated. These factors were remnant ear, mastoid skin, adjacent scalp, rib cartilages, normal ear, and mastoid process. An individualized design and precise framework fabricating were performed for each patient. Necessary modifications in fabricating base frame, helix, tragus, and antihelix were introduced to achieve a stable and individualized framework. These efforts also reduced the quantity of required cartilage for ear reconstruction.ResultsFollow-up time ranged from one month to five years, and 1217 (90.1%) patients were satisfied with the reconstructed ears, which showed appropriate color, texture, size, and location. The modifications made conferred a harmonious and individualized contour of the reconstructed ears. Complication incidences such as hematoma, skin necrosis, and framework absorption were all very low.ConclusionsBased on preoperative assessment, individualized design, and precise sculpting, a harmonious and individual auricle with detailed anatomical structures was achieved using our modified Nagata method. A stable and sophisticated framework can be fabricated with less cartilage requirement in this method.