This video demonstrates the carving and creation of the auricular framework as performed by Dr. Rousso after harvesting cartilaginous ribs 6-9. This is a modification of the techniques described by Dr. Nagata and Dr. Firmin.
Surgical steps in the carving of microtia in order to create a new auricular framework from the patients autologous rib.
medical comorbidities including restrictive lung diseases.
patients that are younger than 8 do not always have enough rib cartilage that can be harvested for a procedure like this.
setup for the carving portion of the microtia reconstruction procedure should be done on a separate table with needle drivers, sutures, 3mm and 4mm skin punches, saline. The table should ideally be facing the microtic ear while carving to assure laterality is correct.
physical exam including palpation of rib cartilage length
pre-operative pediatric clearance
6&7th rib with its synchondrosis for base frame and the tragus-antitragus complex
8th rib floating -for creation of helix
9th rib floating - for creation of antihelix
more difficult procedure than a synthetic implant surgery
risks of pneumothorax with rib cartilage harvest.
Risk of extrusion
risk of infection, bleeding, seroma .