Enhancement Of Aesthetic Outcomes In Patients With Bilateral Microtia

Background: Microtia is a complex and challenging condition for plastic surgeons, especially when it is bilateral, due to lack of a standard contralateral ear that could be used as a guide to achieve proper size and position of the newly reconstructed ear. Usually in bilateral cases each side is operated separately in two stages, with an overall four operative times for both sides. Objective: In the current study, we aim at reconstruction of bilateral ears in only three stages, taking into consideration the aesthetic outcomes, similarity of both sides, and overall patient satisfaction. Patients and Methods: In the current study, 12 patients with bilateral microtia underwent bilateral total ear reconstruction in three stages. The first and second stages are completed separately, one side at a time with one month interval. Then, the third stage is performed for both sides at the same time, three to six months after the second stage. According to the length of a line between the eyebrow and tip of the nose, a 3D model of a patient with a previously reconstructed ear will be selected, with the model length that should match the length of this line. This model will be used as a template in total auricular reconstruction. In the first stage reconstruction of one side was done. Then, in the second stage reconstruction of the other side was performed. In the third stage separation of both sides was done simultaneously. The aesthetic outcome, similarity of both sides, cost saving, postoperative complications and patient satisfaction were assessed. Results: The patients were followed-up for 1 year postoperatively. The aesthetic outcome shows good patient satisfaction and similarity of frameworks between both sides. There was a decrease in the number of surgical stages without an increase in the rate of complications or donor site morbidity. Also, reduction in the surgical cost is considered one of the advantages. Conclusion: Management of patients with bilateral microtia is feasible and effective in a three stages reconstruction. It is considered both time and cost-effective treatment modality with a significant aesthetic outcome, and high patient satisfaction.