Cited by 640Reconstructive Facial Surgery TechniquesCongenital Ear and Nasal AnomaliesNasal Surgery and Airway Studies

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A New Method of Total Reconstruction of the Auricle for Microtia

Nagata, Satoru·1993·Plastic and Reconstructive Surgery

DOI 10.1097/00006534-199308000-00001

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Abstract

This new method for total reconstruction of the auricle is a two-stage operation in which the first stage involves fabrication and grafting of a three-dimensional costal cartilage framework and the second stage is the ear elevation operation. The three-dimensional frame was designed with emphasis on the fabrication of the helical crus, intertragic notch, and antitragus and by extending the crus helicis and fixing it to the undersurface of the base frame. The reconstructed auricle will have four different floors: the cymba and cavum conchae are the bottom (fourth) level, the crus helicis is the third level, the fossa triangularis and the scapha are the second level, and the helix, anthelix, tragus, and antitragus are the top level. The skin incision was made in a W-shaped fashion to create skin flaps with ample surface area to cover the three-dimensional frame without skin grafting. Furthermore, the semilunar costal cartilage was utilized for ear elevation. Thus this new method for total reconstruction of the auricle eliminates the major problems encountered with the conventional method.

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Yturralde, K. J., Le, P. B., Martinez, O. P., et al. (2023) · Journal of Craniofacial Surgery · doi:10.1097/scs.0000000000009709 · Cited by 6
Reconstruction of Segmental Acquired Auricular Defects
Ali, S. N., Khan, M. A. A., Farid, M., White, N., & Yap, L. H. (2010) · Journal of Craniofacial Surgery · doi:10.1097/scs.0b013e3181d0258b · Cited by 6
“The Nagata method for auricular reconstruction uses autologus cartilage and is undertaken as a 2-stage procedure for the reconstruction of microtia.(2) In our cohort of acquired segmental auricular defects, this technique was modified into a single stage and was found to be suitable for reconstruction of segmental aur…”
Method
Cost analysis of microtia treatment in the Netherlands
Kolodzynski, M. N., Westerflier, C. V. A. V. H. T., Kon, M., & Breugem, C. C. (2017) · Journal of Plastic Reconstructive & Aesthetic Surgery · doi:10.1016/j.bjps.2017.06.026 · Cited by 6
“A reconstruction with autologous costal cartilage remains the golden standard and was introduced by Tanzer13, expounded by Brent14,15 and significantly influenced by the work of Nagata and Firmin.5,6,16 Reconstructions with a porous polyethylene implant advocated by Reinisch7 is gaining popularity.”
Background
Restoration of Ear Defects by Prefabricated Radial Forearm Flap
Trung, V. T., Long, P. V., & Van, H. T. (2020) · Plastic & Reconstructive Surgery Global Open · doi:10.1097/gox.0000000000002616 · Cited by 6
Microtia Part I: Preoperation and In-operation Lessons from 1012 Ear Reconstruction Operations
Chen, X., Zhang, R., Zhang, Q., et al. (2022) · Aesthetic Plastic Surgery · doi:10.1007/s00266-022-02818-6 · Cited by 6
“Since reports by Tanzer [1], Brent [2, 3], Nagata [4], Firmin [5] and others on microtia reconstruction methods, ear reconstructive surgery has seen further improvements and become more mature.”
Background
Thickness optimization of auricular silicone scaffold based on finite element analysis
Jiang, T., Shang, J., Tang, L., et al. (2015) · Journal of the mechanical behavior of biomedical materials/Journal of mechanical behavior of biomedical materials · doi:10.1016/j.jmbbm.2015.08.032 · Cited by 6
Auricular reconstruction with polyethylene implants or silicone prosthesis: A single institution experience
Kadah, B. A., Naumann, A., Schneider, M., Schick, B., Linxweiler, M., & Papaspyrou, G. (2018) · Journal of Cranio-Maxillofacial Surgery · doi:10.1016/j.jcms.2018.10.005 · Cited by 6
Guided cartilage regeneration using resorbable template.
Pomahač, B., Zuhaili, B., & Yusuf, K. (2007) · PubMed · Cited by 6
Soft-Tissue Reconstruction for Atypical Microtia Malformations and Trauma
Ghanem, M. A., Abreu, D. V., Quintanilla-Dieck, M. D. L., et al. (2008) · Archives of Otolaryngology - Head and Neck Surgery · doi:10.1001/archotol.134.8.879 · Cited by 6
Craniofacial Disorders
Berkowitz, C. D. (2005) · Elsevier eBooks · doi:10.1016/b978-0-323-01199-0.50148-1 · Cited by 6
Improvement of Quality of Life After Microtia Reconstruction Using a Modified Firmin Technique—Case Series of 130 Patients
Asirova, G. V., Wynands, J., & Almeida, D. (2025) · Aesthetic Plastic Surgery · doi:10.1007/s00266-025-04697-z · Cited by 5
“…auricu-locephalic angle similar to Brent’s technique, a fragment of cartilage from the ﬁfth rib is placed behind the auricle and covered with a temporoparietal fascia (TPF) ﬂap, combined with retroauricular skin advancement and a super-thin skin graft from the occipital region of the head [23, 24].”
Relationship between ear appearance and psychological function among congenital unilateral microtia after autologous cartilage ear reconstruction: a chain mediation model
Li, X., Li, C., Zhang, T., Xu, J., & Fu, Y. (2025) · BMC Psychology · doi:10.1186/s40359-025-03073-5 · Cited by 8
“The surgical approach employed in this study was based on the technique described by Nagata [21].”
Reconstruction of the Auricle with Autogenous Rib Cartilage Grafts
Kaji, N., & Asato, H. (2013) · Advances in oto-rhino-laryngology · doi:10.1159/000350608 · Cited by 5
Novel Classification of Posttraumatic Ear Deformities and its Surgical Management
Kumar, U., & Jain, P. (2020) · Indian Journal of Plastic Surgery · doi:10.1055/s-0040-1715187 · Cited by 7
Anatomical variant of the superficial temporal artery in temporoparietal fascia flap for microtia reconstruction
Ha, N. H., Vu, D. D., Ngo, L. M., & Tran, H. T. T. (2024) · Journal of Plastic Reconstructive & Aesthetic Surgery · doi:10.1016/j.bjps.2024.01.029 · Cited by 5

Authors: Nagata, S.
Corresponding author: Nagata, Satoru
Venue: Plastic and Reconstructive Surgery
Publisher: Ovid Technologies (Wolters Kluwer Health)
Published: 1993-08
Volume: 92
Issue: 2
Pages: 187-201
ISSN: 0032-1052 (ISSN-L)
DOI: 10.1097/00006534-199308000-00001
OpenAlex: W2002001684
Cited by: 640
References: 0
Citations by year: 2026: 25 · 2025: 34 · 2024: 34 · 2023: 37 · 2022: 21 · 2021: 43 · 2020: 95 · 2019: 42 · 2018: 37 · 2017: 22 · 2016: 23 · 2015: 25 · 2014: 28 · 2013: 20 · 2012: 17
FWCI: 0.87
Type: journal article
Language: en
Open access: closed
Locations: Plastic & Reconstructive Surgery (publishedVersion)
PubMed (publishedVersion)
Topics: Health Sciences › Medicine › Surgery › Reconstructive Facial Surgery Techniques
Health Sciences › Medicine › Genetics (clinical) › Congenital Ear and Nasal Anomalies
Health Sciences › Medicine › Surgery › Nasal Surgery and Airway Studies
Keywords: microtia, ear reconstruction, two-stage reconstruction, skin flaps
MeSH terms: Adolescent, Cartilage, Child, Ear, External, Female, Humans, Male, Reoperation, Surgery, Plastic, Surgical Flaps, Suture Techniques, Time Factors

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A New Method of Total Reconstruction of the Auricle for Microtia

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