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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Method
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BackgroundMethod
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“Current reconstructive methods include 1) use of autologous costal cartilage or a synthetic framework to fashion an auricular construct, which is then implanted, or 2) placement of a prosthetic bone anchored ear.(2,3) Reconstruction using costal cartilage carries the risk of donor-site morbidity, with rigidity that is…”
Method
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“There are currently three widely accepted methods for auricular reconstruction: the use of an autologous cartilage graft from a rib costal cartilage donor site, Medpor® foreign body implant, or prosthetic reconstruction (Brent, 1992; Nagata, 1993; Park, 2000; Reinisch & Lewin, 2009 ; Tanzer, 1959).”
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Self-citation
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“Although the operation timing of auricular reconstruction has not been unified all over the world, scholars believe that the operation should be performed around the age of 6 years(3,4) or 10 years.(5) Therefore, the surgical cases reported in the literature are mainly adolescent patients.”
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“The two-stage method for adult congenital microtia relies on Nagata’s design concept.(3,12) We have made technical improvements tailored to adult patients.”
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“12 0 5 10 Nagata ( two stage) (8) Single stage using TPF flap (4) Dieffenbach (3) Converse (2) Mustardee with costal.”
Method
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“Two widely used and successful techniques based on autogenous rib grafts have been proposed by Brent [6, 7] and Nagata [8].”
Method
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“During auricular reconstruction using the Nagata technique, a mastoid skin ﬂ ap needed to be elevated.”
Background
Retroauricular Island Flap as an Innovation for Microtia Ear Reconstruction
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HSP90 and TLR4 Interplay in Keloids
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Craniofacial microsomia
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Periosteal Flap Technique for Elevation of the Pinna in Microtia
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“For total or major auricular reconstruction, the reconstructive method accompanied with the use of threedimensionally framed costal cartilage has been the most popular method since the report by Tanzer,(1) later popularized by Brendt and Nagata.(2) Many studies and techniques have been described in the literature for…”
Method
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BackgroundMethodInfluential
Pursuing Mirror Image Reconstruction in Unilateral Microtia: Customizing Auricular Framework by Application of Three-Dimensional Imaging and Three-Dimensional Printing
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Nanomaterials for cartilage tissue engineering
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RETRACTED ARTICLE: Comparative Assessment of Effectiveness of Various Fixation Methods for Auricular Prostheses
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Retracted
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“Nagata and Firmin use a V- or U-shaped cartilage piece to construct the tragus and antitragus [11, 12].”
BackgroundMethodInfluential
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[Anthropometric measurements of moderate concha-type microtia after auricular cartilage unfolding].
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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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