16.0: Thursday, March 17, 2005

A Better Intra-Operative Template for Use in Microtia Reconstruction: the Waterproof, Sterile Mirror-Image Ear

Walter Ting-Yu Chang, MD and Mitchell Stotland, MD.

Satisfactory treatment of the microtic ear represents a technical and artistic challenge for the plastic surgeon. The standard of care in 2005 remains a staged autologous reconstruction based on the landmark work of Tanzer, popularized and modified by contemporary surgeons such as Brent and Nagata. At the time of costochondral framework fabrication, as the subtle auricular contours are fashioned, most surgeons find it helpful to employ some form of model to provide artistic cues. While it is easiest to enlist willing volunteers in the operating room who will lend an ear, the value of this practice is limited by variability in ear size and detail, lighting, viewing angle, as well as inaccessibility from within the sterile field. As a result, surgeons have traditionally used a sterile template created from the patient's contralateral normal ear. The disadvantages of traditional methods for creating these templates, however, are that they may be tedious and/or offer a crude facsimile lacking any three-dimensional cues. Due to these considerations, we have developed an ear template consisting of a waterproof, sterile, mirror-image digital photograph of the normal ear. It is simple and inexpensive to make and offers several practical advantages.