Current Management of Microtia

Background and Purpose: Microtia reconstruction remains one of the most challenging procedures
encountered by the reconstructive surgeon. A national report on the current management of microtia
has never been presented before. The purpose of this project was to survey members of the American
Society of Plastic Surgeons (ASPS) to identify their preferences and practices and report their opinion
regarding issues related to microtia reconstruction.

Methods: An anonymous web-based survey consisting of 19 questions was distributed to the members
of the ASPS. Questions focused on the management of microtia. The study design was descriptive, using
correlational data analysis.

Results: Thirty-eight percent of respondents perform microtia reconstruction; 91 percent learned the
autogenous cartilage based reconstruction, while only 16 percent were exposed to alloplastic
reconstruction, respectively; 70 percent of respondents learned autogenous cartilage based ear
reconstruction exclusively. Fifty percent report a steep learning curve. In the pediatric patient
population, 49 percent prefer performing the surgery between 7-10 years of age, while 40 percent
prefer 4-6 years of age. Fifty-nine percent believe that in 15 years, tissue engineering will represent the
gold standard of microtia reconstruction.

Conclusion: Staged microtia repair using autogenous cartilage remains the heavily favored method of
microtia reconstruction amongst plastic surgeons. Moreover, there is a deficiency in training relative
to newer surgical techniques, such as alloplastic and osseointegrated options. This study also
highlights the continuing need to elucidate the optimal timing for microtia repair in the pediatric
patient in order to mitigate the potential psychosocial morbidity well described in the literature.