Auricular reconstruction in congenital anomalies of the ear.

In looking at the use of autogenous cartilage for auricular reconstruction as a corrective option for congenital anomalies of the ear, it is obvious that it has become refined to the point that the surgical outcome typically pleases patients and their families if their expectations are realistic. Thus, surgeons are able to help ward off the agonizing abuse that these young patients are inevitably subjected to when born with deformities that are visible to peers. Delay of reconstruction beyond age 10 can lead to significant, and possibly, permanent psychologic sequelae resulting from harassment. Key elements of successful auricular reconstruction are careful staging of surgeries, effective communication with family as to expectations and results, and selection of a surgeon with extensive experience. The risk versus reward question can be answered clearly by one look at the face of a delighted child who is moved to tears when his or her bandages are removed; parents, of course, are equally gratified. Although more studies are needed to pinpoint specific problems and forestall complications, this is certainly a viable surgical series that parents of children with microtia would do well to consider thoroughly. At the same time, this author strongly encourages plastic surgeons to fine-tune their skills in this area so that the operation can be made more widely available. Extreme satisfaction is inherent in perfecting and using this complex orchestration of staged procedures.