Subtractive thinking: A novel combined application of antihelix reconstruction and outer helix reconstruction to treat mild cases of type I to II conchal microtia.

BACKGROUND: The management of mild cases of type Ⅰ to Ⅱ conchal microtia involves grafting cartilage to the affected ear to increase the cartilaginous area and transfer more skin to cover the larger cartilage. Herein, we performed a novel combined surgical procedure based on "subtractive thinking" that included antihelix reconstruction and outer helix reconstruction that was successful in patients with mild type I to II conchal microtia.

METHODS: From January 2018 to September 2022, 65 patients with mild, unilateral, type I to II conchal microtia were enrolled in this study. All patients were treated with a novel method at the Plastic Surgery Hospital of Peking Union Medical College. The perimeters, widths, and lengths of the healthy and affected ears were measured both preoperatively and postoperatively. Patients' levels of satisfaction were determined based on postoperative results.

RESULTS: The mean postoperative follow-up duration was 14.9 ± 2.65 months. All patients experienced no complications. Analysis revealed that our surgical method could effectively treat mild type I to II concha microtia irrespective of the auricular perimeter, width, and length (p < 0.0001). Furthermore, the patient satisfaction rate was 100%.

CONCLUSION: The combined surgical procedure, which includes antihelix and outer helix reconstructions, is a viable method of reconstructing type I to II auricular concha microtia.