Microtia The ear is an important organ of the five senses, located on both sides of the skull. However, the absence of the outer ear due to congenital or acquired reasons not only affects its appearance, but is also a huge psychological blow to the patient. In the past, there were often either no solutions for these patients or the cost was too high for them to afford, so it is a great challenge for our doctors to return a beautiful and healthy auricle to the patient. Microtia, also known as congenital microtia syndrome, is a small ear deformity caused by congenital dysplasia or acquired trauma to the auricle, often accompanied by external auditory atresia, middle ear deformity and maxillofacial deformity, the incidence of which varies by region and race. The incidence of this disease is the second most common congenital malformation of the face, second only to cleft lip and palate malformation. The etiology of this disease is not clear, and no specific causative factors have been found. Maternal factors such as viral infection in early pregnancy, pre-eclampsia, medication, mental stimulation, radiation and environmental pollution may be one of the causes of microtia. Treatment The main method of treatment is surgical auricular reconstruction. Ear reconstruction is a complex and delicate surgery, and only a few hospitals are able to perform this type of surgery. Timing of surgery When to perform a reconstructive surgery depends on both psychological and personal considerations. Since children’s awareness of their bodies is usually formed at the age of 4-5 years old and can cause psychological developmental disorders due to ridicule from classmates when the child goes to school, ear reconstruction surgery should be performed before the child starts school. From a physiological point of view, the auricle of a 3-year-old child is already 85% of the size of an adult, and the width of the auricle almost stops growing after the age of 10. The length of the auricle of a child between the ages of 5 and 10 is only a few millimeters smaller than that of an adult, so if the auricle is reconstructed during this period, the size and shape of the reconstructed ear and the affected ear can be as similar as possible after adulthood. In terms of rib cartilage development, it is generally believed that children’s rib cartilage can be sculpted into ear scaffolds around the age of 6, and after the age of 15, the cartilage will calcify and harden. Surgical methods The Brent-Nagata method is the most widely used method for auricular reconstruction. It has the advantages of short time, few postoperative complications and realistic postoperative appearance. In the first stage, rib cartilage is surgically obtained, usually 2 cartilage for adults and 2-3 cartilage for children, and then sculpted into an ear scaffold and buried in the skin pocket of the mastoid area where the residual ear cartilage has been removed; at the same time, the remaining rib cartilage is buried under the skin of the chest for the second stage lift. Immediately after surgery, the auricular shape comes to life, but the reconstructed ear does not stand up and requires a second stage of surgery. The second stage is an auricular lift, usually six months after the first stage, to erect the fitting auricle and restore its three-dimensional structure. The hospital stay is about 7 to 10 days. After resting for about six months after this phase, the reconstructed ear is basically stabilized with skin reshaping and scar softening before the third phase of surgery. The third stage is to deepen the earnail cavity and reconstruct the ear screen on the basis of the completed ear reconstruction to make the reconstructed ear more perfect and realistic. The cost of auricular reconstruction is about 17,000 RMB for the first stage and 11,000 RMB for the second stage, the total cost is about 28,000 RMB, which is still very inexpensive, that is, you can return a healthy wish to a disabled child with very little money. Post-operative care and precautions Protect the reconstructed auricle from collision and extrusion, prevent mosquito bites in summer, avoid frostbite in winter and pay attention to warmth, wear soft scarves and ear muffs, and add an elastic lap band to the chest skin supply area to prevent scar growth. Stage II patients should have their stitches removed 7~10d after surgery. Patients should be instructed to pay attention to local hygiene, clean regularly to prevent infection, and the crusts at the wound should fall off by themselves, keep dry, and shower only when the trauma is completely healed. Dietary care: In order to reduce excessive facial muscle movements that pull the ear after surgery, patients should be instructed to eat a high-protein, full-liquid or semi-liquid diet, prohibit spicy and hard foods, eat small and frequent meals, and reduce talking. The reconstructed auricle is poorly elastic and should not be squeezed or collided by external forces to prevent skin breakdown and ear stent exposure.