American Association of Plastic Surgeons

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Lessons Learned From 2327 Implant Ear Reconstructions
John Reinisch, MD1, Youssef Tahiri, MD2, Caitlin Pray, PA-C2;
1University of Southern Califonia, Los Angeles, CA, USA, 2Cedars-Sinai Medical Center, Los Angeles, CA, USA

PURPOSE: There are two dominant methods of surgical ear reconstruction for microtia. One uses rib cartilage and the second a porous polyethylene (PPE) implant. The senior author helped develop the PPE method of ear reconstruction in 1990 and has gradually modified the procedure to minimize complications and improve microtia outcomes over the last 34 years. Through September 2023, we have performed 2,327 implant ear reconstructions. We present the lessons learned from this large series.
Methods: A review of all patients having a primary ear reconstruction surgery for microtia was performed. Outcomes, complications, and modifications of the surgical process was noted.
Results: A total of 2,327 ear reconstructions were performed using a porous polyethylene framework. Of the total cases, 654 were done with a simultaneous atresia repair, 305 were done following a previously completed atresia repair, and 224 were done along with the placement of an implantable bone conduction hearing device. Changes in the implant design, surgical technique, and postoperative protocol were made to reduce complications and improve outcomes.
Conclusion: Performing ear reconstructions for over three decades has taught the authors 15 important lessons that make implant ear reconstruction an excellent and efficient method for microtia reconstruction.
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