"Mortise and Tenon Joint" Technique to Improve the Stability of Three-Dimensional Costal Cartilage Framework in Fully Expansion Ear Reconstruction.

Objective: For full expansion of ear reconstruction, the stability of a cartilage framework is very important. However, most techniques for framework fabrication focus on three-dimensional structure and adequate projection. Few studies are available on improving the stability of the reconstructed framework. This study introduces a new "mortise and tenon joint" technique to create a more stable framework in fully expansion ear reconstruction.

Methods: A total of 137 patients with microtia underwent full expansion ear reconstruction with the "mortise and tenon joint" technique from January 2018 to July 2022.

Results: Hematoma was found in 2 patients after the expander was implanted and evacuated timely to save the flap. Ear cartilage framework exposure occurred in 3 patients after the second stage of surgery. The wounds were debridement and covered by a retroauricular fascia flap with a skin graft. No other complications, such as infection, expander exposure, or rupture, were observed. All patients were followed up for 6 to 12 months after ear reconstruction and asked to fill in a form anonymously about their satisfaction with the reconstructed ear. One hundred thirty-four patients (97.8%) were satisfied with the results.

Conclusions: In fully expansion ear reconstruction, the "mortise and tenon joint" technique improves not only the stability of the cartilage framework but also the stereoperception of the reconstructed ear. Most patients who underwent the new technique were satisfied with clear contour and delicate substructures of the reconstructed ear, matched skin color, and long-term dimensional stability.