A modified crescent cartilage block for improving the retroauricular contour of the reconstructed ear: A retrospective cohort study

BACKGROUND:The use of a semilunar cartilage block to elevate a reconstructed ear does not always achieve a well-defined auriculocephalic sulcus. Herein, we modified the conventional crescent cartilage block through sculpting a concavity at its posterior surface, with the aim of improving the retroauricular contour. The study aimed to verify the effectiveness and reliability of this modified cartilage block through a retrospective cohort study. METHODS:A retrospective review of patients who underwent Nagata microtia reconstruction between October 2017 and November 2018 were conducted. The esthetic outcomes of auricular projection and cranioauricular sulcus in patients who accepted the modified semilunar block were compared with those of patients who underwent the same procedure using the traditional crescent pad. RESULTS:A total of 163 (84 of the modified group and 79 of the traditional group) patients were included. The mean (median) esthetic scores for ear projection in the modification and traditional groups were 3.13 (3) and 3.06 (3), respectively. The rate of favorable ear projection in the modification group (83.3%) was similar with that in the traditional group (78.5%) (p = 0.550). The mean (median) esthetic scores for cranioauricular sulcus in the modification and traditional groups were 2.51 (3) and 2.90 (3), respectively. The rate of favorable retroauricular sulcus in the modification group was 75.9%, whereas that in the traditional group was 51.2%, with the differences reaching statistical significance (p = 0.001). CONCLUSIONS:The concave crescent-shaped block can improve the contour of the auriculocephalic sulcus under the premise of ensuring the ear projection.