Abstract: Objective To introduce the modifications in autogenous rib cartilage reconstruction of microtia, so as to present more natural and stable morphology of the reconstructed ear. Methods From 2009, 234 cases of microtia were received modified total ear reconstruction by autogenous costal cartilage. Modifications of the two-staged surgery were as follows: Decreasing the needed rib cartilage into 6~8 in donor site;Different cartilage framework in different patient;Designing a U shape cartilage block to support the complex of tragus and antitragus; The negative suction management in the second stage surgery;Using specific bone cement in the second stage surgery for ear elevation. Results All the patients were followed up for more than 6 months, most reconstructed ears were satisfiable in symmetry and stability of the three dimensional morphology and the cranio-auricular angle. Skin color and texture were favorable as well. The most common complication was reduction of the projection angle of the constructed ear caused by hypertrophic scars and severe scar contractures. Conclusion These modifications in autogenous rib cartilage reconstruction of microtia are effective and practical. So far the results of ear reconstruction are satisfactory but not in complete control.

Key words: Congenital microtia, Total ear reconstruction, Autogenous costal cartilage, Modification