Classification System of Congenital Microtia and Therapeutic Strategy

JIANG Hai yue; PAN Bo; LIN Lin

doi:10.3969/j.issn.1672-2922.2013.04.001

Abstract：The degree of phenotypic variability of congenital anomalies of the ear makes the development of a meaningful classifica-tion system challenging. Based on their clinical observation of many years, the authors classify microtia into 4 types to facili-tate choice of therapeutic methods. Type I:Ear is smaller than normal, but almost all the structures of a normal auricle are rec-ognizable, commonly combined with cup ear or protruding ear. There is no need for auricle reconstruction in this group. Free auricular composite tissue grafting or/and ear deformity correction can be used to improve morphology. Type II:Some struc-tures of a normal auricle are recognizable, such as tragus and concha. For severe superior cartilage folding (IIA), auricle convo-lution reduction and free auricular composite tissue transplantation may be useful. For other cases in this groups (IIB), auricle reconstruction will be needed. Type III:None of the structures of a normal auricle are recognizable. Auricle reconstruction is needed. Lobule reconstruction with remnant ear tissues is possible. Type IV: There are no useful remnants for lobule recon-struction. There may be a small random tag or scattered tags or nothing (anotia). Total auricle reconstruction (including lobule reconstruction) is needed. It is one of the core success factors to choose appropriate therapeutic methods according to the partic-ular types of microtia. It would be ideal if remnant ear tissue structures can be used in auricle reconstruction, with a goal of per-fect union of these remnants and reconstructed parts for the best possible outcomes.