The application of multilayered three-dimensional costal cartilage framework in auricular reconstruction with expanded postauricular skin flap

Background: This study introduces a construction method for a multilayered threedimensional costal cartilage auricular framework and retrospectively analyzed its clinical effectiveness in auricular reconstruction with an expanded postauricular skin flap. Methods: We designed multiple techniques for constructing a multilayered three-dimensional costal cartilage auricular framework to enhance stability and aesthetic outcomes. Postoperative follow-up included a comprehensive morphological assessment of the reconstructed ears, as well as evaluations of postoperative complications and patient satisfaction. Results: The study collected data on 75 patients who underwent auricular reconstruction in our department between January 2021 and December 2022, totaling 81 ears. During the followup period of 1 to 2 years postoperatively, plastic surgeons conducted a comprehensive morphological assessment of the reconstructed ears. Of these, 64 ears (79.0%) were rated as having good morphology, 13 ears (16.0%) as moderate, and 4 ears (4.9%) as poor. A survey on patient satisfaction revealed that 62 patients (82.7%) were satisfied with their reconstructed ears, 11 patients (14.7%) found the results acceptable, and 2 patients (2.7%) deemed them unacceptable. Postoperative complications included infections in 2 ears (2.5%), hematoma in 1 ear (1.2%), cartilage framework exposure in 3 ears (3.7%), and hypertrophic scarring in 5 ears (6.2%). There were no instances of skin flap necrosis, frame deformation, absorption, or wire exposure during the follow-up period. Conclusions: The multilayered three-dimensional costal cartilage auricular framework we constructed for auricular reconstruction with an expanded postauricular skin flap resulted in the majority of reconstructed ears maintaining a satisfactory shape, with clear substructures, lifelike morphology, and strong three-dimensionality. Patient satisfaction with the surgical outcomes was high, achieving good stability and aesthetic effects. (c) 2025 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights are reserved, including those for text and data mining, AI training, and similar technologies.