Donor-site morbidity of ear cartilage autografts

Background: The external ear provides a versatile cartilage source for reconstructive procedures, especially for augmentative rhinoplasty. The authors evaluated the short- and long-term morbidity associated with ear cartilage harvest using concha, tragus, and scapha as donor sites. Methods: The study included 52 patients in whom a cartilage graft from the external ear was harvested between February of 2001 and June of 2005. Donorsite morbidity was assessed in the early postoperative follow-up period. Twenty-eight patients were examined within a follow-up time of 3 to 168 months. Long-term morbidity assessment included documentation of patients' subjective complaints, clinical examination of the donor site, and anthropometric measurements. Results: The relevant morbidity factors in the early postoperative period were hematoma formation (6.7 percent) and sensory impairment (3.3 percent). In long-term follow-up, sensory impairment was the most frequent condition objectively assessed and subjectively complained of (12.9 percent). Overall, sensory impairment was confined to concha as the donor site. Anthropometric measurements showed a mean difference in the length of the affected ear compared with the contralateral ear of 1.8 mm, a width difference of 2.5 mm, a difference in tragus/lateral canthus distance of 1.4 mm, and a difference in protrusion angle of 2.4 degrees. Statistically significant differences between values obtained from operated and nonoperated ears could not be detected for every evaluated parameter using the paired t test. Aesthetically relevant complications were rare and their occurrence restricted to single cases. Conclusion: Cartilage graft harvest from the auricle can be considered as a relatively safe procedure with a favorable aesthetic outcome.