Improvement of Quality of Life After Microtia Reconstruction Using a Modified Firmin Technique-Case Series of 130 Patients.

Abstract

Background: Microtia usually presents as a unilateral defect often associated with hearing impairment and significant psychosocial challenges. Reconstruction with autologous rib cartilage is currently the gold standard due to lower complication rates. However, outcomes remain variable.

Aims and objectives: This study aims to assess the outcomes of a modified two-stage surgery technique, focusing on complications, aesthetics, satisfaction, and quality of life.

Materials and methods: A retrospective review of 130 patients undergoing ear reconstruction from 2016 to 2022 was conducted. Data included defect etiology, classification, and complications. Quality of Life was assessed using an adaptation of the questionnaire proposed by UK Care Standards for the Management of Patients with Microtia and Atresia.

Results: Most patients had congenital microtia (78%), with type III being the most common (81%). The majority were male (73%), with a mean age of 21 years. Surgeon-assessed outcomes were good in 90% of cases. The most common complication was partial skin necrosis (13%). Among 73 respondents (answer rate of 56%), there was a significant improvement in quality of life post-reconstruction (p = 2.4e-12).

Conclusion: Modifications to Firmin's technique, such as smaller thoracic incisions, limited dissection, and specific flap designs, enhanced aesthetic results while reducing complications. In conclusion, our modified technique offers improved outcomes in microtia reconstruction, emphasizing the importance of technical refinements in achieving satisfactory results and enhancing patient well-being.

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