Ear Reconstruction with Rib Grafts

The complete reconstruction of the ear using rib grafts is the most complicated surgical procedure for the ear. Though there are a number of other reconstruction techniques available, including implants, soft tissue and prosthetics, the most common technique uses rib cartilage to shape the ear.

Some of the conditions that may indicate a need for ear reconstruction include:
  • Microtia — absence of 1 or both ears since birth
  • Very small or underdeveloped ears
  • Trauma resulting in avulsed ears
  • Disease leading to the surgical removal of the ear

Who should undergo ear reconstruction with rib grafts?

The ideal age for repair of congenital ear defects is around 5-6 years old, when the ear has completely matured. Older patients may undergo the surgery any time. Patients who have been a victim of trauma may be able to reattach an avulsed ear immediately if the ear is in excellent shape and conditions are right. If the ear may not be immediately attached, it is often better to let the injured area heal for six months, so that a new ear may be reconstructed against healthy living tissue.

What happens during surgery?

Reconstructive ear surgery with rib grafts is often performed in a series of 4 procedures. When both ears need to be constructed the process may take as many as 6 separate surgeries. These surgeries are typically scheduled about 2-3 months apart. The construction of the new ear is often done from cartilage portions of the sixth, seventh or eighth ribs, which are shaped and sculpted to match the existing ear.

The first surgery involves the attachment of this rib graft to the ear opening using fine sutures. The second surgery involves the attachment of the earlobe, the third involves the elevation or lifting of the external contours of the ear, and the fourth and final surgery is the forming of the tragus and external canal. These surgeries may vary in scope and intensity due to the specifics of the procedure. Blood transfusions are typically not required. Tissue expansion may be used to create excess skin and tissue to cover the ear as needed.

What should I expect after ear reconstruction?

The recovery from each procedure is slightly different, but typically only the first procedure requires a hospital stay of generally 2-3 days. For all procedures, sutures may typically be removed after about a week. Bandages will be applied, and drains may be used to allow the release of any fluid buildup. Bruising should resolve in 5-10 days, and swelling in 2-5 weeks.

None of the 4 procedures should cause significant discomfort, but there could be some atypical pain or sensitivity, which may be treated with prescription medication if necessary.

Very unlikely complications of this procedure may include asymmetry, changes in sensitivity, hearing difficulties, and infection.

Learn more about ear reconstruction in Kansas City

Please contact our office in Kansas City to set up a consultation if you are a candidate for an ear reconstruction. Dr. Brian T. Andrews is more than happy to answer any questions or concerns you may have regarding the procedure.