Double Tissue Expanders in Auricular Reconstruction for Patients Following Aural Atresia Repair

ABSTRACT Objective This study aims to evaluate the efficacy of a three‐stage auricular reconstruction using double tissue expanders for patients with congenital microtia who have undergone prior aural atresia repair. The focus is on addressing the challenges posed by hypertrophic scar tissue at the opening of the external auditory canal, which complicates subsequent auricular reconstruction. Methods Sixteen patients with unilateral congenital microtia and previous aural atresia repair were retrospectively reviewed. All patients underwent a three‐stage auricular reconstruction with double tissue expanders for skin expansion, followed by ear reconstruction with autologous costal cartilage. Surgical outcomes were assessed through objective measurements of the reconstructed ear and patient satisfaction scores using a Likert scale and Visual Analog Scale (VAS). Results The mean follow‐up period was 11.63 ± 3.67 months. The reconstructed ears showed no significant differences in perimeter, width, and length when compared to the contralateral normal ear ( p > 0.05). Patient satisfaction rates were high, with 85% reporting satisfaction with the overall esthetic outcome. Complications included hematomas (12.5%) and a local infection leading to ear framework exposure (6.25%), which were successfully managed with conservative treatment. Conclusion The three‐stage auricular reconstruction technique with double tissue expanders is an effective and reliable method for auricular reconstruction in patients with prior aural atresia repair. It provides satisfactory esthetic outcomes, minimizes the need for skin grafting, and addresses the challenges associated with retroauricular hypertrophic scar tissue. Level of Evidence: 4.