Evaluation of Patient-Specific Three-Dimensional Printed Templates for Framework Carving in Autologous Microtia Reconstruction: A Prospective Randomized Comparative Study

Framework carving is the most difficult step in autologous microtia reconstruction. Conventional two-dimensional (2D) templates provide only a flat outline and do not reflect the depth and three-dimensional shape of the auricle, whereas a patient-specific three-dimensional (3D) printed template may improve intraoperative visualization of the ear during carving. This prospective randomized comparative study was conducted on 20 patients with unilateral microtia who were randomly allocated into 2 equal groups. Group A (n=10) underwent reconstruction using patient-specific 3D-printed auricular templates, and Group B (n=10) underwent reconstruction using conventional 2D templates. Patient satisfaction was assessed using the Visual Analog Scale (VAS), and aesthetic outcome was assessed using the Ear Assessment Rating (EAR) score by a blinded surgeon; postoperative complications and the need for secondary surgical procedures were also recorded. Patient satisfaction was significantly higher in the 3D group (VAS 9.2±0.63 versus 7.0±0.67, P<0.001), and the mean EAR score was significantly greater in the 3D group (12.0±0.82 versus 8.5±1.18, P<0.001). Postoperative complications occurred in 1 patient (10%) in each group (P>0.99), and secondary procedures were required in 2 patients (20%) in the 3D group versus 3 patients (30%) in the 2D group (P=0.62). Patient-specific 3D-printed templates significantly improved aesthetic outcomes and patient satisfaction, with complication and secondary-procedure rates comparable to those of conventional templates, and represent a valuable adjunct for framework fabrication in autologous microtia reconstruction.