Microtia Reconstruction in Children Based on the Nagata Method

BACKGROUND: Microtia reconstruction using the Nagata technique is seldom offered to younger patients under 10 years, as there may not be enough cartilage for reconstruction. In this study, we present our 13-year experience of microtia reconstruction by using the modified Nagata method in patients aged ≤10 years. METHODS: Technical modifications included a refinement to the first-stage framework fabrication, whereby the base frame was sufficiently broadened to accommodate the helical crus. Besides shaping the helix, the eighth costal cartilage was split into another 2 pieces, followed by a novel use of the inferior portion to create the antihelix-antitragus complex, and the thick C-shaped portion was used for a second-stage projection strut with the residual cartilage pieces. An alternative surgical technique using expanded polytetrafluoroethylene (e-PTFE) was introduced to the patients without cartilage leftovers during ear elevation. RESULTS: Between 2012 and 2025, 255 ears were reconstructed in 242 patients aged 7 to 10 years using this technique. During more than 1 year of follow-up, 222 patients (91.7%) had satisfactory outcomes. Surgery-related complications (hematoma, infection, and skin necrosis) occurred in 9 ears (3.53%). Framework resorption by habitual compression with the affected ear was 2.75%. CONCLUSIONS: Microtia reconstruction using the Nagata method in patients aged ≤10 years can be safe and successful. It should be considered as an option for growing microtia patients with relatively early reconstruction.