Correction of Congenital Microtia Using Stereolithography for Surgical Planning

Reconstruction of congenital microtia is one of the most challenging processes facing the reconstructive surgeon. Pioneering work by Tanzer1 and Brent2 established the foundation for techniques used in auricular reconstruction. The reconstructive procedure is a multistaged process that starts with the grafting of a well-sculpted cartilage framework.2 The goal is creation of a three-dimensional framework to match the proportions of the contralateral auricle. Traditional methods in auricular reconstruction use two-dimensional templates. As proposed by Tanzer1 and Brent,2 the contralateral normal pinna is traced on exposed radiographic film. The tracing is then cut out, reversed, and used as a template for the cartilage framework. Costal cartilage, harvested from the contralateral sixth, seventh, and eighth ribs, is assembled to form the basic framework of the new auricle. Experienced surgeons are adept in the art of carving the contours and proportions to duplicate a normal-appearing auricle. Three-dimensional auricular models have been developed by various authors using premade synthetic, three-dimensional templates, plaster models, and paper models to serve as a reference for the assembly and complex carving of the cartilage framework.3–5 These models reportedly decrease operative time, improve the contours and proportions of the cartilage framework, and facilitate teaching. A three-dimensional auricular model was developed at our institution by using stereolithography technology. Stereolithography uses digital data obtained through computed tomography to produce a life-size, anatomically accurate plastic model of the structure scanned. In this case, we constructed a mirror-imaged, stereolithographic, three-dimensional plastic model of the contralateral auricle in a patient with unilateral congenital microtia to serve as an intraoperative aid. The method and results of constructing a stereolithographic model of the auricle are presented.

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