External ear reconstruction in hemifacial microsomia

Restoration of a missing external ear is important for the child/adult with craniofacial deformities to achieve balance and harmony of the face and head. Ear reconstruction is not an isolated requirement, however. For 2 reasons, we believe that external ear reconstruction is an integral part of craniofacial reconstruction: (1) the auricle is located, not in the face mask, but just outside the face mask, and projects onto the posterior part of the temporal bone; and (2) isolated microtia may be an early clinical marker of hemifacial microsomia. This is the first English-language article describing the specific requirement for external ear reconstruction in hemifacial microsomia. It may also be the first article to describe the long-term follow-up of 2-stage ear reconstruction in hemifacial microsomia. After reviewing the long-term results, we offer recommendations on the management of microtia in hemifacial microsomia.