Preoperative planning Careful preoperative planning is essential in repair of microtia. Correction should usually begin at about age 6, especially for unilateral cases. At this age the child has not been exposed to cruel teasing and there is sufficient cartilage for framework fabrication. Furthermore, the child at this age is aware of the problem, wants it resolved, and is able to manage the necessary postoperative care. Forty five percent of patients in a series by Brent underwent reconstruction between the ages of five and seven.
Preoperative photographs are essential.
To completely assess middle ear development, axial and coronal planes are necessary. If normal sensorineural function has been established preoperatively, the otologist can then assess middle and inner ear development and plan the third stage of the reconstruction. Auricular reconstruction is performed before the atresia repair as this ensures a virgin field without scars and compromised blood flow for the implanted auricular framework. Also, the cosmetic result is limited if the auricle has to be reconstructed around a bony canal drilled in the temporal bone. Method of Repair Autogenous cartilage is best since it has withstood the test of time.