{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T13:02:25Z","timestamp":1791378145112,"version":"4.3.2"},"reference-count":14,"publisher":"SAGE Publications","issue":"4","license":[{"start":{"date-parts":[[2014,7,1]],"date-time":"2014-07-01T00:00:00Z","timestamp":1404172800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["JAMA Facial Plast Surg"],"published-print":{"date-parts":[[2014,7]]},"abstract":"<jats:sec>\n                    <jats:title>Importance<\/jats:title>\n                    <jats:p>Auricular reconstruction is a unique blend of cosmesis and functionality. The choice of the optimal framework material to use is an important decision for the patient with microtia.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To evaluate and compare the outcomes of reconstruction of microtia using porous polyethylene implants and rib cartilage grafts.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design, Setting, and Participants<\/jats:title>\n                    <jats:p>Retrospective medical record review from January 1, 2001, through December 31, 2012, at a tertiary academic institution. Thirty-five patients (36 ears) undergoing microtia repair were divided into groups using high-density porous polyethylene (17 ears), rib cartilage (17 ears), and both materials (2 ears). Only patients with completed repair were included in the analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Exposures<\/jats:title>\n                    <jats:p>Reconstructive surgery for microtia.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Main Outcome and Measures<\/jats:title>\n                    <jats:p>We compared groups in terms of mean number of operations, age at treatment initiation, and complications (infection, extrusion, cartilage exposure, and pneumothorax). Photographs were graded by blinded observers to give each patient a score on protrusion, definition, shape, size, location, and color match.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The cartilage group was older than the polyethylene group (mean age, 8.0 vs 6.9 years;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2009=\u2009.23). The mean number of operations was 4.88 for the cartilage group vs 3.35 for the polyethylene group (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2009=\u2009.004). Two patients in the polyethylene group had postoperative infections and implant extrusion and underwent subsequent reconstruction with cartilage grafts. Patients in the cartilage group had no infection or extrusion; 1 had a minor cartilage exposure. No patient had pneumothorax. Patients in the polyethylene group had significantly better grades for ear definition and size match, whereas those in the cartilage group had a significantly better color match. Patients in the cartilage group had better protrusion and location outcomes, although the difference was not significant.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions and Relevance<\/jats:title>\n                    <jats:p>Comparison of reconstruction with porous polyethylene implants and rib cartilage grafts showed neither material to be clearly superior. Polyethylene implants may achieve a better cosmetic outcome in the categories of ear definition, shape, and size with a higher risk for infection and extrusion. Patients in the cartilage group were older and underwent significantly more surgical procedures, which should factor into the decision on which technique to choose.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of Evidence<\/jats:title>\n                    <jats:p>\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"http:\/\/archfaci.jamanetwork.com\/public\/instructionsForAuthors.aspx#SecLevelofEvidence\">3<\/jats:ext-link>\n                      .\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1001\/jamafacial.2014.30","type":"journal-article","created":{"date-parts":[[2014,4,24]],"date-time":"2014-04-24T18:31:20Z","timestamp":1398364280000},"page":"240-244","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":73,"title":["Comparison of Microtia Reconstruction Outcomes Using Rib Cartilage vs Porous Polyethylene Implant"],"prefix":"10.1177","volume":"16","author":[{"given":"Kristin K.","family":"Constantine","sequence":"first","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery, The University of Texas Southwestern Medical Center, Dallas"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jim","family":"Gilmore","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery, The University of Texas Southwestern Medical Center, Dallas"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kenneth","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery, The University of Texas Southwestern Medical Center, Dallas"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"suffix":"Jr","given":"Joseph","family":"Leach","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery, The University of Texas Southwestern Medical Center, Dallas"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2014,7,17]]},"reference":[{"issue":"2","key":"e_1_3_1_2_2","doi-asserted-by":"crossref","first-page":"161","DOI":"10.1097\/00006534-197802000-00001","article-title":"Microtia: a long-term follow-up of 44 reconstructed auricles.","volume":"61","author":"Tanzer RC","year":"1978","unstructured":"Tanzer RC. Microtia: a long-term follow-up of 44 reconstructed auricles. Plast Reconstr Surg. 1978; 61(2):161-166. 622405","journal-title":"Plast Reconstr Surg"},{"key":"e_1_3_1_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0094-1298(20)31239-6"},{"issue":"2","key":"e_1_3_1_4_2","doi-asserted-by":"crossref","first-page":"319","DOI":"10.1097\/00006534-199908000-00001","article-title":"Technical advances in ear reconstruction with autogenous rib cartilage grafts: personal experience with 1200 cases.","volume":"104","author":"Brent B","year":"1999","unstructured":"Brent B. Technical advances in ear reconstruction with autogenous rib cartilage grafts: personal experience with 1200 cases. Plast Reconstr Surg. 1999; 104(2):319-338. 10654675","journal-title":"Plast Reconstr Surg"},{"issue":"2","key":"e_1_3_1_5_2","doi-asserted-by":"crossref","first-page":"257","DOI":"10.1016\/S0094-1298(01)00013-X","article-title":"Microtia repair with rib cartilage grafts: a review of personal experience with 1000 cases.","volume":"29","author":"Brent B","year":"2002","unstructured":"Brent B. Microtia repair with rib cartilage grafts: a review of personal experience with 1000 cases. Clin Plast Surg. 2002; 29(2):257-271, vii. 12120682","journal-title":"Clin Plast Surg"},{"key":"e_1_3_1_6_2","doi-asserted-by":"publisher","DOI":"10.1097\/00006534-199308000-00001"},{"issue":"4","key":"e_1_3_1_7_2","first-page":"371","article-title":"Total auricular reconstruction with a three-dimensional costal cartilage framework.","volume":"40","author":"Nagata S","year":"1995","unstructured":"Nagata S. Total auricular reconstruction with a three-dimensional costal cartilage framework. Ann Chir Plast Esthet. 1995; 40(4):371-403. 8561450","journal-title":"Ann Chir Plast Esthet"},{"issue":"1","key":"e_1_3_1_8_2","doi-asserted-by":"crossref","first-page":"35","DOI":"10.1080\/02844319850158930","article-title":"Ear reconstruction in cases of typical microtia: personal experience based on 352 microtic ear corrections.","volume":"32","author":"Firmin F","year":"1998","unstructured":"Firmin F. Ear reconstruction in cases of typical microtia: personal experience based on 352 microtic ear corrections. Scand J Plast Reconstr Surg Hand Surg. 1998; 32(1):35-47. 9556819","journal-title":"Scand J Plast Reconstr Surg Hand Surg"},{"issue":"4","key":"e_1_3_1_9_2","doi-asserted-by":"crossref","first-page":"384","DOI":"10.1097\/SAP.0b013e31819fae51","article-title":"Reconstruction of congenital microtia-atresia: outcomes with the Medpor\/bone-anchored hearing aid-approach.","volume":"62","author":"Romo T","year":"2009","unstructured":"Romo TIII, , Morris LG, , Reitzen SD, , Ghossaini SN, , Wazen JJ, , Kohan D. Reconstruction of congenital microtia-atresia: outcomes with the Medpor\/bone-anchored hearing aid-approach. Ann Plast Surg. 2009; 62(4):384-389. 19325342","journal-title":"Ann Plast Surg"},{"issue":"2","key":"e_1_3_1_10_2","doi-asserted-by":"crossref","first-page":"129","DOI":"10.1016\/j.fsc.2006.01.006","article-title":"Medpor alternative for microtia repair.","volume":"14","author":"Romo T","year":"2006","unstructured":"Romo TIII, , Presti PM, , Yalamanchili HR. Medpor alternative for microtia repair. Facial Plast Surg Clin North Am. 2006; 14(2):129-136, vi. 16750770","journal-title":"Facial Plast Surg Clin North Am"},{"issue":"1","key":"e_1_3_1_11_2","doi-asserted-by":"crossref","first-page":"120","DOI":"10.1055\/s-2008-1037453","article-title":"Aesthetic microtia reconstruction with Medpor.","volume":"24","author":"Romo T","year":"2008","unstructured":"Romo TIII, , Reitzen SD. Aesthetic microtia reconstruction with Medpor. Facial Plast Surg. 2008; 24(1):120-128. 18286440","journal-title":"Facial Plast Surg"},{"issue":"3","key":"e_1_3_1_12_2","doi-asserted-by":"crossref","first-page":"181","DOI":"10.1055\/s-0029-1239448","article-title":"Ear reconstruction using a porous polyethylene framework and temporoparietal fascia flap.","volume":"25","author":"Reinisch JF","year":"2009","unstructured":"Reinisch JF, , Lewin S. Ear reconstruction using a porous polyethylene framework and temporoparietal fascia flap. Facial Plast Surg. 2009; 25(3):181-189. 19809950","journal-title":"Facial Plast Surg"},{"key":"e_1_3_1_13_2","first-page":"53","article-title":"Ear reconstruction with porous polyethylene implants.","volume":"68","author":"Berghaus A","year":"2010","unstructured":"Berghaus A, , Stelter K, , Naumann A, , Hempel JM. Ear reconstruction with porous polyethylene implants. Adv Otorhinolaryngol. 2010; 68:53-64. 20442561","journal-title":"Adv Otorhinolaryngol"},{"issue":"4","key":"e_1_3_1_14_2","doi-asserted-by":"crossref","first-page":"518","DOI":"10.1007\/s00266-008-9249-0","article-title":"Combined fascial flap and expanded skin flap for enveloping Medpor framework in microtia reconstruction.","volume":"33","author":"Yang SL","year":"2009","unstructured":"Yang SL, , Zheng JH, , Ding Z, , Liu QY, , Mao GY, , Jin YP. Combined fascial flap and expanded skin flap for enveloping Medpor framework in microtia reconstruction. 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