{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,10]],"date-time":"2026-10-10T04:35:46Z","timestamp":1791606946907,"version":"4.3.4"},"reference-count":17,"publisher":"Georg Thieme Verlag KG","issue":"02","license":[{"start":{"date-parts":[[2023,2,28]],"date-time":"2023-02-28T00:00:00Z","timestamp":1677542400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Indian J Plast Surg"],"published-print":{"date-parts":[[2023,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>\n          Introduction:\u2003Autologous costal cartilage framework placement is currently the gold standard in patients with microtia. In this article, we present the modifications developed by the author, generally following the principles established by Nagata, and discuss the technical details that have led us to achieve consistently stable and good long-term outcomes for auricular reconstruction in microtia.<\/jats:p><jats:p>\n          Materials and Methods:\u2003A retrospective review of microtia reconstruction performed from 2015 to 2021 was done. Those who underwent primary reconstruction for microtia and with a minimum follow-up of 6 months with documented photographs were included. Those who underwent secondary reconstruction for microtia and those who did not follow-up for a minimum period of 6 months were excluded. Outcomes were assessed with regard to appearance, and durability of the result. Influence of certain changes like delaying reconstruction until 15 years of age, use of nylon for framework fabrication, etc. over the outcome were assessed.<\/jats:p><jats:p>\n          Results:\u2003Of 11 ears reconstructed at less than 15 years of age, only one patient (9%) had a good long-term outcome, whereas of the 17 ears reconstructed at greater than 15 years of age, nine patients (53%) had a good long-term outcome. In our experience, infections and wire extrusions were the significant events related to severe cartilage resorption.<\/jats:p><jats:p>\n          Conclusion:\u2003In our experience, delaying the first stage to 15 years or later, using double-armed nylon sutures, and reducing the projection of the third layer of the framework in select cases have helped to improve our outcomes. Second stage of reconstruction can be avoided if patient is satisfied with the projection achieved in the first stage.<\/jats:p>","DOI":"10.1055\/s-0043-1762907","type":"journal-article","created":{"date-parts":[[2023,3,1]],"date-time":"2023-03-01T00:11:23Z","timestamp":1677629483000},"page":"130-137","source":"Crossref","is-referenced-by-count":6,"title":["Microtia Reconstruction: Our Strategies to Improve the Outcomes"],"prefix":"10.1055","volume":"56","author":[{"given":"Mohit","family":"Sharma","sequence":"additional","affiliation":[{"name":"Department of Plastic and Reconstructive Surgery, Amrita Hospital, Faridabad, Haryana, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Srilekha Reddy","family":"G.","sequence":"additional","affiliation":[{"name":"Amrita Institute of Medical Sciences, Kochi, Kerala, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shruti","family":"Kongara","sequence":"additional","affiliation":[{"name":"Amrita Institute of Medical Sciences, Kochi, Kerala, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vasundhara","family":"Jain","sequence":"additional","affiliation":[{"name":"Amrita Institute of Medical Sciences, Kochi, Kerala, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shravan Rai","family":"K.S","sequence":"additional","affiliation":[{"name":"Tara Healthcare, Jayanagar, Bengaluru, Karnataka, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ankita","family":"Harijee","sequence":"additional","affiliation":[{"name":"Amrita Institute of Medical Sciences, Kochi, Kerala, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abhinandan","family":"Badam","sequence":"additional","affiliation":[{"name":"Amrita Institute of Medical Sciences, Kochi, Kerala, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9350-2311","authenticated-orcid":false,"given":"Nirav G.","family":"Maharaja","sequence":"additional","affiliation":[{"name":"Amrita Institute of Medical Sciences, Kochi, Kerala, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas","family":"Joseph","sequence":"additional","affiliation":[{"name":"Department of Plastic and Reconstructive Surgery, KMC Hospital, Mangalore, Karnataka, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Janarthanan","family":"R.","sequence":"additional","affiliation":[{"name":"Amrita Institute of Medical Sciences, Kochi, Kerala, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1440-4500","authenticated-orcid":false,"given":"Subramania","family":"Iyer","sequence":"additional","affiliation":[{"name":"Amrita Institute of Medical Sciences, Kochi, Kerala, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2023,2,28]]},"reference":[{"key":"ref1","first-page":"19","article-title":"Sandhan karma -base of modern plastic and reconstructive surgery","volume":"5","author":"B Sakharkar","year":"2013","journal-title":"Rasamruta"},{"issue":"09","key":"ref2","doi-asserted-by":"crossref","first-page":"151","DOI":"10.47223\/IRJAY.2021.4918","article-title":"Sandhan karma -base of ayurveda and modern sciences -a review","volume":"4","author":"P Potalia","year":"2021","journal-title":"Int Res J Ayurveda Yoga"},{"key":"ref3","first-page":"1","article-title":"History of auricular reconstruction","volume":"68","author":"H Weerda","year":"2010","journal-title":"Adv Otorhinolaryngol"},{"issue":"04","key":"ref4","doi-asserted-by":"crossref","first-page":"247","DOI":"10.1055\/s-0031-1288915","article-title":"Historic aspects of ear reconstruction","volume":"25","author":"A Madjidi","year":"2011","journal-title":"Semin Plast Surg"},{"key":"ref5","volume-title":"Auricular reconstruction","author":"P C Neligan","year":"2018"},{"issue":"02","key":"ref6","doi-asserted-by":"crossref","first-page":"161","DOI":"10.1097\/00006534-197802000-00001","article-title":"Microtia\u2013a long-term follow-up of 44 reconstructed auricles","volume":"61","author":"R C Tanzer","year":"1978","journal-title":"Plast Reconstr Surg"},{"key":"ref7","first-page":"187","volume-title":"Reconstruction of the ear","author":"B D Brent","year":"2013"},{"issue":"02","key":"ref8","doi-asserted-by":"crossref","first-page":"221","DOI":"10.1097\/00006534-199402000-00001","article-title":"Modification of the stages in total reconstruction of the auricle: Part I. Grafting the three-dimensional costal cartilage framework for lobule-type microtia","volume":"93","author":"S Nagata","year":"1994","journal-title":"Plast Reconstr Surg"},{"issue":"02","key":"ref9","doi-asserted-by":"crossref","first-page":"231","DOI":"10.1097\/00006534-199402000-00002","article-title":"Modification of the stages in total reconstruction of the auricle: Part II. Grafting the three-dimensional costal cartilage framework for concha-type microtia","volume":"93","author":"S Nagata","year":"1994","journal-title":"Plast Reconstr Surg"},{"issue":"02","key":"ref10","doi-asserted-by":"crossref","first-page":"243","DOI":"10.1097\/00006534-199402000-00003","article-title":"Modification of the stages in total reconstruction of the auricle: Part III. Grafting the three-dimensional costal cartilage framework for small concha-type microtia","volume":"93","author":"S Nagata","year":"1994","journal-title":"Plast Reconstr Surg"},{"key":"ref11","volume-title":"Auricular reconstruction: congenital auricular defects\u2014microtia","author":"S Nagata","year":"2008"},{"issue":"02","key":"ref12","doi-asserted-by":"crossref","first-page":"144","DOI":"10.4103\/0970-0358.163050","article-title":"Objective analysis of microtia reconstruction in Indian patients and modifications in management protocol","volume":"48","author":"M Sharma","year":"2015","journal-title":"Indian J Plast Surg"},{"key":"ref13","doi-asserted-by":"crossref","DOI":"10.1055\/b-005-143332","volume-title":"Auricular Reconstruction","author":"F Firmin","year":"2017"},{"issue":"12","key":"ref14","doi-asserted-by":"crossref","first-page":"3213","DOI":"10.1016\/j.bjps.2021.08.004","article-title":"Long-term aesthetics, patient-reported outcomes, and auricular sensitivity after microtia reconstruction: a systematic review","volume":"74","author":"E M Ronde","year":"2021","journal-title":"J Plast Reconstr Aesthet Surg"},{"issue":"12","key":"ref15","doi-asserted-by":"crossref","first-page":"3235","DOI":"10.1016\/j.bjps.2021.08.001","article-title":"Long-term complications of microtia reconstruction: a systematic review","volume":"74","author":"E M Ronde","year":"2021","journal-title":"J Plast Reconstr Aesthet Surg"},{"issue":"06","key":"ref16","doi-asserted-by":"crossref","first-page":"456","DOI":"10.1089\/fpsam.2020.0144","article-title":"Risk factors for delayed resorption of costal cartilage framework following microtia reconstruction","volume":"22","author":"A Kim","year":"2020","journal-title":"Facial Plast Surg Aesthet Med"},{"issue":"03","key":"ref17","doi-asserted-by":"crossref","first-page":"652","DOI":"10.1097\/PRS.0000000000000063","article-title":"Single-stage autologous ear reconstruction for microtia","volume":"133","author":"L Kasrai","year":"2014","journal-title":"Plast Reconstr Surg"}],"container-title":["Indian Journal of Plastic Surgery"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/www.thieme-connect.de\/products\/ejournals\/pdf\/10.1055\/s-0043-1762907.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,5,5]],"date-time":"2023-05-05T00:12:38Z","timestamp":1683245558000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.thieme-connect.de\/DOI\/DOI?10.1055\/s-0043-1762907"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,2,28]]},"references-count":17,"journal-issue":{"issue":"02","published-online":{"date-parts":[[2023,5,4]]},"published-print":{"date-parts":[[2023,4]]}},"URL":"https:\/\/doi.org\/10.1055\/s-0043-1762907","archive":["Portico","CLOCKSS"],"relation":{},"ISSN":["0970-0358","1998-376X"],"issn-type":[{"value":"0970-0358","type":"print"},{"value":"1998-376X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,2,28]]}}}