Framework growth after reconstruction for XXXX : is it real and what are the implications?

@entity1 @entity9407
Historically, fashioning an auricle for a @entity1 born with @entity9407 has been one of the most challenging endeavors in the repertoire of reconstructive surgeons. Despite many ideas advanced on types of materials for the auricular framework, the hands-down favorite and today's medium of choice is autogenous costal cartilage. A subject that remains up for discussion, however, is the question of growth potential in these cartilaginous frameworks. Popularization of the surgical technique for auricular reconstruction has led to much bandying about of opinions on this very important question of growth. Although previous reports allude to the probability of an increase in auricular size after reconstruction, this report is the first to document changes in auricular size with measurements taken directly from @entity1 at the time of graft implantation and during subsequent long-term follow-up. The goals of this study are to define the behavior of the autogenous framework after reconstruction of the microtic auricle. This information serves to clarify the issue of proper framework sizing and to make evident the early age at which reconstruction can begin. The records of @entity1 who underwent costal cartilage auricular reconstruction for grade III @entity9407 between 1990 and 1996 were reviewed, and a cohort of 10 @entity1 was chosen for inclusion based on availability for follow-up and lack of any interval modifications of their cartilaginous framework. The average age was 6.7 years, and the average time interval from initial reconstruction to follow-up was 3.2 years. Measurements of the auricular framework height and width were taken at implantation and at time of final follow-up, and measurements were recorded of the normal ears of @entity1 with unilateral @entity9407 . The mean auricular size was examined for significance of interval change using the two-sample Student's t tests, assuming unequal variances. The results revealed an average height increase of 5 mm (10.4 percent) in the study population. Auricular width changes averaged 2.75 mm (7.02 percent). Growth trends revealed a distinct tendency toward increasing auricular framework size over time, with slowing as @entity1 neared adolescence. Comparison of the reconstructed auricle to the normal ear of each @entity1 with unilateral @entity9407 showed that the reconstructed ear paralleled the growth of the normal side, with no statistically significant differences in height or width at follow-up. This is the first report of auricular framework behavior based on @entity1 having direct measurement of their framework initially and in long-term follow-up. This @entity1 sample underscores a clear pattern of growth in the reconstructed auricles paralleling that of the normal ears. The implications of this finding are important in that the initial oversizing of the framework becomes unnecessary. Moreover, the decision as to age at initial reconstruction is not affected by anticipated growth rates.
