Rib graft reconstruction versus osseointegrated prosthesis for microtia: asignificant change in patient preference

Until recently the options for reconstruction of the microtic ear were unsa tisfactory and the ear was often left alone. With recent advances, both aut ologous rib reconstruction and osseointegration produce good quality result s. It is our practice to offer all patients a choice of no surgery, autolog ous rib cartilage reconstruction or an osseointegrated prosthetic ear. This study reports on parental choice between the reconstructive options as ass essed by questionnaire. Earlier patients who have had their surgery were co mpared with more recent patients who have chosen an option but are awaiting surgery. In the patients who have had Surgery, seven (30%) chose a prosthe tic ear and 16 (69.5%) chose rib cartilage reconstruction, compared to thos e patients that are awaiting surgery, four (11%) chose a prosthetic ear and 31 (88.6%) chose rib cartilage reconstruction. The results show a signific ant increase in the choice for rib cartilage reconstruction in those patien ts awaiting surgery. Although high quality autologous reconstruction is not widely available we feel it is important that parents are at least informe d that it is an alternative to osseointegration and no surgery.