Episode # 3 • 17 Jan 2025
Microtia Reconstruction with Rib Cartilage Explained
with Dr. Sean Evans, Dr. Jason Qian
How do you guide families through the complex journey of microtia repair from infancy to reconstruction? On this episode of BackTable ENT & Allergy Podcast, host Dr. Jason Qian welcomes Dr. Sean Evans, Assistant Professor of Otolaryngology, Head and Neck Surgery at Emory University and pediatric otolaryngologist at Children's Healthcare of Atlanta, to discuss autologous rib cartilage auricular reconstruction. They discuss referral pathways, early hearing management, how to counsel families across all reconstruction options, and the grading and staging vocabulary that can trip up trainees.
Timestamps
00:00 - Introduction
04:15 - Reconstruction Options and Counseling
09:40 - Microtia Grading and Staging
16:11 - Bone Conduction Implant Selection
21:16 - Preoperative Imaging and Planning
24:58 - Anesthesia and Pain Control
29:00 - Rib Harvest Technique
34:07 - Skin Flap Elevation and Thickness
39:31 - Framework Carving and Fixation
45:02 - Refining the Cartilage Construct
50:43 - Case Photos and Stage Two
56:52 - Postoperative Wound Care
01:00:21 - Closing Remarks
Resources
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More about this episode
The conversation moves into surgical planning and technique, from preoperative imaging and the Jahrsdoerfer score to multimodal pain control, rib harvest, flap thickness, and skin redraping. Dr. Evans details the two-surgeon approach, intraoperative challenges like pleural injury, and the nuances of framework carving and fixation. The episode covers wound care, laser hair removal, mentoring, and why continuous learning, from case photos to texting mentors, remains essential for mastering microtia repair.
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