In a first for South Tamil Nadu, ENT surgeons at Meenakshi Mission Hospital and Research Centre successfully reconstructed the ear of a 16-year-old boy born with microtia, a congenital condition characterised by an underdeveloped external ear, using cartilage harvested from his own ribs. In a remarkable achievement, the team completed the complex 3D ear reconstruction, which is traditionally performed in multiple stages, in a single surgery, minimising pain, reducing hospital stay, and enabling faster recovery.
The boy, born of a consanguineous marriage, had no hearing in his left ear since birth and relied entirely on his right ear for hearing. However, the underdeveloped left ear had become a major source of embarrassment, taking a significant psychological and emotional toll on him. The 3D ear reconstruction, performed primarily for cosmetic rehabilitation, has now gifted him a natural-looking ear that closely resembles his right ear.
Crafted using cartilage harvested from his own ribs and positioned precisely to mirror the opposite ear, the reconstructed ear blends seamlessly with the existing anatomy. As the surgeons utilised the patient’s own skin, there is no noticeable difference in colour or texture. The use of rib cartilage, known for its flexibility and durability, enables the reconstructed ear to bend like a normal ear. Importantly, because the reconstruction utilised the patient’s own tissues while preserving the underlying blood supply and nerve connections, the reconstructed ear has normal sensation, closely resembling a natural ear.
Performing the entire procedure in a single sitting was a significant achievement in itself, as it involved four distinct stages: harvesting rib cartilage; meticulously carving, shaping and suturing it to replicate the patient’s normal right ear; removing the underdeveloped ear while preserving the overlying skin and its underlying blood supply; and finally, positioning and securing the customised ear in the anatomically correct location. Conventionally, these stages are performed in a staged manner, with intervals ranging from a few hours to several days between procedures.
The surgery was led by Dr. D. R. Nageswaran, Senior Consultant & HOD, Department of ENT who underwent specialised training in Japan for this advanced technique.
In his comments, Dr. Nageswaran said that microtia affects approximately one in every 10,000 children. The incidence is relatively higher in Tamil Nadu, largely due to the prevalence of consanguineous marriages in certain communities. The condition often imposes a significant emotional and psychological burden on affected children because of the visible facial difference.
“While restoring hearing may not be possible in every case, we can now provide children with a natural-looking ear through advanced 3D ear reconstruction using the patient’s own rib cartilage, instead of artificial implants,” he said.
Dr. Nageswaran explained that although the human body has 12 pairs of ribs, only a few cartilage segments are required for the procedure. “In this case, we harvested cartilage from only four ribs. The surgery leaves minimal scarring at the donor site and does not compromise the strength or stability of the rib cage,” he added.
Dr. Nageswaran also emphasised that hearing impairment associated with microtia can often be addressed through early intervention. “There have been tremendous advances in hearing restoration, including cochlear implantation and other auditory rehabilitation procedures, which can significantly improve hearing outcomes in appropriately selected children,” he added.
Explaining the significance of the achievement, Dr. B. Kannan, Medical Administrator, said, “We are immensely proud of the surgical expertise demonstrated by our team. This is the first time such a complex 3D ear reconstruction has been performed in South Tamil Nadu. While similar procedures may have been carried out elsewhere in the State with the assistance of visiting experts from other cities, this surgery was planned and executed exclusively by our in-house team. What makes this achievement even more remarkable is that all four complex stages of the reconstruction were completed in a single sitting, reflecting the high level of skill, coordination and expertise of our surgeons.”
Dr. Rakesh R bright, Associate Consultant and Dr. Hariharan, Consultant were also present during this press meet.