Abstract
BACKGROUND: Total ear reconstruction in patients with microtia remains a complex aesthetic and technical challenge. Accurate positioning and customization of porous polyethylene implants are critical, yet current methods often rely on manual planning and intraoperative adjustments. METHODS: At Schneider Children's Medical Center, high-resolution 3D facial scans or CT data were used to design patient-specific preoperative jigs and a custom single-piece implant. The jig guided precise ear positioning using facial landmarks and incorporated vascular mapping via CTA to identify branches of the superficial temporal artery. BioMed Elastic 50A Resin was used for jig printing, and the implant was tailored to patient age and anticipated ear growth. RESULTS: The technique enabled accurate ear alignment with the contralateral ear, minimized intraoperative adjustments, and eliminated the need for implant assembly. The integration of vascular mapping into the jig improved flap design and may reduce complications. Compared to traditional methods, this 3D-guided approach demonstrated improved positioning accuracy, reduced operative time, and enhanced aesthetic predictability. CONCLUSIONS: This 3D-guided technique streamlines ear reconstruction and offers an efficient and reproducible solution that improves surgical planning and outcomes in patients with microtia.