Purpose Ear reconstruction is a challenging operation with a steep learning curve. In view of its rarity, attaining a high standard for new surgeons is extremely difficult. This study describes the author’s experience with 57 ear reconstructions using costal cartilage for congenital and post-traumatic ear deformity.
Methods
We performed 53 autologous ear reconstructions for microtia and post-traumatic ear defect over a period of 10 years utilizing the two-stage technique popularized by Firmin in most of the cases. An assessment of complications, pattern of progress and aesthetic outcome of the reconstructed ears was carried out.
Results
There were 4 cases of partial skin necrosis. In early cases, deficiencies were seen in the proportions of the reconstructed ear and the quality of definition. Better shape and definition were evident as more surgical experience was gained. This occurred because of increased appreciation of the ear proportions and improved framework carving.
Conclusions
The series demonstrates the early learning curve in microtia reconstruction and underlines the importance of appropriate training and case availability in achieving high-quality results in autologous ear reconstruction.

This case report highlights the diagnostic dilemma in a case of osteosarcoma of the maxillary alveolar ridge and the importance of accurate histopathologic diagnosis for appropriate course of management. This is a case of a 19-year male who had a 2-month history of rapidly enlarging maxillary alveolar ridge mass. Excision biopsy was done with histopathologic diagnosis of pleomorphic adenoma. After a month, the mass recurred hence, a second excision biopsy was done revealing Intracapsular Carcinoma Ex Pleomorphic Adenoma. After a month, the mass again recurred. The patient consulted at our institution. The mass was completely excised with negative margins. Final histopathologic analysis revealed a possibility of osteosarcoma. Immunohistochemical stains (SATB2, S100 and CK) revealed immunomorphologic features consistent with osteosarcoma.

The patient did not consult our tumour clinic; thus, he noted a recurrence of mass on the right alveolar ridge after 3 months. A wide excision of the recurrent mass was done with negative margins. The patient had a delay again in starting chemotherapy, so there was a recurrence 1 month post-operation. The patient eventually started chemotherapy and is on his third cycle of chemotherapy, with a significant decrease in the size of the mass.