Microtia repair series tests rib-site cryoablation
Lurie Children’s reported early use of ultrasound-guided intercostal nerve cryoablation to reduce pain after rib-cartilage harvest for natural ear reconstruction.
A Lurie Children’s team has reported early experience using intercostal nerve cryoablation during rib-cartilage harvest for total microtia reconstruction. The first 3 patients were described in Plastic and Reconstructive Surgery, according to the hospital.
The Chicago hospital said it is the first in the world to offer natural ear reconstruction without prolonged postoperative pain after microtia repair. That claim is tied to a workflow in which specialists freeze the nerve at the rib-harvest site before plastic surgery.
Lurie Children’s described the procedure as minimally invasive, ultrasound-guided, and approximately 20 minutes long. The hospital said patients can go home without pain as early as 1 day after surgery.
More than 30 patients have now received the approach, according to Lurie Children’s. The hospital said the method has reduced opioid use and shortened hospital stays.
Shankar Rajeswaran, MD, division head of interventional radiology at Lurie Children’s and associate professor of radiology at Northwestern University Feinberg School of Medicine, co-authored the report. He said the approach “removes the pain obstacle” from natural ear reconstruction.
The hospital said the nerve at the rib-harvest site regenerates within 6 months. Rajeswaran also said the team observed no adverse effects from the procedure.
Microtia is a congenital condition affecting the outer ear. Cleveland Clinic says the condition can range from a small or narrow outer ear to absence of the outer ear, may cause hearing loss, and affects up to 4 in 10,000 babies globally.
Lurie Children’s Microtia and Aural Atresia Program uses a multidisciplinary model. Its program page says Akira Yamada, MD, PhD, creates a 3D ear framework using the patient’s own rib cartilage during reconstruction.
An ongoing study by Yamada and Rajeswaran will compare microtia repair outcomes with and without the nerve-freezing procedure. The study will evaluate opioid use, length of stay, and functional recovery, with completion expected by the end of 2026.
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