A. Ear reconstruction or auricular reconstruction is a form of surgery done to rebuild an ear that has been damaged by cancer surgery, trauma, or is misshaped or missing because of a disorder present at birth (congenital disorder) is called ear reconstruction.

A. Ear reconstruction surgery may be needed in the following cases:

1. Congenital defects such as atresia (absence of the external ear) or microtia (small ear)
2. Injury or trauma to the ear
3. Large ears, lop ears (when the ear tip folds down), or pointed ears
4. Presence of genetic conditions like Treacher Collins syndrome and Goldenhar syndrome

A. The following may be considered to be good candidates for ear reconstruction surgery:

• Age of five years and above
• Non-smokers
• Good overall general health

A. There are different types of ear reconstruction surgeries, which may include:
Microtia repair:
A congenital condition or genetic defect in which one or both of the outer ears are absent, small, or malformed is known as microtia.
Microtia repair includes the creation of a new ear out of the body tissue of the patient or building an artificial, prosthetic ear.

Otoplasty:
It is a type of cosmetic surgery done on the outer, visible ear parts.
Example is ear pinning, which is a surgical procedure done to angle the ears closer to the head and make the ears less prominent.

Ear defect repair:
Trauma or cancer surgery may lead to tissue loss.
Plastic surgery may be needed for restoring the form and function of the outer ear.

A. Eat reconstruction surgery is performed by a plastic surgeon in association with an ENT specialist.

A. The following diagnostic tests may be performed before an ear reconstruction surgery:

1. Physical examination: The doctor evaluates the shape, size, and placement of the patient’s ears. Measurements and photographs are also taken by the doctor.
2. Medical history: The history of any medical diseases, injury or trauma, ear infections, surgeries, or any medications that the patient may be currently taking is noted.
3. Blood tests and urinalysis: These are routine tests performed before any surgery to check for underlying medical conditions.
4. Imaging tests: X-rays and CT scans are types of imaging tests that may be performed to obtain clear images of the internal structures of the ear.
5. General screening tests: The test is performed to see how well the patient can hear the words spoken at different volumes, and also how well the patient responds to other sounds.
6. Tuning fork tests: These tests help the doctor to check for hearing loss.
7. Audiometer tests: This test is also performed to check for loss of hearing.

A. The following preparation may be done before an ear reconstruction surgery:

• The doctor should be informed about any medications, supplements, or herbs that you are currently taking.
• If you have any medical diseases, inform the doctor about the same.
• If you have a known allergy to anesthesia, certain medications, latex, tape, or iodine, inform the doctor about the same.
• You should stop smoking at least fifteen days before the procedure.
• You will be advised to stop taking blood thinners like warfarin and aspirin a few days before the procedure.
• If the procedure is being performed under general anesthesia, you will be asked to not eat or drink anything after midnight, the day before the procedure. 

A. The ear reconstruction surgery procedure is generally performed under local anesthesia with sedation (the procedure area is numbed) or general anesthesia (the patient is made unconscious before the procedure).
The surgeon first makes an incision on the back of the ear or inside the folds of the ear.
The tissue of the ear is now manipulated depending on the type of procedure being performed. This may include cartilage or skin removal, folding and shaping of cartilage using permanent sutures (stitches), or grafting of cartilage to the ear.
The incisions are now closed using sutures.
Certain type of surgeries does not require an incision. The surgeon places a needle into the cartilage to increase its flexibility and stitches are then used to fix or reshape the ear.
The procedure generally takes one to three hours to complete, depending on the severity of the condition and the type of procedure being performed.

A. The following are the post-procedure steps after ear reconstruction surgery:

• The ears of the patient are covered in bandages to support and protect the ear after the procedure.
• It is normal for the patient to have some redness, soreness, itching, swelling, and discomfort after the procedure.
• The doctor prescribes painkillers to relieve the pain and discomfort of the patient.
• The patient should avoid sleeping sideways till complete healing occurs to avoid pressure on the operated ear.
• The patient should avoid rubbing or placing excessive force on the incisions.
• The patient should wear button-down shirts or shirts having loose-fitting collars to avoid clothes rubbing against the ears.
• The bandages are removed by the doctor a few days after the procedure. The ears are likely to be red and swollen.
• The patient may need to wear a loose headband covering the ears at night for some weeks. This prevents the patient from pulling his/her ears forward when rolling over in bed.
• Dissolvable stitches disappear on their own. However, non-dissolvable stitches need to be removed by the doctor a few weeks after the procedure.
• The patient should follow the doctor’s instructions on when to resume daily activities like bathing and other physical activities.
• Light exercises like walking can be resumed three days after the surgery.
• Heavy lifting and strenuous physical activities can be resumed three weeks after the surgery.
• Swimming should be avoided for four to six weeks after the surgery.
• Sun exposure, sun lamps, and tanning beds should be avoided for six weeks after the procedure.

A. The following complications may occur due to an ear reconstruction surgery:

• Bleeding
• Infection
• Blood clot formation
• Allergic reaction to the anesthesia used
• Asymmetry of ear
• Change in the sensation of the skin
• Persistent pain
• Poor healing of the wound
• Swelling of the skin
• Skin discoloration 
• Irregularities of the skin contour
• Need for a revision surgery
• Scarring

A. The cost of ear reconstruction surgery varies depending on the type of procedure performed and the condition of the patient.
The cost also varies among different doctors in different hospitals. On average, the cost of ear reconstruction surgery in India is between INR 50,000 to INR 2,00,000.