American surgeons are freezing nerves while harvesting cartilage from ribs for natural ear reconstruction in children with microtia to eliminate months of pain after the surgical repair.
The Ann & Robert H. Lurie Children’s Hospital of Chicago said it was the first in the world to use the pain-reducing procedure during surgery for microtia, a rare condition where a child is born with an underdeveloped or missing outer ear.
Previously, children with microtia suffered prolonged postoperative pain because cartilage for ear reconstruction was harvested from one of their ribs, the hospital said.
Now, before plastic surgery, the hospital’s specialists freeze the nerve at the rib harvesting site through a minimally invasive, ultrasound-guided procedure that lasts 20 minutes. Patients can go home without pain as early as a day after surgery.
More than 30 patients have benefited from this method to control pain, with reduced opioid use and shorter hospital stays.
Experience with the groundbreaking approach in the first three patients was reported in Plastic and Reconstructive Surgery on 7 April 2026.
“Severe pain after a rib harvest was a major challenge in microtia repair that uses the patient’s own tissue to reconstruct the ear,” said senior author Dr Akira Yamada.
“Remarkably, pain is no longer a concern during recovery, so opioids are mostly eliminated and kids go home sooner. This is monumental.”
Dr Yamada is a plastic surgeon at the hospital and Professor of Paediatric and Plastic Surgery at Northwestern University Feinberg School of Medicine.
He said that by removing pain, freezing the nerve at the rib harvesting site allowed patients to enjoy the full benefits of natural ear reconstruction, including lifelong ear sensation and normal appearance.
The alternative was to use artificial cartilage for the reconstruction but Dr Yamada said the ear does not look natural and does not have any sensation.
“Our innovation removes the pain obstacle from natural ear reconstruction,” said co-author Dr Shankar Rajeswaran, division head of interventional radiology at the hospital and Associate Professor of Radiology at Northwestern University Feinberg School of Medicine.
“It is a paradigm shift in how we approach pain management in microtia patients. The nerve at the rib harvesting site regenerates within six months, without causing additional pain. We observed no adverse effects from the procedure.”
In an ongoing study expected to be completed by the end of the year, the doctors will compare outcomes of microtia repair with the nerve freezing procedure and without.
They will evaluate opioid use, length of hospital stay and functional recovery.
Australian Microtia Atresia conference
Meanwhile, Microtia Atresia Australia will run the Australian Microtia and Atresia Conference in Brisbane on 12 September 2026.
The conference will provide current, up to date information to support families in making informed decisions for their children with microtia and atresia. The full day of presentations on the Saturday will be followed by a family fun day on the Sunday afternoon.
There will be an in-person and a virtual version for those unable to attend in person.
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