A One Stage Reconstruction of Defective Type Cleft Earlobe: Infra-auricular Transposition Flap

PURPOSE: Reconstruction of the cleft earlobe is challenging. Several procedures are available to reconstruct congenital earlobe deformities. However, for large defective type, surgical procedures and designs are complex and tend to leave a visible scar. We present a simple method of reconstruction for defective type congenital cleft earlobe using a one stage technique with infra-auricular transposition flap. This allows for easy and accurate size estimation and good aesthetic outcomes. METHODS: A 4-year-old male patient has congenital cleft earlobe and antihelical deformity. Otoplasty for antihelical deformity correction and one stage infra-auricular transposition flap for earlobe reconstruction were performed. The flap was designed from the inferoanterior margin of the earlobe. The size of the flap was determined based on the normal side, and the width and length of the flap was 1 cm and 3 cm in size, respectively. An incision was made at the midline of the defective lobule. Further, the elevated flap was inserted. The elevated flap and the incision margins of the lobule were sutured together. Then, the donor site was closed primarily. RESULTS: The volume and shape of the reconstructed earlobe were natural. There was no flap necrosis. The donor site had no morbidities and scar was not easily notable. CONCLUSION: Infra-auricular transposition flap can be designed easily and offer sufficient volume of earlobe. Furthermore, the scar is inconspicuous. In conclusion, infra-auricular transposition flap can be a good option for reconstructing a large defect type cleft earlobe.

Reconstruction of Defective Type Congenital Cleft Earlobe with S-shaped Flap

PURPOSE: Congenital cleft earlobe is relatively rare malformation and defective type congenital cleft earlobes are reconstructed with mainly local flap methods rather than primary closure or z-plasty. Various methods are introduced but many of these remain visible scars or require complex operative techniques. We designed a new and simple method of reconstruction for defective type cleft earlobe. METHODS: On the posterior surface of the auricle and mastoid area, S-shaped line was drawn continuously. One arc is for turnover hinge flap to make the anterolateral surface of the earlobe, and the other is for transposition flap to reconstruct the posterolateral surface. The donor site of the transposition flap was closed primarily. RESULTS: Four patients were operated by S-shaped flap design method. They were all female, and defective sides were right in two and left in another two. We obtained aesthetically satisfactory postoperative results with inconspicuous scars at the posterior side of the auricle. In one case, minor revision was performed because of insufficient blood supply of the hinge flap. CONCLUSION: We can reconstruct defective type cleft earlobe with new, simple S-shaped design for hinge flap and transposition flap.