Refined Converse otoplasty with Ω shape for prominent ears / 中华整形外科杂志

Objective@#To investigate the feasibility and efficiency of refined Converse otoplasty with Ω shape for correcting prominent ears.@*Methods@#Refined Converse otoplasty with Ω shape was performed in 8 cases(3 cases of bilateral deformities)of prominent ears during January 2014 to September 2016. The postauricular fascial-perichondrial complex tissues were elevated through postauricular incision based on Converse otoplasty. The new antihelix was reformed by parallel mattress sutures though postauricular parallel cartilaginous incisions. The Ω shape appeared on the transverse section of the auricular cartilage after fascial-perichondrial sutures.@*Results@#Postoperative 6 month to one year follow-up presented satisfactory results in all 8 cases. The appropriate location and contour of the recreated antihelix was achieved. The included angle between fossae helicis and concha was decreased. The auricles were symmetric in both unilateral and bilateral patients of prominent ears. The scars were inconspicuous. Hematoma, infection, suture extrusion and secondary deformities were not seen in our series.@*Conclusions@#Natural and clear contour of the recreated antihelix was achieved by refined Converse otoplasty with Ω shape. Reoccurrence was not seen and complications were rare.

Otoplastia, nueva alternativa quirúrgica / Otoplasty, a new surgical alternative

Entre las diferentes anomalías que se pueden encontrar en la región de cabeza y cuello, las orejas en pantalla se encuentran entre las más frecuentes. Las causas más comunes son una cavidad desproporcionada de la concha y falta del desarrollo del pliegue del antehélix. Existen diversas técnicas para la corrección de estas anomalías, entre las más usadas están la de Pitanguy, Converse, Stenvers, Stenstrõm y Mustarde. El objetivo de la otoplastia es reducir el ángulo formado por la oreja y la cabeza, hasta unos 25 a 30 grados, y en los casos indicados la reducción y reacomodación de la concha con la consecuente disminución del tamaño del pabellón. Este tipo de intervención quirúrgica puede realizarse en personas de 7 años en adelante. La técnica que utilizamos es una combinación entre las técnicas descritas por Pintanguy, Stenvers, Stenstrõm y Mang, además de una modificación personal al islote descrito por este último autor, para buscar un antehélix con un pliegue lo más natural posible. No existe una técnica universal que corrija adecuadamente todos los aspectos estéticos de las orejas prominentes, por tanto, se utilizan técnicas combinadas que llenen las expectativas funcionales y estéticas de los pacientes.

Prominent ears are one of the most frequent deformities found in head and neck. The most common causes are an excessively deep conchal bowl or an inadequate antihelical fold growth. There are variety of surgical techniques to correct this anomaly. Among the most used are Pitanguy´s, Converse´s,Stenvers´s, Stenstrõm´s and Mustarde´s techniques. The aim of the otoplasty is to reduce the anglebetween the ear and the mastoid skin to a 25 to 30 degrees, and in some cases reduction and change in the position of the conchal bowl with the subsequent decrease of the ear size. This type of surgical technique might be performed in kids 7 years or older. In order to get the most natural antihelix foldpossible a combination of the Pitanguy´s, Stenvers´s, Stenstrõm´s and Mang´s technique was performed,besides of a personal change to the small isle described by the last author. There is not a single technique that manage all the aesthetic aspects of the prominent ear; therefore a combination of different techniques are used in order to satisfy the functional and esthetic patient´s needs.

Correction of Cup Ear Using the Mattress Suture

PURPOSE: Constricted ear, which is named by Tanzer includes lop ear, cup ear, and sort of prominent ear. It has been classified into three groups by Tanzer. Especially the group I and IIA have been corrected by banner flap, Musgrave's technique, tumbling concha-cartilage flap, reversed banner flap and others. However, these techniques were too invasive for correcting mild degree of deformity. Therefore, we corrected the ear with mattress suture which is simple and less invasive. Method: The operations were done for 5 patients from March 2005 to April 2008. All the cases were unilateral ears with constriction including helix and scaphoid fossa without differences in length between both ears. Though a posterior auricular skin incision, the folded cartilage is exposed and two parallel incisions on superior crus were made. After mattress suturing in cartilage, the superior crus of antihelix was formed and its force enables the folded portion to be in a normal anatomic position. Result: All the 5 patients got satisfactory results. There were no complications like hematoma or skin necrosis, and no recurrence during follow-up period(the average period was 11 months). And we couldn't recognize the difference between height of both auricles. CONCLUSION: Mattress suture is simple, less invasive, and suitable in correcting mild deformity of constricted ear with better result, so here we suggest the method.

A Case of Angioleiomyoma of the Ear Antihelix / 대한피부과학회지

Angioleiomyoma is a benign tumour arising from the vascular smooth muscle of blood vessel walls. It usually occurs in the lower extremities of females as a slow-growing, firm and occasionally painful mass. Only 8.5~10% of angioleiomyoma have been reported to occur on the head and neck area. Furthermore, to the best of our knowledge only 9 cases of angioleiomyoma have been reported to occur on the ear. Herein, we report a case of angioleioyoma in a 66 year-old woman who presented with a 4 year history of a painless, nontender nodule on the anti-helix of the ear, an unusual site of occurrence.

Case Report of the Correction of Atypical Deformity of the Third and Fourth Crus of Antihelix

The third crus of the antihelix is a very rare anomaly that is characterized by an abnormal elevation of cartilage extending from antihelx to helix. that results in an additional prominence with varying degrees of an helical deformity. In this report, an unusual a 16-years- old male case of a third and fourth crus of the antihelix accompanying constricted helical deformity on upper pole is presented and the surgical correction of the deformity is described. A curvilinear incision is made on the posterior surface of the ear and the skin flap was reflected. In order to correct deformity of the helix and make the scapha concave, a series of additional scoring were made into the extra crus cartilage, and the cartilage was sutured by a few horizontal mattress sutures. For structural support, Medpor was placed on the scapha. Through-and-through mattress sutures are tied over a bolster of gauze for 2 weeks to eliminate dead space and to accentuate the helical sulcus. During the 9 month follow-up, the result was satisfactory.

Correction of Constricted Ear using the Reversed Banner Flap

There exist many methods reconstructing a constricted ear. But those methods are usually lack of considerations about various components: shape of ear, height, width and circumference. Therefore we contrived a new method which we called 'a reversed banner' flap, modifying the banner flap by Tanzer. The banner flap considers only the increase of height. Moreover the transition of the flap is unnatural because of the base of the flap located medially. A total of 7 earswere reconstructed. Four patients were group I, and three patients were group II(by Tanzer's classification). To increase width and circumference as well as height, our method consists of steps as follows: (1) V-Y advancement skin flap on the root of helix. (2) Laterally based banner flap on the deformed helix, preserving the superior crus of antihelix. (3) Pooling out designed flap from root of helix and fixation to the inferior crus of antihelix. (4) Expansion of hooded helix lateral to superior crus. (5) Conchal cartilage grafts to the newly formed cartilage gaps. (6) Reinforcement of superior crus with a mattress suture. With this method we could make a more natural shape of ear and maintain the form of reconstructed ear.

Correction of Constricted Ear using the Reversed Banner Flap

There exist many methods reconstructing a constricted ear. But those methods are usually lack of considerations about various components: shape of ear, height, width and circumference. Therefore we contrived a new method which we called 'a reversed banner' flap, modifying the banner flap by Tanzer. The banner flap considers only the increase of height. Moreover the transition of the flap is unnatural because of the base of the flap located medially. A total of 7 earswere reconstructed. Four patients were group I, and three patients were group II(by Tanzer's classification). To increase width and circumference as well as height, our method consists of steps as follows: (1) V-Y advancement skin flap on the root of helix. (2) Laterally based banner flap on the deformed helix, preserving the superior crus of antihelix. (3) Pooling out designed flap from root of helix and fixation to the inferior crus of antihelix. (4) Expansion of hooded helix lateral to superior crus. (5) Conchal cartilage grafts to the newly formed cartilage gaps. (6) Reinforcement of superior crus with a mattress suture. With this method we could make a more natural shape of ear and maintain the form of reconstructed ear.