The tumbling concha-cartilage flap for correction of mild constricted ear / 中华整形外科杂志

Objective@#To explore the effect of the tumbling concha-cartilage flap for correction of mild constricted ear.@*Methods@#From January 2015 to January 2017, 6 constricted ears of 6 cases were corrected using this procedure. All patients were from Plastic Surgery Hospital, Chinese Academy of Medical Science. They were four male and two female patients, age from 3 to 28 years old, with average age of 14 years. Through anterior and posterior skin incisions, a rectangular or T-shaped cartilage flap was elevated from the concha and tumbled backward. After passing through the postauricular skin, the flap′s tip was fixed to the lidded helix or scapha. The recoiling force of the flap′s conchal side enabled the lidded portion to be in a normal, erect, anatomic position. This method also increased the vertical height of the ear and created a normally shaped scapha.@*Results@#The follow-up time was 6-12 months. Six constricted ears were corrected using this procedure, and maintained natural auricular features.@*Conclusions@#The tumbling concha-cartilage flap is a reliable and effective method for the correction of constricted ear.

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.

Correction of Constricted Ear

The constricted ear was suggested by Tanzer for the purpose of obviating the confusion involving lop ear, cup ear and prominent ear as defect whose helix turns down, and scapha and fossa triangularis are narrowed. The constricted ear has a spectrum of severity and therefore, requires a graded surgical approach. Tanzer has described the degree of deformities of the constricted ear as falling into three groups. For the correction of constricted ear, there are numerous techniques but we have had difficulties in adopting these techniques in various type. We also describe the various constricted ear as the Tanzer's classification and adopted three methods to each type, banner flap(group I), concha cartilage graft (group II) and rib cartilage graft(group III) for reducing postoperative deformity and confusion in correcting the ear deformities. Constricted ear repairs must be individualized to accomodate each specific deformity. We corrected 22 cases of constricted ear in 20 patients using each optimal method described above according to the degree of deformities. Mild deformities need only reshaping and adjusting of existing tissues, moderate deformities need additional skin and severe deformities require a cartilage graft. For correction of constricted ear, accurate identification of the severity of deformity is essential. The results were satisfactory and we report our experience with relative literatures.

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.