Surgical Correction of Cryptotia using Hirose's Rotation Flap

ABSTRACT

Cryptotia is rare in Caucasians but more common in Orientals, particularly in Japanese people, where incidence has been reported as 1:400. The features of cryptotia are the invagination of the upper part of the auricle under the temporal skin and the deformation of the auricular cartilage itself. The principles of the surgical correction are the coverage of skin deficit and the correction of deformed cartilage if needed. For the correction of cryptotia, several methods have been tried. But, inadequate amounts of local tissue often result in undercorrection of the cephalo-auricular sulcus, with a tendency to recurrence of the buried ear. Incision scars, hair line distortion, poor color match of graft and multi-staged operation of tissue expansion are noted as the their shortcomings. Therefore, We have performed Hirose's rotation flap method in 15 cases of the 12 patients that available skin in the inferior part of the cephalo-auricular sulcus is transferred to the upper part where skin is deficient, and satisfactory results were achieved. This method has many advantages that the design is simple and the procedure easy, the required depth of the cephalo-auricular sulcus is achieved, the correction of the cartilage deformity can be carried out with unrestricted access, the hairline is not disturbed by the operation, the scar behind the auricle is not visible, and there is no need for additional skin grafting.