Surgical Correction Of Congenital Earlobe Cleft Using Reverse L-Plasty

ABSTRACT

Congenital earlobe deformity and the presence of the cleft at a site of the earlobe seems to be rare. It is important to well-formed, symmetrically positioned ears as a sign of esthetically pleasing, harmonious facial features. So the patients with cleft earlobe require operative repairs. The surgical techniques for congenital earlobe clefts employed vary from simple closure, Z-plasty, L-plasty, two flap method, triangular flap method, and so on. Among them, Passow-Claus described the classic L-plasty method. We designed the modified method that the L-flap direction faced laterally opposed to that of classic L-plasty and propose to term this method `reverse L-plasty`. Kitayama classified the congenital earlobe cleft into four groups according to the shape of cleft, as longitudinal, transverse, triplelobe or mixed, and defective type. We experienced four cases of congenital earlobe cleft. One patient was a defective type and the others were triplelobe types. There`s no complication in patients. We could obtain the advantages of smooth contour of free border, lack of groove or notching due to scar contracture, and possible in moderate defective type without additional method after long term follow-up. This technique breaks the vertical component of scar contracture, resulting in a smooth lobular border. So we believe that this reverse L-plasty technique offers a better cosmetic result in the repair of the cleft earlobe.