An Optimizing Surgical Procedures for Correcting Severe Constricted Ears: Helix Costal Cartilage Scaffold Combined With V-Y Advanced Flap.

PURPOSE: A constricted ear is a deformity that is distinguished by curling of the upper portion of the ear, which includes the helix, scapha, and antihelix. The treatment for severely constricted ears seems to be quite invasive. To reduce invasiveness and fully utilize the folded cartilage, the authors used a helix costal cartilage scaffold combined with a single V-Y advanced flap in the correction of Tanzer type IIB constricted ear deformity to investigate the clinical effect. MATERIALS AND METHODS: From 2020 to 2021, autologous costal cartilage helix stent combined with local V-Y advanced flap was applied to correct the constricted ear malformation in 18 patients admitted to the Plastic Surgery Hospital of the Chinese Academy of Medical Sciences. RESULTS: All patients were followed for a duration of 6 to 12 months (average 7 months). Reconstructed auricles were cosmetically satisfying, with a natural-looking helix and enlarged cavum conchae cavity, as well as auricle sizes that were close to normal and near symmetry between both ears. CONCLUSIONS: With satisfactory clinical results, our technique can be used to repair types IIB cup ear deformities. It has a broad range of practical applications.

Reconstruction of constricted ears by combing bilateral cartilage flaps bridging with V-Y advancement flap.

BACKGROUND: Despite a number of surgical procedures for the reconstruction of moderate to severe constricted ears described in the literature, a most cost-effective method remains to be explored. It is still a challenge to maximize the full use of the ear cartilage and surrounding skin while achieving the best results. METHODS: From 2011 to 2016, seven constricted ear patients were enrolled in this study. Five of them were moderate (type IIB Tanzer classification) deformities, and two were severe (type III Tanzer classification). All constricted ear patients were treated with bilateral cartilage flaps bridging and the V-Y advancement flap from preauricular skin, with the option of inserting a conchal cartilage graft if additional stability was required. Mean follow-up period was 4.0 ± 3.5years. RESULTS: All patients were satisfied with significant increase in the height of the constricted ears, also with the reconstruction of scapha and antihelix. The surgical scar was not obvious. No complications were observed. Long-term follow-up period revealed that the reconstructive procedure produced the long-lasting cosmetic results. CONCLUSION: Combination of bilateral cartilage flaps bridging with V-Y advancement of preauricular flap can make full use of its deformed tissue and surrounding skin. The method is effective and reliable in the reconstruction of moderate and some severe constricted ears.

Classification and Surgical Strategies of Constricted Ears in a Chinese Specialty Clinic: A Retrospective Study.

BACKGROUND: The constricted ear is an auricular deformity produced by a deficiency in the circumference of the helical rim. The classification and corrective methods for constricted ears continue to be controversial. In order to identify them, the authors have reviewed and analyzed cases operated in a Chinese specialty clinic. METHODS: Correction of constricted ears from January of 2017 to June of 2021 was retrospect through medical records. Data of patients' variables (including sex, age, laterality, type of constricted ear, presence of other ear anomalies), surgical techniques, esthetic outcomes, and postoperative complications have been collected. RESULTS: The deformed ears were classified into four graded types by three criteria including deficiency of auricle cartilage, vertical height in dorsal view, and surgical outcome. A total of 68 constricted ears of 57 patients (type I, n = 6; type IIA, n = 41; type IIB, n = 19, and type III, n = 2) were enrolled in the study. Of the 66 constricted ears undergoing surgical correction, most of them were performed with helical expansion through auricular/costal cartilage graft, Mustardé-type mattress sutures, and tumbling cartilage flap. External molding using Vaseline gauze rolls was implemented on every case to assist reshaping the scapha. A triangular superficial temporal fascial flap was elevated to prevent the reoccurrence of lidding in some cases. Corrective techniques and esthetic outcomes for deformed cases of each graded type were described. Based on a four-point Likert scale, the average esthetic outcome score was 3.7. CONCLUSIONS: The classification was practical and the constricted ears were effectively corrected by simple surgical procedures without removal of deformed auricular cartilage. All corrections were performed in one stage. LEVEL OF EVIDENCE IV: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Comparison of 2 Ear Molding Systems for Nonsurgical Management of Newborn Auricular Deformities.

BACKGROUND: Congenital auricular deformities are common diseases in newborn infants. We compared the efficacy of 2 ear molding systems in the nonsurgical management of newborn auricular deformities in Chinese infants. METHODS: A total of 462 newborns with auricular deformities were treated with either the EarWell or the LiangEar ear molding systems. The posttreatment outcome was graded as excellent, fair, and poor. The differences in effectiveness between the 2 ear molding systems and factors that may affect the posttreatment outcome were analyzed. RESULTS: Both ear molding systems showed substantial efficacy in the treatment of newborn auricular deformities. The effective rate was comparable between the EarWell and the LiangEar systems for 4 types of auricular deformities (cryptotia, prominent ear, helical rim abnormality, and cup ear), while the costs for the LiangEar systems were half as much as that for the EarWell systems. Multivariate regression analysis showed that earlier time points at treatment initiation, less severe auricular deformities, treatment duration, and breastfeeding were the most significant predictive factors for a better outcome. CONCLUSION: Our findings demonstrate that using the EarWell and the LiangEar systems are both optimal nonsurgical approaches for treatment of most newborn auricular deformities.

Non-surgical correction of cryptotia.

INTRODUCTION: Cryptotia is characterized by an absence of the upper part of the temporoauricular sulcus with the superior third of the auricle buried under the temporal skin. The principle of correction of cryptotia is to achieve both a functional and aesthetic ear. METHODOLOGY: A 4-year prospective study was carried out in a single centre on infants with cryptotia. We introduce a two-staged approach for non-surgical correction of cryptotia and a treatment algorithm based on the age of the patient. In the first stage, we unbury the auricle over 2 weeks. The second stage involves 2 additional weeks of helical moulding to correct the underlying or residual deformation. In our algorithm, patients more than 6 weeks of age undergo only the first stage of cryptotia correction, whereas those less than 6 weeks of age progress to the second stage of treatment. RESULTS: A total of 5 patients (7 ears) were treated with ages ranging from 1 day to 7 months. Two patients underwent 2-stage treatment and 3 underwent 1-stage treatment. At 1 year, all buried helices remained retracted. Four out of 7 ears treated had "Excellent" outcomes and 3 out of 7 ears had "Good" outcomes. All caregivers were extremely satisfied with the outcomes. CONCLUSION: This simple and efficacious two-stage technique and algorithm is effective in the correction of cryptotia, even if the treatment is initiated beyond the traditional moulding window in the first six weeks of life. Using this approach, patients with cryptotia benefit by avoiding or simplifying surgical reconstruction in the future.

Leucemia mieloide aguda y policondritis recurrente ¿casualidad o relación causal? / Acute myeloid leukemya and relapsing polychondritis. Chance or causal relationship?

La policondritis recurrente o recidivante es una enfermedad sistémica crónica autoinmune, caracterizada por la inflamación de tejidos cartilaginosos asociada en pocos casos a enfermedades malignas hematológicas. Presentamos el caso de una paciente femenina de 26 años que cursaba concomitantemente con leucemia mieloide aguda (LMA). La manifestación inicial fue una afección cutánea en forma de eritema nodoso, y posteriormente se diagnosticó LMA; durante la fase de aplasia posquimioterapia desarrolló inflamación bilateral del cartílago auricular (condritis auricular) y síndrome vertiginoso con evolución clínica satisfactoria al tratamiento inmunosupresor con glucocorticoides. Conclusiones: Es difícil definir si existe asociación entre la policondritis recidivante y la leucemia mieloide aguda, la quimioterapia o la sumatoria de las dos noxas. Una vez que se establece el diagnóstico se debe iniciar oportunamente la administración de glucocorticoide a altas dosis, ya que pudieran aparecer complicaciones como la necrosis del cartílago y la pérdida de la región afectada. En contraste, el uso de los glucocorticoides tiene una excelente respuesta con modulación completa de la enfermedad, tal como se muestra en el caso presentado(AU)

Relapsing polychondritis is a systemic, chronic and autoimmune disease characterized by the inflammation of cartilaginous tissues. This disease is associated in a few cases with malignant hematological diseases. We present a case of a patient with relapsing polychondritis and concomitantly with acute myeloid leukemia. A 26-year-old female patient, with cutaneous affection as initial manifestation categorized as erythema nodosum. Then she was diagnosed with acute myeloid leukemia. In the aplasia post-chemotherapy phase, the patient developed bilateral inflammation of the ear cartilage (auricular chondritis) and a vertiginous syndrome with satisfactory clinical evolution to immunosuppressive treatment with glucocorticoids. Conclusion: Relapsing polychondritis usually presents with cartilaginous involvement, such as bilateral atrial chondritis, as shown in the case. Early diagnosis and timely treatment are necessary to achieve a good clinical response. Subsequent studies are necessary to evaluate the association between relapsing polychondritis and hematological alterations such as acute myeloid leukemia and the use of chemotherapy(AU)

Non-surgical correction of cryptotia and the analysis of treatment time and other influence factors.

OBJECTIVE: To explore correlations between post-treatment outcomes of non-surgical correction for cryptotia and treatment time and other influence factors. METHODS: Forty-seven consecutive patients with 64 cryptotias were treated with the adjusted external stretching device and followed up over 12 months. A subjective evaluation scale was designed for patients to collect clinical data. Pretreatment and posttreatment evaluation were conducted by two blinded investigators. The correlations between influence factors and outcomes were explored through fractional polynomial method, multiple logistic regression, and robust linear regression methods. RESULTS: Thirty-five patients with 49 cryptotias were included. Twenty-nine cryptotias (23 patients) have been successfully managed. Two of 17 unilateral cryptotias achieved nearly complete symmetry. The final optimal cutoff value for initiating treatment time is 6 months and for the duration of treatment per day is 5 h per day. Positive relationships between initiating treatment time >6 months and onset time, type II and onset time, initiating treatment time >6 months and effect stabilization time were observed. CONCLUSIONS: Initiating treatment time <6 months and duration of treatment per day >5 h benefit for the posttreatment outcomes. Patients wearing the device under 6 months old would have earlier onset time and effect stabilization time. It is hard to achieve complete bilateral symmetry in unilateral patients. The adjustable devices can used for the auricles with different sizes and removed and equipped conveniently.

Criptotia em paciente ocidental adulto: relato de caso / Cryptotia in a Western adult patient: a case report

Criptotia é uma deformidade auricular congênita comum em orientais e rara em ocidentais, sendo a grande maioria dos estudos de técnicas cirúrgicas orientais e aplicados em crianças. Nesta patologia, a cartilagem do polo superior da orelha encontra-se alojada embaixo da pele na região temporal, o que impossibilita o uso de óculos, devido à falta de apoio e torna o polo superior sem definição estética. O presente estudo tem por objetivo relatar o caso de um paciente adulto com criptotia, submetido ao tratamento cirúrgico com retalho de pedículo subcutâneo mastóideo, revisando as principais técnicas descritas para o tratamento deste acometimento. O retalho de pedículo subcutâneo descrito por Yoshimura, mostrou-se adequado para a correção da criptotia em paciente ocidental e adulto.

Cryptotia is a congenital ear deformity common in Easterners and rare in Westerners, with most studies addressing Eastern surgical techniques applied to children. In this pathology, the cartilage of the upper pole of the ear is lodged subcutaneously in the temporal region, which prevents individuals from using glasses due to lack of support and prevents esthetic definition of the upper pole. The present study aimed to report the case of an adult patient with cryptotia undergoing surgical treatment using a mastoid subcutaneous pedicle flap and review the main techniques described for the treatment of this involvement. The subcutaneous pedicle flap described by Yoshimura proved to be adequate for correcting cryptotia in a Western adult patient.

Retalho retroauricular ilhado para reconstrução parcial de orelha: relato de casos / Retroauricular island flap for partial ear reconstruction: case reports

Defeitos parciais de orelha podem ser tratados de diversas formas, dentre elas o fechamento primário, cicatrização por segunda intenção ou retalhos. Diversas opções técnicas foram descritas para a sua reconstrução de modo a manter o contorno natural da orelha, sem sacrificar tecido sadio ou alterar sua estética e função. Apresentamos neste artigo dois casos atendidos no Instituto do Câncer do Hospital de Base de São José do Rio Preto de reconstrução de defeitos condrocutâneos de orelha após ressecção de carcinoma basocelular em região central da orelha, com a confecção de retalho retroauricular ilhado transposto através de uma janela cartilaginosa e com o pedículo desepidermizado. Área doadora com fechamento primário. Tal procedimento constitui técnica segura, pois a região retroauricular é ricamente vascularizada, é de fácil execução, em único estágio e com resultado estético e funcional satisfatório.

Partial ear defects can be treated in several ways, including primary closure, healing by secondary intention, or flaps. Several surgical options have been described for reconstruction in order to maintain the natural contour of the ear, without sacrificing healthy tissues or changing the aesthetics and function. In this article, we present two cases of reconstruction of chondrocutaneous defects of the ear after resection of basal cell carcinoma in the central region of the ear, with the production of a retroauricular island flap transposed through a cartilaginous window with the de-epidermized pedicle. The donor area healed following a primary closure. This procedure can be performed in a single stage, yields satisfactory aesthetic and functional results, and is safe because the retroauricular region is richly vascularized.

Surgical Correction of the Lying Ear Deformities.

BACKGROUND: In contrast to prominent ear, lying ear can be defined when the antihelix of the ear is excessively folded, i.e., the conchoscaphal angle is much less than 90°. In such case, ears may look smaller than the face. These patients want their ears to be exposed more. In Asia, there is also a tendency to prefer large and long ears. The objective of this study was to present a surgical method for correcting lying ear deformities. METHODS: From August 2017 to June 2018, 37 patients (72 ears) underwent surgery using our surgical method for lying ear deformities. After the cartilage was exposed on the posterior auricular surface, the fibrous band present at the conchoscaphal angle was released. Two longitudinal cartilage incisions were performed along the border of the antihelix. Horizontal mattress sutures were performed on the cartilage until the conchoscaphal angle was close to 90°. Onlay cartilage grafting was performed for the most severe portion of the deformity. RESULTS: We performed reoperation for four patients due to recurrence (n = 2), under-correction (n = 1), and cartilage exposure (n = 1). Most patients obtained satisfactory aesthetic results. CONCLUSIONS: There have been few reports of the surgical method for lying ear deformities. Our surgical method can provide satisfactory clinical outcomes for correcting lying ear deformities. LEVEL OF EVIDENCE IV: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Auricular reconstruction.

External ear abnormalities are common. These may affect ear shape, size, prominence and degree of development. They may also be associated with hearing loss. The early identification and management of hearing loss is essential. There are several options for reconstruction of the external ear using both autologous and non-autologous techniques. The aim of this article is to outline the different reconstructive options.

Correction of Tanzer Type IIB Constricted Ears via Z-shaped Double V-Y Advancement Flaps.

BACKGROUND: Correction of Tanzer type IIB constricted ears requires sufficient expansion of the auricular skin to cover the reconstructed cartilaginous framework. To obtain an adequately sized skin cover, skin flap transposition from periauricular donor sites has been described; however, it remains challenging to obtain enough skin to enable satisfactory reconstruction. Herein, we describe a novel method that uses 2 local flaps comprising superoauricular, retroauricular, and preauricular soft tissue to expand the skin cover and correct Tanzer type IIB deformity. METHODS: Fifteen constricted ears in 15 patients were treated via this novel method from June 2013 to July 2017. Two adjoining V-Y advancement flaps shaped like a backward "Z" were created to expand the skin envelope of the upper one-third of the ear. The advancement of these 2 flaps toward each other expanded the skin of the upper one-third of the ear by creating a skin arch, which was then used to wrap the reconstructed cartilaginous framework. The auricular cartilage was refashioned via a method that combined several previously reported techniques. RESULTS: A satisfactory outcome was achieved in all 15 constricted ears, with resultant improvements in size and shape, and an elevated auricular position. CONCLUSIONS: The preauricular, superoauricular, and retroauricular skin areas can be used to successfully expand the skin envelope of the upper auricle via the creation of 2 adjoining V-Y advancement flaps. This results in an ample skin cover with which to accommodate the auricular cartilaginous framework reconstructed by multiple techniques. This novel Z-shaped double V-Y advancement flap method can effectively correct Tanzer type IIB constricted ears.

Simultaneous Bilateral Microtia Reconstruction Using Single-Expanded Postauricular Flap Without Skin Grafting.

BACKGROUND: Auricular reconstruction in patients with congenital microtia permits craniofacial balance and harmony, especially in patients with bilateral microtia. However, published techniques usually require skin grafting, which can lead to color mismatch and visible scarring. Some surgeons prefer to reconstruct the auricle of each side separately, which prolongs the complete cycle of surgery and increases suffering of the patient. In this study, we introduce a modified technique using single expanded flaps without skin grafting to achieve simultaneous bilateral auricular reconstruction. METHODS: Between January 2012 and January 2017, a total of 54 patients with bilateral microtia underwent auricular reconstruction with expanded single flaps. Simultaneous bilateral auricular reconstruction was accomplished through 3 surgical stages. In the first stage, bilateral postauricular skin was expanded using 2 kidney-shaped tissue expanders. In the second stage, bilateral rib cartilage was harvested using minimal incisions, allowing 2 modified 3-layer frameworks to be fabricated. Each framework was then inserted into the pocket through the same incision with subsequent closure using 2-layer suture. In the third stage, the reconstructed ears were further trimmed, if necessary, and the lobules and tragus reconstructed. All the patients were followed up for 6 to 24 months. RESULTS: During follow-up, patients were satisfied with surgical outcome in terms of size, shape, location, detailing, and symmetry of the bilateral ears in more than 50 cases. Only 4 demonstrated postoperative complications. No skin necrosis, exposure of cartilage, or infection was observed or postoperative chest deformities. CONCLUSIONS: Simultaneous bilateral auricular reconstruction using single expanded flaps combined with a modified 3-layer cartilage framework is an effective technique for patients with bilateral microtia.

A New Surgical Method of Correcting Abnormal Cartilage in Mild or Moderate Cryptotia.

OBJECTIVE: This study aimed to introduce a new technique for the correction of mild or moderate types of cryptotia. METHODS: During January 2010 to March 2015, patients with cryptotia deformities came to our hospital and were enrolled in this study. A new surgical method of correction of abnormal cartilage by combining irregular incisions in auricle malformation and directional transplantation of auricular cartilage was designed. The irregular Z shaped flap was designed to correct the skin defects. In the ipsilateral cavum conchae, the auricular cartilage strut was harvested, followed with irregular cartilage incisions and cartilage transplantation. RESULTS: After correction, the corrected auricles in 3 cases showed natural contour with deep auriculotemporal sulcus and no conspicuous scars. The antihelix folding and backward rotation deformities of the auricular cartilage were corrected, and the morphology of superior and inferior crus of the antihelix was not destroyed. One case appeared necrotic. During 1 year of follow-up, there was no incidence of recurrence or revision. CONCLUSIONS: The combined techniques for correction of abnormal cartilage are simple and easy to operate, and the reconstructed auricles show natural contour without conspicuous scars. The new technique is suitable for correction of mild and moderate cryptotia.

Pinna synthetic mold for otoplasty techniques application / Molde sintético auricular para aplicação de técnicas de otoplastia

Abstract Introduction The ear deformity Tanzer type V, also known as prominent ears, is the most common genetic defect of the pinna. The surgery designed for its correction is known as otoplasty. This esthetic surgery can be performed using different techniques, which requires great skill of its operator. Objective The purpose of this work is the development of a new tool for otoplasty techniques training, aimed on the possibility to minimize errors during the otoplasty. Methods Synthetic molds of the external ear from patients with Tanzer type V deformity were made, using silicone material and rayon. Results The main procedures of otoplasty could be performed in the molds made of silicone and rayon with a good esthetic result. Conclusion The elaborated molds had identical size and shape of a human ear and could be positioned in the same shape of the patient ears. Thus, the synthetic molds were presented as promising simulation tools for the training and surgical enhancement of otoplasty, especially for doctors beginners.

Resumo Introdução A deformidade da orelha tipo V de Tanzer, também conhecida como orelhas proeminentes, é o defeito genético mais comum da aurícula. A cirurgia criada para sua correção é conhecida como otoplastia. Essa cirurgia estética pode ser feita com diferentes técnicas, o que requer grande habilidade de seu operador. Objetivo O objetivo desse trabalho é o desenvolvimento de uma nova ferramenta para o treinamento de técnicas de otoplastia, com o objetivo de minimizar erros durante a otoplastia. Método Foram feitos moldes sintéticos da orelha externa de pacientes com deformidade tipo V de Tanzer com material de silicone e rayon. Resultados Os principais procedimentos de otoplastia foram feitos nos moldes de silicone e rayon com um bom resultado estético. Conclusão Os moldes elaborados tinham tamanho e forma idênticos aos de uma orelha humana e puderam ser posicionados no mesmo formato das orelhas dos pacientes. Assim, os moldes sintéticos foram apresentados como ferramentas de simulação promissoras para o treinamento e aperfeiçoamento cirúrgico da otoplastia, especialmente para médicos iniciantes.

Modified Island Technique for Prominent Ears.

There have been several methods described for the correction of prominent ears, including techniques that excise, bend, suture, score, or cut the auricular cartilage. The Island Technique, proposed by Pitanguy, is based on the creation of a cartilage island to define the antihelix and correct the conchoscaphal angle. Visibility of sharp edges has been the main criticism of this technique. To avoid them, we advise performing an internal bevel incision to round off the edges and achieve a more natural look. Also, sometimes prominent ears are asymmetric with different conchoscaphal angles, determining a residual but protruding upper pole, thus requiring different treatment on each side. For such cases, we propose the additional excision of a cartilage strip from the lower border of the auricular scapha, with a greater conchoscaphal angle. In this way, cartilage islands of similar width and identical antihelixes for both ears are created and a symmetric result is achieved. Level of Evidence IV This journal requires that authors assign a level of evidence to each article. For a full description of these evidence-based medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Hybrid Cartilage-Modifying Otoplasty Technique and Outcomes.

IMPORTANCE: Otoplasty is performed to correct prominauris, one of the most common head and neck congenital deformities. Advances in combination hybrid approaches enable surgeons to achieve greater precision and accuracy. OBJECTIVE: To describe a hybrid cartilage-modifying approach and evaluate the procedure's effectiveness and safety. DESIGN, SETTING, AND PARTICIPANTS: Medical record review including patients undergoing otoplasty by the present technique from January 2006 to December 2016 as performed by the senior author at a tertiary academic referral center. Twenty-three patients underwent 24 total procedures including both bilateral (n = 17) and unilateral (n = 7) procedures. Two procedures were revisions. INTERVENTIONS: Hybrid cartilage-modifying otoplasty procedure. MAIN OUTCOMES AND MEASURES: Preoperative and postoperative measurements were recorded. Paired sample t testing was performed to assess changes between preoperative superior, middle, and inferior helical measurements and corresponding postoperative measurements for all operated ears. Two-tailed, independent sample t testing was performed to compare postoperative differences between right and left ears within separate superior, middle, and inferior measurements in patients undergoing bilateral otoplasty. RESULTS: Twenty-four surgeries were performed on 23 patients. The mean (SD) age at surgery was 16.3 (13.6) years with 13 patients (58%) between the ages of 4 and 10 years. Preoperatively, the mean (SD) superior, middle, and inferior helical rim-to-mastoid distance of the 41 discrete ears measured 16.5 (3.1) mm, 24.1 (3.8) mm, and 19.3 (4.4) mm, respectively. Mean (SD) postoperative measurements were 12.1 (2.4) mm, 14.7 (2.5) mm, and 14.0 (2.8) mm, respectively, for mean (SD) decreases of 4.4 (2.7) mm, 9.4 (3.4) mm, and 5.3 (3.6) mm. For the 17 bilateral procedures, the mean (standard error) postoperative scores between ears measured 0.7 (0.9) mm for the superior, 0.5 (0.9) mm for the middle, and 0.2 (1.0) mm for the inferior. The unaffected ear was measured in 4 of 7 (57%) of patients undergoing unilateral otoplasty, and the mean (SD) postoperative differences between left and right ears were 1.3 (0.8) mm, 3.0 (1.2) mm, and 1.0 (0.7) mm for the superior, middle, and inferior, respectively. Preoperative-to-postoperative differences for all ears (n = 41) were significant (P < .001 for all) for superior, middle, and inferior measurements. There were no significant absolute differences identified for superior (P = .41), middle (P = .58), and inferior (P = .88) measurements regarding left vs right postoperative comparisons for bilateral otoplasties. One patient undergoing bilateral repair required subsequent revision surgery of 1 ear. Two patients developed chronic suture site irritation, and 1 patient developed a hematoma. CONCLUSIONS AND RELEVANCE: The present technique allows multiple opportunities to adjust the auricular parameters. The results indicate a low revision rate and high degree of symmetry. LEVEL OF EVIDENCE: 4.

Pinna synthetic mold for otoplasty techniques application.

INTRODUCTION: The ear deformity Tanzer type V, also known as prominent ears, is the most common genetic defect of the pinna. The surgery designed for its correction is known as otoplasty. This esthetic surgery can be performed using different techniques, which requires great skill of its operator. OBJECTIVE: The purpose of this work is the development of a new tool for otoplasty techniques training, aimed on the possibility to minimize errors during the otoplasty. METHODS: Synthetic molds of the external ear from patients with Tanzer type V deformity were made, using silicone material and rayon. RESULTS: The main procedures of otoplasty could be performed in the molds made of silicone and rayon with a good esthetic result. CONCLUSION: The elaborated molds had identical size and shape of a human ear and could be positioned in the same shape of the patient ears. Thus, the synthetic molds were presented as promising simulation tools for the training and surgical enhancement of otoplasty, especially for doctors beginners.

Costal Cartilage Assessment in Surgical Timing of Microtia Reconstruction.

BACKGROUND: Rib cartilage growth is closely related to age and determines the feasibility and outcomes of auricular reconstruction. Ear reconstruction is performed as early as age 6 in efforts to treat children before school matriculation while allowing for sufficient rib growth. But there is controversy over the optimal timing of microtia reconstruction. This study employs CT imaging and surface scanning to guide the timing of auricular reconstruction in children. METHODS: A retrospective analysis was performed on 6-year-old microtia patients between January 2016 and June 2016. A total of 37 patients were underwent preoperative 3D rib-cage CT measurements and normal auricle scanning measurement including: the length of 6th, 7th, and 8th costal cartilage, the width of 6th,and 7th costal cartilage, and the length of normal auricle. Then the data of costal cartilage were compared with the data of the auricle. RESULTS: The average length of the 6th, 7th, and 8th rib cartilage on the right was 76.1 ±â€Š9.2 mm (range, 61.1-94.9 mm), 102.6 ±â€Š9.9 mm (range, 84.5-119.1 mm), and 75.4 ±â€Š19.3 mm (range, 47.3-118.5 mm), respectively, and the the average helical length was 90.5 ±â€Š6.8 mm (range, 76.9-101.5 mm). Comparing the above data, it was revealed that the age of 6 years was an optimal time for ear reconstruction with tissue-expanding technique. CONCLUSIONS: 3D rib-cage CT for preoperative measurement of costal cartilage could be a useful method for planning microtia reconstruction. According to our study, the amount of costal cartilage of almost all 6-year-old microtia patients is enough for ear reconstruction. So age 6 years is the optimal timing of auricular reconstruction with tissue-expanding method.