The Use of a Retroauricular Fascioperichondrial Flap in the Recreation of the Antihelical Fold in Prominent Ear Surgery

Abstract

The surgical treatments for prominent ears are on the basis of the approach over the basics of the deformity decrease the concha-mastoid angle and create a new antihelical fold. The author describes a new retroauricular flap to be used in the recreation of the antihelical fold and critically analyzes the cosmetic results and complications. A skin ellipse is outlined on the posterior surface of the ear. After hydrodissection with anesthetic solution in the outlined area, the skin is removed as thin as possible over the superior mid ear, preserving the underlying connective tissue and perichondrium. A triangular flap is created in the superior third of the raw area and elevated in the subperichondrial plane. The fixation of the flap posteriorly allows the medialization of the upper pole, resulting in a natural antihelical fold. One hundred sixty-one otoplasties were performed in 82 patients (3 unilateral), 53 women and 29 men. Mean age was 19.2 years and mean follow-up time was 3.4 years. Loss of correction at the upper pole led to secondary correction in 12 ears (7.45%). Suture extrusion was observed in 7 ears (4.34%). Hypertrophic scarring developed in 3 ears (1.86%). The accumulated risk of reoperation was of 10.85% in 9 years. The retroauricular fascioperichondrial flap combined with other techniques may be used as a standard procedure in the surgical treatment of prominent ears.

Otoplasty Using Dermoperichondrial Flap as an Adjunct to Mustarde Suture Technique

“…Frascino described the use of a postauricular fascioperichondrial flap with Furnas conchomastoid sutures that can be used with or without Mustarde sutures. 14 Additionally, Cihandide et al reported a distal perichondro-adipo-dermal flap, which is similar in composition to the flap described in the present study. However, a significant difference is that Cihandide et al advocate for the use of the flap without Mustarde sutures, as they believe that the continuity of the flap as opposed to discrete sutures provides improved antihelical creation in the attempt to decrease suture extrusion and recurrence rates.…”

Antihelical shaping of prominent ears using conchal cartilage‐grafting adhesion

“…The ratio of unilateral cases to bilateral cases operated on at our center is higher than cases reported in Western articles. In Salgarelli et al's article,8 unilateral cases were 5% among 140 operated cases, and in Frascino's article,15 unilateral cases were about 4% among 82 operated cases. In the East, bilateral prominent ears have been the accepted tradition,17 and operations on bilateral cases are fewer than those of unilateral cases.…”

“…The postauricular fascial flap technique is relatively simple 15. Even though we used it as an adjuvant procedure, we encountered difficulty during flap dissection.…”

Creating a Neoconchal Complex Using the Adjustable Conchal Sliding Technique in Prominent Ear Correction

“…Another important advantage of the fascial flap technique that may reduce recurrences is that it forms an additional barrier that may prevent the suturing materials from being exposed. 16,17 However, all the techniques described for the suture-assisted otoplasty work either in children or in the existence of a pliable cartilage. 18 Although the scoring performed on the anterior surface of the cartilage to form an antihelical fold was described by Davis and Gibson in 1958 (discussed in Bhatti and Donovan 19 ), it was popularized by Stenstrom 20 and Chongchet.…”