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

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T-bar reconstruction of constricted ears and a new classification

For the correction of constricted ears, many techniques are described in the literature, the majority based on Tanzer's classification of 1975. The improvements in ear reconstruction published by Brent, Nagata, Firmin and Park make better outcomes possible. It is therefore that a new classification for constricted ears is proposed, together with an alternative technique for correction of group IIA and IIB deformities, using a T-strut of costal cartilage to reconstruct the underdeveloped or missing superior crus of the antihelix.