Anatomical external auricular muscle transposition with mini flap transfer for mild cryptotia: A case report
Kosuke Yamagata,
Chihena H. Banda,
Makoto Shiraishi,
Kotaro Shimizu,
Yoshimoto Okada,
Kohei Mitsui,
Kanako Danno,
Ryohei Ishiura,
Hiroshi Furukawa,
Mitsunaga Narushima
Affiliations
Kosuke Yamagata
Department of Plastic and Reconstructive Surgery, Graduate School of Medicine, Mie University, Tsu, Japan; Department of Plastic and Reconstructive Surgery, Graduate School of Medicine, Aichi Medical University, Nagakute, Japan
Chihena H. Banda
Department of Plastic and Reconstructive Surgery, Graduate School of Medicine, Mie University, Tsu, Japan
Makoto Shiraishi
Department of Plastic and Reconstructive Surgery, Graduate School of Medicine, Mie University, Tsu, Japan
Kotaro Shimizu
Department of Plastic and Reconstructive Surgery, Graduate School of Medicine, Mie University, Tsu, Japan
Yoshimoto Okada
Department of Plastic and Reconstructive Surgery, Graduate School of Medicine, Mie University, Tsu, Japan
Kohei Mitsui
Department of Plastic and Reconstructive Surgery, Graduate School of Medicine, Mie University, Tsu, Japan
Kanako Danno
Department of Plastic and Reconstructive Surgery, Graduate School of Medicine, Mie University, Tsu, Japan
Ryohei Ishiura
Department of Plastic and Reconstructive Surgery, Graduate School of Medicine, Mie University, Tsu, Japan
Hiroshi Furukawa
Department of Plastic and Reconstructive Surgery, Graduate School of Medicine, Aichi Medical University, Nagakute, Japan
Mitsunaga Narushima
Department of Plastic and Reconstructive Surgery, Graduate School of Medicine, Mie University, Tsu, Japan; Corresponding author at: Department of Plastic and Reconstructive Surgery, Graduate School of Medicine, Mie University, 2–174 Edobashi, Tsu 514–8507, Japan.
Cryptotia is a congenital ear deformity characterized by the upper helix buried under the skin of the temporal region. Recurrence and inadequate correction of ear position are major complications following auricle reconstruction. Abnormalities of the auricular muscles are closely associated with cryptotia and considered to be the main cause. However, current corrective procedures focus on provision of additional skin and abnormal auricular muscle correction is considered supplementary. We report a surgical approach focused on the anatomical repositioning of the external auricular muscle insertions and skin cover with a mini flap.Two consecutive patients aged 6 and 14 years with mild cryptotia (minimal auricular cartilage deformity) were treated using this technique with a follow-up duration of 12–25 months. The abnormal insertion of the superior auricular muscle (SAM) to the superior helix was repositioned to its correct anatomical position below the eminence of the triangular fossa, effectively moving the ear posterosuperiorly. No complications occurred postoperatively, the increase in vertical length of the superior helix to the superior ear attachment was 7.8 and 7.9 mm at 6months. Both patients could wear facemasks comfortably without them sliding off and were satisfied with the esthetic results. Total follow-up duration was 3 years in Case 1 and 4.4 years in Case 2.Primary correction of the SAM to its anatomical position may be a useful method for reducing the size of the skin flaps required with minimal donor site morbidity in reconstruction of mild cryptotia.
