Skip to main content
Top
Published in: Aesthetic Plastic Surgery 6/2021

01-12-2021 | Incision | Original Article

A New Method of Correcting Cryptotia by Changing Mechanical Fulcrum After Constricted Cartilage Overturned

Authors: Datao Li, Tianya Li, Ruhong Zhang, Qun Zhang, Zhicheng Xu, Feng Xu, Yiyuan Li, Xia Chen

Published in: Aesthetic Plastic Surgery | Issue 6/2021

Login to get access

Abstract

Background

Many techniques have been introduced to correct cryptotia. The previous methods are releasing the constricted cartilage and changing the mechanical fulcrum partly to the right position. However, some patients are still not satisfied with the treatment results, due to cryptotia recurrence and insufficient superior 1/3 width. This study aimed to develop a new method for completely changing the mechanical direction of constricted cartilage for correcting cryptotia.

Methods

From 2007 to 2020, twenty-four cryptotia patients were treated. During surgical reconstruction, the retroauricular skin flap was elevated, the posterior aspect of the upper auricular cartilage was completely exposed, and the abnormal insertion of the auricular intrinsic muscles detached. The sharply curved antihelical cartilage was cut and overturned, and the scalp skin flap was undermined and advanced toward the postauricular sulcus. The edge of the retroauricular scalp flap is fixed on the mastoid periosteum. The incision was closed.

Results

Eighteen patients had unilateral cryptotia, and six had bilateral cryptotia. Relatively favorable results were obtained in the follow-up period (range, 6–48 months). There were no cases of skin necrosis, complications, or revision surgery.

Conclusions

The main advantages of this technique are the surgically reproducible results, and that it can be applied to most cases. The method described in this paper could potentially increase the width of the upper third of the auricle and reduce recurrence rate, while also leaving an inconspicuous scar and a satisfactory auricular contour. It is suggested that this technique could be an alternative method of cryptotia correction.

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.
Literature
1.
go back to reference Shin H, Shin J, Song JK et al (2020) Minimally invasive method for correcting reducible Cryptotia[J]. J Craniofac Surg 31(6):1827–1828PubMedCrossRef Shin H, Shin J, Song JK et al (2020) Minimally invasive method for correcting reducible Cryptotia[J]. J Craniofac Surg 31(6):1827–1828PubMedCrossRef
2.
go back to reference Park S, Takushima M, Minegishi M (1994) Reconstruction of cryptotia using a skin graft[J]. Ann Plast Surg 32(4):441–444PubMedCrossRef Park S, Takushima M, Minegishi M (1994) Reconstruction of cryptotia using a skin graft[J]. Ann Plast Surg 32(4):441–444PubMedCrossRef
3.
go back to reference Wang Y, He Z, Ma X et al (2018) A new surgical method of correcting abnormal cartilage in mild or moderate Cryptotia[J]. Ann Plast Surg 81(6):662–668PubMedCrossRef Wang Y, He Z, Ma X et al (2018) A new surgical method of correcting abnormal cartilage in mild or moderate Cryptotia[J]. Ann Plast Surg 81(6):662–668PubMedCrossRef
4.
go back to reference Ho S, Lee D, Yellon R (1979) Cryptotia[J]. Aesthetic Plast Surg 3(1):15–28CrossRef Ho S, Lee D, Yellon R (1979) Cryptotia[J]. Aesthetic Plast Surg 3(1):15–28CrossRef
5.
go back to reference Simon F, Celerier C, Garabedian EN et al (2016) Mastoid fascia kite flap for cryptotia correction[J]. Int J Pediatr Otorhinolaryngol 90:210–213PubMedCrossRef Simon F, Celerier C, Garabedian EN et al (2016) Mastoid fascia kite flap for cryptotia correction[J]. Int J Pediatr Otorhinolaryngol 90:210–213PubMedCrossRef
6.
go back to reference Chang CC, Wu CI, Chang CN (2010) Aesthetic and functional reconstruction of bilateral cryptotia.[J]. Plastic Reconstr Surg 125(2):54e–56eCrossRef Chang CC, Wu CI, Chang CN (2010) Aesthetic and functional reconstruction of bilateral cryptotia.[J]. Plastic Reconstr Surg 125(2):54e–56eCrossRef
7.
go back to reference Qing Y, Cen Y, Yu R et al (2010) A new technique for correcting cryptotia: bolster external fixation method.[J]. J Craniofac Surg 21(6):1935–1937PubMedCrossRef Qing Y, Cen Y, Yu R et al (2010) A new technique for correcting cryptotia: bolster external fixation method.[J]. J Craniofac Surg 21(6):1935–1937PubMedCrossRef
8.
go back to reference Oh JH, Park KH, Kim BG (2016) Prevention of recurrence in the surgical correction of cryptotia using local flaps with a cartilage wedge graft[J]. J Craniofac Surg 27(2):1CrossRef Oh JH, Park KH, Kim BG (2016) Prevention of recurrence in the surgical correction of cryptotia using local flaps with a cartilage wedge graft[J]. J Craniofac Surg 27(2):1CrossRef
9.
go back to reference Shen W, Cui J, Chen J et al (2012) New technique for correcting mild types of cryptotia: elevate cavum conchae cartilage and suture to cranial periosteum.[J]. The J Craniofac Surg 23(6):1830–1831PubMedCrossRef Shen W, Cui J, Chen J et al (2012) New technique for correcting mild types of cryptotia: elevate cavum conchae cartilage and suture to cranial periosteum.[J]. The J Craniofac Surg 23(6):1830–1831PubMedCrossRef
10.
go back to reference Xu JH, Wu WH, Tan WQ (2009) Surgical correction of cryptotia with the square flap method: a preliminary report.[J]. Scand J Plastic Reconstr Surg 43(1):29–35CrossRef Xu JH, Wu WH, Tan WQ (2009) Surgical correction of cryptotia with the square flap method: a preliminary report.[J]. Scand J Plastic Reconstr Surg 43(1):29–35CrossRef
11.
go back to reference Tan WQ, Xu JH, Wu WH (2008) Surgical correction of cryptotia with the three-flap method[J]. Plast Reconstr Surg 122(1):27e–29ePubMedCrossRef Tan WQ, Xu JH, Wu WH (2008) Surgical correction of cryptotia with the three-flap method[J]. Plast Reconstr Surg 122(1):27e–29ePubMedCrossRef
12.
go back to reference Yu X, Yang Q, Jiang H et al (2017) Surgical correction of cryptotia combined with an ultra-delicate split-thickness skin graft in continuity with a full-thickness skin rotation flap[J]. J Plast Reconstr Aesthet Surg 70:1620PubMedCrossRef Yu X, Yang Q, Jiang H et al (2017) Surgical correction of cryptotia combined with an ultra-delicate split-thickness skin graft in continuity with a full-thickness skin rotation flap[J]. J Plast Reconstr Aesthet Surg 70:1620PubMedCrossRef
13.
go back to reference Elsahy NI (1989) An alternative technique for correction of cryptotia[J]. Ann Plastic Surg 23(1):66–73CrossRef Elsahy NI (1989) An alternative technique for correction of cryptotia[J]. Ann Plastic Surg 23(1):66–73CrossRef
14.
go back to reference Hirose T, Tomono T, Matsuo K et al (1985) Cryptotia: our classification and treatment[J]. Br J Plast Surg 38(3):352–360PubMedCrossRef Hirose T, Tomono T, Matsuo K et al (1985) Cryptotia: our classification and treatment[J]. Br J Plast Surg 38(3):352–360PubMedCrossRef
15.
go back to reference Hayashi R, Matsuo K, Hirose T (1993) Familial cryptotia[J]. Plastic Reconstr Surg 91(7):1337–1339CrossRef Hayashi R, Matsuo K, Hirose T (1993) Familial cryptotia[J]. Plastic Reconstr Surg 91(7):1337–1339CrossRef
16.
go back to reference Byrd HS, Langevin CJ, Ghidoni LA (2010) Ear molding in newborn infants with auricular deformities.[J]. Plastic Reconstr Surg 126(4):1191–1200CrossRef Byrd HS, Langevin CJ, Ghidoni LA (2010) Ear molding in newborn infants with auricular deformities.[J]. Plastic Reconstr Surg 126(4):1191–1200CrossRef
17.
go back to reference Matsuo K, Hirose T (1989) A splint for nonsurgical correction of cryptotia[J]. Eur J Plast Surg 12(4):186–187CrossRef Matsuo K, Hirose T (1989) A splint for nonsurgical correction of cryptotia[J]. Eur J Plast Surg 12(4):186–187CrossRef
18.
go back to reference Park C (2002) Correction of cryptotia using an external stretching device.[J]. Ann Plastic Surg 48(5):534–538CrossRef Park C (2002) Correction of cryptotia using an external stretching device.[J]. Ann Plastic Surg 48(5):534–538CrossRef
19.
go back to reference Zhuang Q, Wei N, Zhou Q et al (2020) Efficacy and timing of neonatal ear correction molding[J]. Aesthetic Plast Surg 44(3):872–878PubMedCrossRef Zhuang Q, Wei N, Zhou Q et al (2020) Efficacy and timing of neonatal ear correction molding[J]. Aesthetic Plast Surg 44(3):872–878PubMedCrossRef
20.
go back to reference Staudt CB, Chardot C, Scala GCL (2009) Orthodontic dynamic expansion system for treatment of cryptotia.[J]. Plastic Reconstr Surg 124(1):165e–166eCrossRef Staudt CB, Chardot C, Scala GCL (2009) Orthodontic dynamic expansion system for treatment of cryptotia.[J]. Plastic Reconstr Surg 124(1):165e–166eCrossRef
21.
go back to reference Zhou Z, Chen C, Bi J et al (2019) Study on application of ear correction model to infantile cryptotia[J]. Int J Pediatr Otorhinolaryngol 118:62–67PubMedCrossRef Zhou Z, Chen C, Bi J et al (2019) Study on application of ear correction model to infantile cryptotia[J]. Int J Pediatr Otorhinolaryngol 118:62–67PubMedCrossRef
22.
go back to reference Ono I, Gunji H, Suda K et al (1995) A new operative method for treating severe cryptotia. Plast Reconstr Surg 96:461–468PubMedCrossRef Ono I, Gunji H, Suda K et al (1995) A new operative method for treating severe cryptotia. Plast Reconstr Surg 96:461–468PubMedCrossRef
23.
go back to reference Yotsuyanagi T, Yamashita K, Shinmyo Y et al (2001) A new operative method of correcting cryptotia using large Z-plasty[J]. Br J Plast Surg 54(1):20–24PubMedCrossRef Yotsuyanagi T, Yamashita K, Shinmyo Y et al (2001) A new operative method of correcting cryptotia using large Z-plasty[J]. Br J Plast Surg 54(1):20–24PubMedCrossRef
24.
go back to reference Onizuka T, Tokunaga S, Yamada K (1978) a method for repair of cryptotia[J]. Plast Reconstr Surg 62(5):734–738PubMedCrossRef Onizuka T, Tokunaga S, Yamada K (1978) a method for repair of cryptotia[J]. Plast Reconstr Surg 62(5):734–738PubMedCrossRef
25.
go back to reference Cho BC, Han KH (2005) Surgical correction of cryptotia with V-Y advancement of a temporal triangular flap. Plast Reconstr Surg 115:1570–1581PubMedCrossRef Cho BC, Han KH (2005) Surgical correction of cryptotia with V-Y advancement of a temporal triangular flap. Plast Reconstr Surg 115:1570–1581PubMedCrossRef
26.
go back to reference Park C (2009) Upper auricular adhesion malformation: definition, classification, and treatment[J]. Plast Reconstr Surg 123(4):1302–1312PubMedCrossRef Park C (2009) Upper auricular adhesion malformation: definition, classification, and treatment[J]. Plast Reconstr Surg 123(4):1302–1312PubMedCrossRef
27.
go back to reference Park C, Yoo Y-S, Hong S-T (2010) An update on auricular reconstruction: three major auricular malformations of microtia, prominent ear and cryptotia[J]. Curr Opin Otolaryngol Head Neck Surg 18(6):544–549PubMedCrossRef Park C, Yoo Y-S, Hong S-T (2010) An update on auricular reconstruction: three major auricular malformations of microtia, prominent ear and cryptotia[J]. Curr Opin Otolaryngol Head Neck Surg 18(6):544–549PubMedCrossRef
28.
go back to reference Adams MTA, Cushing S, Sie K (2011) Cryptotia repair: a modern update to the trefoil flap[J]. Archiv Fac Plastic Surg 13(5):355–358CrossRef Adams MTA, Cushing S, Sie K (2011) Cryptotia repair: a modern update to the trefoil flap[J]. Archiv Fac Plastic Surg 13(5):355–358CrossRef
29.
go back to reference Li D, Zhang R, Zhang Q et al (2014) A novel method of naturally contouring the reconstructed ear[J]. Plast Reconstr Surg 133(5):1168–1174PubMedCrossRef Li D, Zhang R, Zhang Q et al (2014) A novel method of naturally contouring the reconstructed ear[J]. Plast Reconstr Surg 133(5):1168–1174PubMedCrossRef
30.
go back to reference Hodgson EL, McGregor AD (2001) Correction of cryptotia using fullthickness skin grafts. Ann Plast Surg 47:471–472PubMedCrossRef Hodgson EL, McGregor AD (2001) Correction of cryptotia using fullthickness skin grafts. Ann Plast Surg 47:471–472PubMedCrossRef
31.
go back to reference Kim YS (2013) Correction of cryptotia with upper auricular deformity: double V-y advancement flap and cartilage strut graft techniques. Ann Plast Surg 71:361–364PubMedCrossRef Kim YS (2013) Correction of cryptotia with upper auricular deformity: double V-y advancement flap and cartilage strut graft techniques. Ann Plast Surg 71:361–364PubMedCrossRef
32.
go back to reference Nakajima T, Yoneda K, Yoshimura Y (1991) Correction of cryptotia using a subcutaneous pedicled flap. Br J Plast Surg 44:406–409PubMedCrossRef Nakajima T, Yoneda K, Yoshimura Y (1991) Correction of cryptotia using a subcutaneous pedicled flap. Br J Plast Surg 44:406–409PubMedCrossRef
33.
go back to reference Mutimer KL, Mulliken JB (1988) Correction of cryptotia using tissue expansion. Plast Reconstr Surg 81:601–604PubMedCrossRef Mutimer KL, Mulliken JB (1988) Correction of cryptotia using tissue expansion. Plast Reconstr Surg 81:601–604PubMedCrossRef
34.
go back to reference Wesser DR (1972) Repair of a cryptotic ear with a trefoil flap: case report. Plast Reconstr Surg 50:192–193PubMedCrossRef Wesser DR (1972) Repair of a cryptotic ear with a trefoil flap: case report. Plast Reconstr Surg 50:192–193PubMedCrossRef
35.
go back to reference Sakamoto Y, Nakajima H, Kishi K et al (2010) A new surgical correction of cryptotia with superior auricular myocutaneous flap[J]. J Plastic Reconstr Aesthetic Surg Jpras 63(12):1995–2000CrossRef Sakamoto Y, Nakajima H, Kishi K et al (2010) A new surgical correction of cryptotia with superior auricular myocutaneous flap[J]. J Plastic Reconstr Aesthetic Surg Jpras 63(12):1995–2000CrossRef
36.
go back to reference Marsh D, Sabbagh W, Gault D (2011) Cryptotia correction – the post-auricular transposition flap[J]. J Plast Reconstr Aesthet Surg 64(11):1444–1447PubMedCrossRef Marsh D, Sabbagh W, Gault D (2011) Cryptotia correction – the post-auricular transposition flap[J]. J Plast Reconstr Aesthet Surg 64(11):1444–1447PubMedCrossRef
37.
go back to reference Hikiami R, Kakudo N, Morimoto N et al (2017) A new modified method of correcting cryptotia with a subcutaneous pedicled flap[J]. Plastic Reconstr Surg Global Open 5(10):e1548-1550CrossRef Hikiami R, Kakudo N, Morimoto N et al (2017) A new modified method of correcting cryptotia with a subcutaneous pedicled flap[J]. Plastic Reconstr Surg Global Open 5(10):e1548-1550CrossRef
38.
go back to reference Cho YK, Bae SG, Cho BC (2014) Comparison between Z-plasty and V-Y Advancement for the surgical correction of Cryptotia[J]. Arch Craniofac Surg 15(1):7–13PubMedPubMedCentralCrossRef Cho YK, Bae SG, Cho BC (2014) Comparison between Z-plasty and V-Y Advancement for the surgical correction of Cryptotia[J]. Arch Craniofac Surg 15(1):7–13PubMedPubMedCentralCrossRef
39.
go back to reference Kim SK, Yoon CM, Kim MH et al (2012) Considerations for the management of cryptotia based on the experience of 34 patients. Arch Plast Surg 39:601–605PubMedPubMedCentralCrossRef Kim SK, Yoon CM, Kim MH et al (2012) Considerations for the management of cryptotia based on the experience of 34 patients. Arch Plast Surg 39:601–605PubMedPubMedCentralCrossRef
40.
go back to reference Lee D, Kim YS, Tai SR et al (2019) Cryptotia recurrence lowering technique with additional acellular dermal matrix graft[J]. Archiv Craniofac Surg 20(3):170–175CrossRef Lee D, Kim YS, Tai SR et al (2019) Cryptotia recurrence lowering technique with additional acellular dermal matrix graft[J]. Archiv Craniofac Surg 20(3):170–175CrossRef
41.
go back to reference Kuwahara H, Masataka Akimoto P, Masahiro Murakami P et al (2019) A comparative finite element analysis of two surgical methods for Cryptotia[J]. Plastic Reconstr Surg Global Open 7(7):e2315-2320CrossRef Kuwahara H, Masataka Akimoto P, Masahiro Murakami P et al (2019) A comparative finite element analysis of two surgical methods for Cryptotia[J]. Plastic Reconstr Surg Global Open 7(7):e2315-2320CrossRef
42.
go back to reference Musgrave RH (1966) A variation on the correction of the congenital lop ear[J]. Plastic Reconstr Surg 37(5):394–398CrossRef Musgrave RH (1966) A variation on the correction of the congenital lop ear[J]. Plastic Reconstr Surg 37(5):394–398CrossRef
Metadata
Title
A New Method of Correcting Cryptotia by Changing Mechanical Fulcrum After Constricted Cartilage Overturned
Authors
Datao Li
Tianya Li
Ruhong Zhang
Qun Zhang
Zhicheng Xu
Feng Xu
Yiyuan Li
Xia Chen
Publication date
01-12-2021
Publisher
Springer US
Keyword
Incision
Published in
Aesthetic Plastic Surgery / Issue 6/2021
Print ISSN: 0364-216X
Electronic ISSN: 1432-5241
DOI
https://doi.org/10.1007/s00266-021-02413-1

Other articles of this Issue 6/2021

Aesthetic Plastic Surgery 6/2021 Go to the issue