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defines the rim of the concha. Moreover, the inferior crus also forms the wall that separates the concha from the triangular fossa. The root and superior crus of the antihelix form the anterior wall of the scaphoid fossa, and the helix forms the posterior wall. The triangular fossa dips within the Y-arms of the superior and inferior crura. The corrugated contours of these auricular crests and valleys provide a pillar effect (support) that stabilizes the auricle. The vertical walls of the conchal cup translate to a semi-horizontal plane as the concha merges with the folded crest of the antihelix. The scaphaâhelix is nearly parallel to the plane of the temporal surface of the head. If the roll of the antihelix and its crest are effaced and flat, rather than rolled or folded, the steep pitch of the conchal wall continues into the un-formed antihelix and scapha and ends at the helix, with little interruption. Said planar orientation places the scaphaâhelix complex nearly perpendicular to the temporal plane of the head â because of which the ear appears prominent, thus, such an ear also lacks the stability provided by the pillar effect, and so allows the superior auricular pole to protrude. In the literature, effacement (deficiency) of the antihelical fold is the foremost subject of most discussions of the prominent ear, because it is an aurical deformity manifested as a spectrum of defects and deformities â ranging from an indistinguishable antihelix (with a confluent concavity, from antihelix to scapha and the helical rim projected outwards and forwards) to loss of definition solely of the superior antihelix (with prominence of the upper pole of the ear).
341:. Although of small area, the surface anatomy of the external ear is complex, consisting of the auricle and the external auditory meatus (auditory canal). The outer framework of the auricle is composed of the rim of the helix, which arises from the front and from below (anteriorly and inferiorly), from a crus (shank) that extends horizontally above the auditory canal. The helix merges downwards (inferiorly) into the cauda helices (tail of the helix), and connects to the lobule (earlobe). The region located between the crura (shanks) of the antihelix is the triangular fossa (depression), while the scapha (elongated depression) lies between the helix and antihelix. The antihelix borders in the middle (medially) to the rim of the concha (shell) and the concha proper, which is composed of the conchal cymba above (superiorly) and the conchal cavum below (inferiorly), which are separated by the helical crus, and meet the antihelix at the antihelical rim. The tragus (auditory canal lobule) and the antitragus (counterpart lobule) are separated by the intertragal notch; the auditory canal lobule does not contain cartilage, and displays varied morphologic shapes and attachments to the adjacent cheek and scalp.
1136:. Once the cartilage is loosened, the concha (bowl) is moved closer to the head, after removing the excess skin and cartilage from the ear rim, and is sutured to reshape the antihelical fold, to balance the ear lobe (lobule) with the proportions of the auricle. The corrected ear then is emplaced and sutured closer to the head. Surgical ear pinback can be performed upon an anesthetized patient (local or general anesthesia), and usually is performed as an outpatient procedure that allows the patient to convalesce at home. The post-operative bruising and swelling usually subside within two weeks, and the narrow, surgical scars are hidden in the posterior skin folds of the ear; yet the outcome is not fully noticeable until the swelling and bruising have gone. Historically, otopexy dates from 1881, when Edward Talbott Ely first performed ear pinback plastic surgery at the Eye, Ear, and Throat Hospital, Manhattan, New York City.
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cartilages during the first 6 weeks of their life. The taping approach can involve either adhesive tape and a splinting material, or only adhesive tape; the specific deformity determines the correction method. This non-surgical correction period is limited, because the extant maternal estrogens in the child's organism diminish within 6â8 weeks; afterwards, the ear cartilages stiffen, thus, taping the ears is effective only for correcting "bat ears" (prominent ears), and not the serious deformities that require surgical re-molding of the auricle to produce an ear of normal size, contour, and proportions. Furthermore, ear correction by splints and tape requires the regular replacement of the splints and the tape, and especial attention to the child's head for any type of skin erosion, because of the cumulative effects of the mechanical pressures of the splints proper and the adhesive of the fastener tape.
593:(the positional flattening of the side of the head, not caused by the inappropriate union of two bones). Hence, in the occurrence of a flattening of the skull (parallelogram deformation of the cranial vault), the side of the head afflicted with occipital plagiocephaly presents a prominent ear. In subtle cases, the prominent ear might be more readily evident in an elder patient, whose ears are asymmetrically positioned, reason for which the residual occipital flattening (occipital plagiocephaly), and mild facial asymmetry, are unapparent at first view. This effect, of the shape of the patient's head, upon the outward and extended position of the ear is notably indicated in the 1881 illustrations that describe the Ely otoplasty technique.
919:â A rare congenital defect characterized by a protuberant auricle with a cleft (indentation) between the earlobe and the outer cartilage rim, between the fifth and sixth hillocks. This deformity also is known as 'Cosman ear', after Dr. Bard Cosman (1931â1983), the American plastic surgeon who identified it. The degree of anatomical deficiency is variable, and usually can be corrected with a cartilage graft and a V-Y advancement-flap of retroauricular skin, harvested from the back of the ear, because there often is excess skin in the upper-third of the ear being corrected. To reconstruct a 'Question mark' ear featuring a severely deformed auricle, the otoplastic procedure for correcting microtia is applied.
1256:(congenitally) or in the birth canal (acquired). The possible defects and deformities include protuberant ears ("bat ears"); pointed ears ("elfin ears"); helical rim deformity, wherein the superior portion of the ear lacks curvature; cauliflower ear, which appears as if crushed; lop ear, wherein the upper portion of the auricle is folded onto itself; and others. Such deformities usually are self-correcting, but, if at 1 week of age, the child's external ear deformity has not self-corrected, then either surgical correction (otoplasty 5â6 years of age) or non-surgical correction (tissue molding) is required to achieve an ear of normal proportions, contour, and appearance.
224:(1882â1960) first reproduced the auricle by burying an external-ear support framework, made of autologous rib cartilage, under the skin of the mastoid region of the head, which reconstructed the auricle; he then separated this from the skin of the mastoid area by means of a cervical flap. In 1937, Dr. Gillies also attempted a similar pediatric ear reconstruction with an auricle support framework fabricated from maternal cartilage. This otoplasty correction technique proved inadequate, due to the problems inherent to the biochemical breakdown and elimination (resorption) of the cartilage tissue by the patient's body.
985:(usual for children). In order to correct a lop ear with a small helix (the cartilage-supported outer rim of the auricle), an incision to one side of a flat cartilage piece leaves unopposed elastic forces on the opposite side, which permits the evolution of the ear contour; thus, a small incision on one side of the lop-ear cartilage, along the new anti-helical fold, can be a technical element of the corrective ear surgery. Yet, when done without an incision, the procedure is deemed an 'incisionless otoplasty', wherein the surgeon places a needle through the skin, to model the cartilage and to emplace the retention
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instead be used, wherein tissue is moved from behind the ear rim and then around and forward to repair the defective front of the ear rim. To perform the AntiaâBuch helical advancement, the surgeon first designs the incision inside the helical rim and around the crus (shank) of the helix with ink. The surgeon then cuts the skin and the cartilage, but does not pierce the posterior skin of the ear. The helical rim then is advanced to allow the suturing (closure), and a dog-ear-shaped graft of skin is removed from the back of the ear. The closure of the sutures advances the crus of the helix into the helical rim.
1260:
853:â The hidden ear features the rim of the helix cartilage buried under the skin of the scalp in the temporal region. After making an incision, the upper portion of the ear is exposed by outward traction on the auricle, after making an incision around the visible helical rim. Then, the medial surface of the freed helical-rim cartilage is resurfaced either with a skin graft or with a skin flap. In most cases of cryptotia, the upper-ear cartilage that is buried under the scalp is developmentally normal, but occasionally, it is abnormal and might also require correction.
547:
1303:(2005), reported the efficacy of splinting the ears of a child during the early neonatal period as a safe and effective non-surgical treatment for correcting congenital ear deformities. The study used a variety of physician-designed, physician-fabricated and commercially fabricated splints, such as a wire core segment in 6-French silastic tubing, self-adhering foam, temporary stopping with dental material, dental waxes, thermoplastic materials and other commercial ear-splint devices.
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lobule prominence. The latter feature of conchal shape, while not the sole cause of lobular prominence, appears to play a key role. As the cartilage angle, between the concha cavum and the antitragus, becomes more acute (i.e. as the antitragus tips closer towards the concha), this supporting structure outwardly projects the lobule and the lower-third of the ear. This feature has a greater influence upon the lobule position than does the commonly described helical tail.
164:
466:(2008) reported that the comparisons of the head-to-ear angles and the scapaha-to-concha angles of a 15-patient cohort with prominent ears, with the analogous ear angles of a 15-person control group, established that the average head-to-ear angle was 47.7 degrees for the study group, and 31.1 degrees for the control group; and that the average scapha-to-concha angle was 132.6 degrees for the study cohort, and 106.7 degrees for the control group.
555:
1281:), or solely with tape; or with non-surgical tissue-molding appliances, such as custom-made, defect-specific splints designed by the physician. Therapeutically, the splint-and-adhesive-tape treatment regimen is months-long, and continues until achieving the desired outcome, or until there is no further improvement in the contour of the auricle, likewise, with the custom and commercial tissue-molding devices.
780:
859:â A defect wherein the rim cartilage of the conchal bowl of the ear is flat, rather than folded inwards; it is an evolutionary remnant from when the human head muscles permitted the person to voluntarily prick up the ears in a given direction. The 'Darwinian ear' eponym derives from Charles Darwin (1809â1882), the British biologist and evolutionary theoretician (see
883:â A congenital defect characterized by either the severe underdevelopment or the absence of the auricle. At one end of the spectrum is an auricle slightly smaller than normal, but of normal appearance, and at the other end of the spectrum is anotia, the absence of the auricle. The 'Nagata classification' correlates the ear deformity with the surgical approach thus:
324:
626:; when observed from the front perspective, the head and face of the person present a triangular configuration. Such wide-to-narrow skeletal sloping, from the head to the face, might create the bone promontory upon which rests and from which projects the upper anatomy of the auricle, which otherwise is an external ear of normal proportions, size, and contour.
869:â A protruding ear characterized by the defects of a too-small helix (the cartilage-stiffened rim of the auricle) and a large, central depression around the auricular canal (ear opening); the combined effects of the deformations produce a "cup ear" appearance. The usual plastic correction is enlargement of the helix and closer anchoring to the head.
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surgical scar in the concha, the surgeon meticulously closes the conchal defect with sutures. The design of the cartilage-crescent excision means to produce a closing incision will lay at the junction of the conchal floor and the posterior conchal wall â where it is least noticeable, and causes minimal distortion of the normal contours of the ear.
510:
conchal wall, however, the cephalad part of the concha can protrude disproportionately, another cause for a protruding upper pole. Similarly, the caudal part of the concha can project disproportionately, and cause a protruding lower auricular pole, therefore, these deformational features require special attention in the operating room.
845:â In mild cases of constricted ear, the crus (shank) of the helix is advanced out of the concha, and into the helical rim in order to increase its circumference. In severe cases of constricted ear, some of the cartilage is discarded and a complete reconstruction of the auricle is performed, as in the procedure for correcting microtia.
618:(upper jaw). Moreover, in severe cases of hemifacial microsomia, without the occurrence of microtia (small ears), the normal external ear might appear to have been sheared off the head, because the upper half of the auricle is projecting outwards, and, at the middle point, the lower half of the auricle is canted inwards, towards the
571:
563:
316:
1299:
prominent ears, which derive from varied causes, such as the abnormal development and functioning of the intrinsic and extrinsic ear muscles, which might generate forces that deform the auricle; and external forces consequent to malpositioning of the head during the prenatal and neonatal periods of the child's life. A study,
1027:, though each method differs: whereas the Mustardé method is an open invasive method, by which the cartilage on the back of the ears is extensively exposed and an area of skin is excised, the Merck method is a closed minimally invasive procedure, by which the cartilage is not exposed anywhere and skin is also not removed.
877:â Ears that are proportionately oversized to the person's head; the surgeon reduces them by making an incision on the lateral surface of the auricle, just inside the helical rim. The scapha (elongated hollow) is reduced, and a segment of the helical rim is excised, and the incision is closed primarily to avoid redundancy.
292:â Techniques that resect (cut and remove) the pertinent excess cartilage from the support-framework of the auricle, which then render it pliable to being re-molded, reconfigured, and affixed to the head at the projection distance-and-angle characteristic of a normal ear; the relevant procedures are the cartilage-incision
1226:, which are painful and unattractive. This complication might be avoided by using absorbable sutures; to which effect, monofilament sutures are likelier to protrude, but have a lesser incidence rate of granulomas, whereas braided sutures are unlikely to protrude, but have a greater incidence rate of granulomas.
383:
angle of less than 25 degrees, from the side of the head. Ear configurations, of distance and angle, that exceed the normal measures, appear prominent when the man or the woman is viewed from either the front or the back perspective. In the occurrence of prominent ears, the common causes of anatomic defect,
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of the ear's skin. After removing the dressing, the patient then wears a loose headband whilst sleeping for a 3â6-week period; it should be snug, not tight, because its purpose is preventing the corrected ear(s) from being pulled forward, when the sleeping patient moves whilst asleep. An overly-tight
1163:
For several days after the surgery, the otoplasty patient wears a voluminous, non-compressive dressing upon the corrected ear(s), and must avoid excessive bandage pressure upon the ear during the convalescent period, lest it cause pain and increased swelling, which might lead to the abrasion, or even
1088:
Repositioning the earlobe is the most difficult part of the otoplasty, because when an auricle that has been repositioned in its upper two-thirds, and that yet retains a prominent lobule (earlobe) will appear disproportionate to and malpositioned upon the head â as it did in the original, uncorrected
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of the conchal part of the antihelix: with this method, the antihelix is moved in the direction of the ear canal entrance with the fingers and fixed in this position by mattress sutures. Thus, a large cavum conchae is reduced without any excision of cartilage and the ear moves towards the head to the
513:
Moreover, regarding the shape and projection of the ear, the importance of the concha must be considered in relation to the three-tiered configuration of the auricular cartilage framework, because the more delicate antihelix and helical complex are mounted upon the sturdier concha; therefore, changes
1298:
Congenital ear deformities are defined as either malformations (microtia, cryptotia) or deformations, wherein the term "ear deformation" implies a normal chondrocutaneous component with an abnormal auricular architecture. The conditions are categorized as constricted ears, Stahl's ear deformity, and
485:
The antihelix normally forms a symmetric Y-shaped structure in which the gently rolled (folded) crest of the root of the antihelix continues upwards as the superior crus, and the inferior crus branches forwards, from the root, as a folded ridge. The root of the inferior crus of the antihelix sharply
395:
Prominent conchaThis deformity is caused either by an excessively deep concha, or by an excessively wide concha-mastoid angle (<25 degrees). These two anatomic abnormalities can occur in combination, and produce a prominent concha (the largest, deepest concavity of the auricle), which then causes
373:
The support framework of the reconstructed auricle must be more rigid than the natural cartilage framework of a normal ear, in order for it to remain of natural size, proportion, and contour. If the reconstructed auricle framework were as structurally delicate as the cartilage framework of a natural
1232:
the most common, but significant, complication of otoplasty is overcorrection, which can be minimized by the surgeon's detailed attention to the functional principles of the surgical technique employed. Hence, function over form minimizes the creation of the unnatural contours characteristic of the
654:
diversity of the earlobes found among men, women, and children, some earlobes are large, some earlobes are pendulous, and some earlobes are large and pendulous, but some are prominent because of the structure and form of the dense, interlacing connective tissue fibers that shape the earlobe anatomy
588:
tends to push the concha forward, which extends the auricle (external ear) away from the side of the head. The external ear is mounted upon the bony base of the underlying temporal bone, therefore, anomalies and asymmetries of the skeletal shape can cause either auricle, or both auricles, to become
509:
If the posterior wall of the concha is excessively high, and the concha is excessively spherical, then there is an excessive angle and distance between the plane of the scaphaâhelix and the plane of the temporal surface of the head. Such protrusion usually is evenly distributed around the posterior
1063:
from either an anterior or a posterior approach, the surgeon removes a full-thickness crescent of cartilage from the posterior wall of the concha (ascertaining to neither violate nor deform the antihelical fold), to thereby reduce the height of the concha. Moreover, to avoid producing a noticeable
775:
skin graft harvested from the scalp; and conversely, a proper ear reconstruction might require several surgeries. In the correction of infantile ear defects and deformities, the otoplasty usually is performed when the child is about six years old, as the healthy ear is almost adult-sized, and thus
382:
In the practice of otoplasty, the term "prominent ears" describes external ears (auricles) that, regardless of their size, protrude from the sides of the head. The abnormal appearance exceeds the normal head-to-ear measures, wherein the external ear is less than 2 cm (0.79 in), and at an
943:
does not require a full-thickness excision, and is excised with a 5 mm (0.20 in) margin, to preserve the perichondrium, and then covered with a skin graft. Invasive melanomas of the helical rim require wedge resection to achieve adequate margins; these defects might be large and require
746:
graft from the patient's rib cage, which then is sculpted into an auricular framework that is emplaced under the temporal skin of the patient's head, so that the skin envelope encompass the cartilage framework, the ear prosthesis. Once placed and anchored with sutures, the surgeon then creates an
754:
In the case of the patient encumbered with several congenital defects of the ear or who has insufficient autologous cartilage to harvest, it might be unfeasible to effect the corrections with grafts of rib cartilage. In such a case, the reconstructive AntiaâBuch helical advancement technique may
1155:
usually are permanent (non-absorbable), but the surgical wound or wounds can be sutured with either absorbable sutures or with non-absorbable sutures that the plastic surgeon removes when the surgical wound has healed. Depending upon the deformity to be corrected, the otoplasty can be performed
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deformity. The otoplastic technique most effective for lobular repositioning is the Gosain technique (or a variant), wherein the surgeon cuts the skin on the medial surface of the earlobe, and, in suturing it closed, takes a bite of the conchal undersurface to pull the earlobe towards the head.
1043:
one full-thickness incision along the desired curvature of the antihelix permits folding it with slight force, thereby creating an antihelical fold (as in the
Luckett procedure). Yet, because such a fold is sharp and unnatural in appearance, the technique was modified as the ConverseâWood-Smith
828:
might also result from an acute trauma, and, unless evacuated, the blood in the ear tends to become cartilaginous, resulting in a "cauliflower ear", which, once fully developed, is very difficult to correct. The successful management of a hematoma might require either repeated aspirations or an
716:
Rear perspective: when the auricle is viewed from behind, the helical rim is straight, not bent, as if resembling the letter 'C' (the middle-third to flat), or crooked, as if resembling a hockey stick (the earlobe is insufficiently flat). If the helical rim is straight, the upper-, middle-, and
529:
Understanding the first deformational element is well recognized, and, despite limited attention to the second element, once seen, it is easily understood. Therefore, understanding the third element leads to understanding the surgical-technical approach to correcting the isolated lower-pole and
1276:
circulating in the organism of the child. During that biochemically privileged period, prominent ears, and related deformities, can be permanently corrected by molding the auricles (ears) to the correct shape, either by the traditional method of taping, with tape and soft dental compound (e.g.
1092:
Another prominent-earlobe correction technique is suturing the helical-cartilage tail to the concha, yet, because the tail of the helix does not extend much into the lobule, setting it back does not reliably correct the set back of the earlobe proper; other techniques involve skin excision and
1289:
The traditional, non-surgical correction of protuberant ears is taping them to the head of the child, in order to "flatten" them into the normal configuration. The physician effects this immediate correction to take advantage of the maternal estrogen-induced malleability of the infantile ear
391:
Underdeveloped antihelical foldThis anatomic deformity occurs consequent to the inadequate folding of the antihelix, which causes the protrusion of the scapha and the helical rim. The defect is manifested by the prominence of the scapha (the elongated depression separating the helix and the
747:
auricle (outer ear) of natural proportions, contour, and appearance. In the next months, in follow-up surgeries, the surgeon then creates an earlobe, and also separates the reconstructed auricle from the side of the head (15â18 millimetres (0.59â0.71 in)), in order to create a
494:
The concha of the ear is an irregular hemispheric bowl with a defined rim. The normal scaphaâhelix surrounds the posterior part of the bowl (much as the brim of an inverted hat surrounds the crown). The pitch at which the scaphaâhelix projects from the conchal cup is determined:
447:
describes the presence of a third crus (shank) in the auricle, which produces a pointed elfin ear. The third crus is additional to the two crura (shanks) of the normal triangular fossa (depression), which traverses the scapha (elongated depression separating the helix and the
1132:â An otopexy that "flattens" protuberant ears against the head (15â18 millimetres (0.59â0.71 in)), wherein the surgeon makes an incision to the natural crease behind (retroauricular sulcus) the external ear, and cuts a small tunnel along the front of the poorly folded
1036:
the abrasion (roughening or scoring) of the anterior (front) surface of the anti helical fold cartilage causes the cartilage to bend away from the abraded side (per the Gibson principle), towards the side of intact perichondrium, the membrane of fibrous connective
1185:
can be immediately addressed if the patient complains of excessive pain, or when the surgical wound bleeds. The dressing is immediately removed from the ear to ascertain the existence of a hematoma, which then is immediately evacuated. If the surgical wound is
1005:
Depending upon the auricular defect, deformity, or reconstruction required, the surgeon applies these three otoplastic techniques, either individually or in combination to achieve an outcome that produces an ear of natural proportions, contour, and appearance:
956:â A congenital defect characterized by a backwards-oriented helix (the auricle's curved, cartilage border), which deforms the ear by protruding the ante-helix (inner ridge of the auricle). The eponym derives from Hermann A. Wildermuth (1852â1907), the German
663:
Functionally, the external ear is served by three ear muscles, the auricularis posterior muscle (rear ear-muscle), the auricularis superior muscle (upper ear-muscle), and the auricularis anterior muscle (front ear-muscle), the most notable of which is the
708:
The corrective goal of otoplasty is to set back the ears so that they appear naturally proportionate and contoured without evidence or indication of surgical correction. Therefore, when the corrected ears are viewed, they should appear normal, from the:
1018:
the surgeon emplaces mattress sutures on the back of the ears, which are tied with sufficient tension to increase the definition of the antihelical fold, thereby setting back the helical rim. The cartilage is not treated. This is the technique of
374:
auricle, its anatomic verisimilitude as an ear would gradually be eroded by a combination of the pressure of the tight skin-envelope in the temporal region of the head, and of the pressure of the progressive contracture of the surgical scar(s).
1221:
suture extrusion in the retroauricular sulcus (the groove behind the ear) is the most common otoplastic complication following corrective surgery. Such extruded sutures are easy to remove, but the extrusion occurrence might be associated with
788:
729:
associated with prominent ears, the child's age might be 2 years. Nonetheless, it is advantageous to restrict the further growth of the deformed ear. Regardless of the patient's age, the otoplasty procedure requires that the patient be under
812:â A defect characterized by the outer edges of the ears folded forward, away from the sides of the head, and towards the face; hence the person's feline appearance. The plastic correction anchors, and thus flattens, the ear against the head.
1543:
Merck, W.H. (2013). "Dr Merck's stitch method. A closed minimally invasive procedure for correction of protruding ears (Die
Fadenmethode nach Dr. Merck. Ein geschlossenes, minimal-invasives Verfahren zur Anlegung abstehender Ohren)."
254:- Techniques that leave intact the cartilage support-framework of the ear, and reconfigure the distance and the angle of projection of the auricle from the head, solely by means of sutures, as in the permanent suture-insertion of the
1101:
Depending upon the pre-surgical degree of prominence of the upper-third of the auricle, the surgical creation of the antihelical fold might be inadequate to fully correct the position of the helical rim, near the root of the helix.
524:
The effect of the angulation of the cartilage, at the junction between the cavum concha; and the sweep of cartilage up to the antitragal prominence, affects the position and prominence of the lobule (earlobe) and lower third of the
336:
The external ear (auricle) is a surgically challenging area in terms of anatomy, composed of a delicate and complex framework of shaped cartilage that is covered, on its visible surface, with thin, tightly adherent, hairless
574:
The soft tissues of the right ear: the three muscles that serve the auricle (external ear) the auricularis posterior (left), the auricularis superior (above), and the auricularis anterior (right) as considered for otoplasty
470:
414:
which features an abnormally small auricle, and protrudes from the head because of the inadequate development of the circumference of the helical rim, which, in turn, causes the auricle to collapse forwards, and form a 'cup
1795:
da Silva
Freitas, R.; Sanchez, M. E. R.; Manzotti, M. S.; Baras, F.; Ono, M. C. C.; de Oliveira e Cruz, G. A. (2008). "Comparing Cephaloauricular and Scaphaconchal Angles in Prominent Ear Patients and Control Subjects".
642:. The tail of the helix (cauda helicis), which projects outwards from the concha, carries the earlobe with it, causing it to protrude, which physical condition contributes to prominence of the lower pole of the auricle.
950:â A pointed-ear defect characterized by an abnormal folding of the skin and cartilage of the auricle, which produce an "elfin ear" characterized by an ear-rim with a pointed upper-edge, rather than a rounded upper-edge.
601:
The undersized development of one side of a person's face, demonstrates the influence of skeletal development upon the position of the external ear on the head, as caused by the deficient morphologic development of the
274:: a minimally invasive method, by which the ear is no longer cut open and the cartilage is left completely intact. The mattress sutures are inserted in the ear through 2 to 3 small stab incisions on the back of the ear.
238:
The development of plastic surgery procedures, such as the refinement of J.F. Dieffenbach's ear surgery techniques, has established more than 170 otoplasty procedures for correcting prominent ears, and for correcting
724:
The severity of the ear deformity that is to be corrected determines the advantageous timing of an otoplasty; for example, in children with extremely prominent ears, 4 years old is a reasonable age. In cases of
514:
in conchal size and shape greatly influence the overlying tiers, hence it is rare to see prominence of the ear that does not have a conchal element. The concha affects the prominence of the ear three-fold ways:
589:
prominent. In relation to the protruding mastoid process, the most recognizable skeletal anomaly is the change in the position and in the projection of the auricle, as associated with non-synostotic
306:â Techniques that combine the excision of cartilage portions from the support framework of the auricle, in order to reduce the degree of projection and the distance of the external ear from the head.
935:
lesions in the concha or over the antihelix can usually be excised and skin grafted. If the cartilage is involved, it can be excised and the graft placed directly on the posterior skin. Malignant
421:
which is hidden in the side of the head. The condition of a hidden ear is produced when the developed helix of the auricle is contained under the skin of the scalp in the temporal region. (see
197:(1794â1847) reported the first surgical approach for the correction of prominent ears â a combination otoplasty procedure that featured the simple excision (cutting) of the problematic excess
1118:(absent auricle) involves adding structural elements to replace the missing structures. The cartilage tissue grafts for such extensive reconstructions usually are harvested either from the
1044:
technique, wherein two incisions are made, running parallel to the desired antihelical fold, and tubing sutures are emplaced to create a more defined fold of natural contour and appearance.
1169:
headband can abrade and erode the side surface of the ear, possibly creating an open wound. A dressing does not have to be worn if the patient was operated upon with the stitch method.
713:
Front perspective: when the ear (auricle) is viewed from the front, the helical rim should be visible, but not set back so far (flattened) that it is hidden behind the antihelical fold.
2041:
28. Merck, W.H. (2017) "Ohrmuschelkorrektur ohne
Hautschnitt - die Fadenmethode von Merck". In: K.Bumm (Herausgeber): Korrektur und Rekonstruktion der Ohrmuschel. Springer, 153â169.
795:
The otoplastic technique(s) applied to correct, reconstruct, or replace a deformed, defective, or a missing ear, is determined by the indications that the patient presents; some are:
160:. Moreover, two centuries later, contemporary practices of otoplastic praxis were derived from the techniques and procedures developed and established in antiquity by Sushruta.
622:, underdeveloped side of the face of the patient. A similar type of asymmetric development of the head and face features a relatively broad head, a narrow face, and a narrow
1142:, addressing macrotia, might involve reducing one or more of the components of oversized ears; the incisions usually are hidden in, or near, the front folds of the auricle.
566:
Otoplasty: The cranial surface cartilage of the right ear; the ponticulus (center right) and the cauda helicis (right) also can be proximate causes of prominent ears.
1057:
the surgeon decreases the angle (-25 degrees) between the concha and the mastoid process of the head with sutures emplaced between the concha and the mastoid fascia.
1263:
Non-surgical otoplasty: the therapeutic aspects, before (left), during (center), and after (right), of a tissue-molding procedure performed with an EarWell device.
672:(bridge) of the conchal cartilage, and to the posterior auricular ligament (rear ligament of the ear). The posterior muscle of the ear is composed of two to three
462:
The degrees of angle between the head and the ear, and the degrees of angle between the scapha and the concha, determine the concept of prominent ears. The study,
1070:
the surgeon applies a corrective technique that combines the pertinent technical aspects of the Furnas suture technique and of the conchal excision techniques.
839:â A defect characterized by an indentation (notch) to the fleshy portion of the earlobe. The usual correction is transplantation of an autologous tissue graft.
895:â The patients presents an ear remnant, malpositioned earlobe, concha (with or without acoustic meatus), tragus, and antitragus with an incisura intertragica.
684:
and is inserted to the lower part of the cranial surface of the concha, where it is surrounded by fibroareolar tissue deep within the temporal fascia. The
268:: An open invasive method, whereby the retroauricular cartilage is extensively exposed, a part of the skin is excised, and mattress sutures are inserted.
1419:
Tanzer, R. C.; Converse, J. M.; Brent, B. (1977). "Deformities of the auricle". In
Converse, J. MD; Converse, John Marquis; Littler, J. William (eds.).
820:â An ear deformed by repeated trauma (injury) to the tissues as occurs to boxers and wrestlers; the name of deformity derives from its resemblance to a
227:
In 1964, Radford C. Tanzer (1921â2004) re-emphasized the use of autologous cartilage as the most advantageously reliable organic material for resolving
2124:
688:
irrigates the ear tissues with small, branch-artery blood vessels (rami). Likewise, the rear muscle of the ear is innervated with fine rami of the
1893:
441:
describes the ear that features a deformity of the supralobular region (upper area of the auricle), and has the appearance of a question mark.
1969:
1923:
1878:
1781:
1759:
1428:
1647:
Converse, John
Marquis; Nigro, Anthony; Wilson, Frederick A.; Johnson, Norman (1955). "A technique for surgical correction of lop ears".
833:
of the concha features through-and-through bolster sutures to compress the skin against the cartilage, which usually prevents recurrence.
558:
The soft tissues of the ear: the anatomic location of the posterior muscle of the ear (auricularis posterior) in relation to the auricle.
925:â A congenital defect characterized by the outer edge of the ear curling forward, inwards (like a curled scroll), and towards the head.
2069:
538:
The combined effects of an effaced antihelix and a deep concha also contribute to severe auricular protrusion (a very prominent ear).
1381:
783:
Ear showing Darwin's tubercle, an evolutionary human-ear vestige in a woman, and the like morphologic feature in a macaque monkey.
763:
The ear defect or deformity to be corrected determines the otoplasty techniques and procedures to be applied: for example, a torn
2061:
1272:
In the early weeks of infancy, the cartilage of the infantile auricle is unusually malleable, because of the remaining maternal
1252:
Approximately 20â30 per cent of newborn children are born with deformities of the external ear (auricle) that can occur either
550:
Auricular prominence: in the occipital area, behind the auricle, a protruding mastoid process is a proximate cause of bat ears.
201:
from the posterior sulcus (back groove) of the ear, and the subsequent affixing, with sutures, of the corrected auricle to the
277:
1569:
Fritsch, M.H. (2009) "Incisionless
Otoplasty". Otolaryngologic Clinics of North America |volume=42 |issue=6 |pages=1199â208,
1937:
1259:
931:â Cutaneous malignancies of the helical rim can be excised and closed with the AntiaâBuch helical advancement technique.
357:
supply of the external ear. The sensory innervation involves the front and back (anterior and posterior) branches of the
2117:
2094:
194:
2236:
327:
Prominent ears: the bat-wing type, which extend outwards and to the front, can be corrected with an otopexy procedure.
911:â The patient presents deformities of the ear that are not comprehended in the four preceding Nagata classifications.
685:
350:
939:
should be excised with the same margins as melanomas of the equivalent depth in other parts of the body. Melanoma
689:
84:
319:
The auricle is an anatomic structure composed of a cartilage support framework covered with thin, hairless skin.
2262:
144:
were practiced throughout Asia until the late 18th century; the
October 1794 issue of the contemporary British
134:, lips, and genitalia that were amputated as criminal, religious, and military punishments. The ancient Indian
742:
Generally, for reconstructing an entire ear, or a portion of the rim cartilage, the surgeon first harvests a
431:, a prominent external ear that features an oversized auricle, but is otherwise morphologically normal. (see
2110:
829:
incision to fully evacuate the accumulated blood. After evacuation of the blood, the management of an acute
607:
521:
An extension of the helical crus across the concha creates a firm cartilage bar that pushes the ear outwards
358:
146:
1031:
696:. Deep within these muscle and ligament structures lie the mastoid fascia and the tendinous origin of the
297:
281:
244:
901:â The patient presents an ear remnant, malpositioned lobule, and a small indentation instead of a concha.
2241:
2052:
1322:
802:â A congenital defect characterized by ears without an earlobe; the name of the defect derives from the
665:
88:
1954:
Furnas, D. (1968). "Correction of prominent ears by concha mastoid sutures." Plast
Reconstr Surg 42:189
546:
361:, and is reinforced by the auricular temporal and lesser occipital nerves. The auricular branch of the
265:
255:
806:
minority of northern Spain and western France, where it was a common belief that they had no earlobes.
41:
2267:
889:â The patient has an ear remnant and malpositioned lobule, but no concha, acoustic meatus, or tragus.
860:
697:
651:
404:
399:
Protruding earlobeThis defect of the earlobe causes the prominence of the lower third of the auricle.
235:
viability, resistance to shrinkage, and resistance to softening, and lower incidence of resorption.
2231:
772:
731:
271:
1604:
Stenström, Sten J. (1963). "A 'natural' technique for correction of congenitally prominent ears".
464:
Comparing
Cephaloauricular and Scaphaconchal Angles in Prominent Ear Patients and Control Subjects
167:
The German polymath Johann Friedrich Dieffenbach was a pioneer in the fields of plastic surgery. (
1821:
1672:
1629:
1157:
982:
293:
830:
720:
Side perspective: the contours of the ear should be soft and natural, not sharp and artificial.
163:
2134:
2065:
2026:
1813:
1707:
1664:
1621:
1519:
1475:
1457:
1424:
1408:
1377:
639:
240:
73:
61:
2016:
2008:
1805:
1699:
1656:
1613:
1509:
1465:
1207:
is rare after otoplasty, but it is treated aggressively, with antibiotics in order to avoid
1152:
974:
768:
114:
108:
392:
antihelix) and the upper-third of the ear; and occasionally of the middle third of the ear.
208:, the membrane covering the mastoid process at the underside of the mastoid portion of the
2187:
2097:
1839:
1317:
994:
986:
816:
677:
673:
585:
202:
127:
53:
668:, which functions to pull the ear backwards, because it is superficially attached to the
676:(skeletal-muscle fibers contained in perimysium connective tissue), originates from the
2226:
2021:
1996:
1587:
Fritsch, M.H. (2013). "Ohranlegung ohne Hautschnitt (Incisionless otoplasty. A review).
1470:
1445:
1327:
1195:
751:, the small, rounded projection located before the external entrance to the ear canal.
354:
247:
of the auricle; as such, otoplasty corrections are in three surgical-technique groups:
221:
23:
1703:
1514:
1497:
717:
lower-thirds of the auricle will be proportionately setback in relation to each other.
638:(tail of the helix) is bound to the fibrofatty tissues of the earlobe by a network of
554:
476:
determine the surgical anatomy of the auricle, as considered for otoplasty correction.
2256:
2192:
2182:
1660:
1617:
1398:
681:
635:
611:
603:
590:
518:
The overall enlargement of the concha projects the ear away from the mastoid surface;
284:, whereby the cartilage on the front of the ear is scored with superficial incisions.
259:
209:
1825:
1728:
Bisaccia, Emil; Lugo, Alexander; Johnson, Brad; Scarborough, Dwight (October 2004).
1633:
83:
Congenital ear deformities occasionally overlap with other medical conditions (e.g.
28:
2177:
1278:
748:
693:
2102:
1676:
1093:
sutures, between the fibrofatty tissue of the lobule and the tissues of the neck.
1578:
Fritsch, M.H. (2004). "Incisionless Otoplasty". Facial Plastic Surgery 20, 267â70
2210:
2172:
2012:
1941:
1729:
1312:
1212:
932:
821:
779:
362:
151:
131:
52:, "to shape") is a procedure for correcting the deformities and defects of the
2164:
1809:
1208:
1204:
1191:
1160:
or at hospital; while the operating room time varies between 1.5 and 5 hours.
970:
669:
619:
384:
338:
205:
1461:
1412:
130:
techniques and procedures for correcting, repairing and reconstructing ears,
2202:
2146:
1844:
1223:
1187:
1133:
990:
957:
907:â The patient presents either no ear remnant, or a minute, ear remnant. (v)
849:
422:
232:
198:
77:
2030:
1817:
1711:
1668:
1625:
1523:
1479:
787:
323:
262:
and the incisionless Fritsch otoplasty for creating an anti helical fold:
1273:
1182:
1165:
1123:
978:
936:
873:
825:
743:
726:
623:
615:
432:
365:
supplies a portion of the posterior wall of the external auditory canal.
228:
135:
65:
764:
1995:
Lindford, Andrew J; Hettiaratchy, Shehan; Schonauer, Fabrizio (2007).
771:; a slight damage to the rim of the auricle might be repaired with an
387:, and abnormality can occur individually or in combination; they are:
1894:"Agotes, the mysterious cursed race of the Basque-Navarrese Pyrenees"
1115:
69:
776:
can act as a corrective template for the auricular reconstruction.
570:
562:
469:
1258:
803:
786:
778:
569:
561:
553:
545:
468:
322:
315:
314:
280:: It is a combination of the minimally invasive technique and the
162:
1498:"The correction of prominent ears using simple mattress sutures"
1450:
GMS Current Topics in Otorhinolaryngology, Head and Neck Surgery
2106:
407:
defects, deformities, and abnormalities do occur, such as the:
2138:
1690:
Chongchet, V. (1963). "A method of antihelix reconstruction".
1119:
57:
502:
By the height of the posterior wall of the conchal bowl, and:
16:
Surgery to correct the deformities and defects of the auricle
1557:
Fritsch, M.H. (1995). "Incisionless Otoplasty". Laryngoscope
1194:
therapy helps avoid the occurrence either of abscess or of
80:
support framework of the auricle to correct these defects.
505:
By the completeness of the hemisphere formed by the concha
499:
By the acuteness of the fold of the crest of the antihelix
969:
Otoplastic surgery can be performed upon a patient under
1868:
1866:
1864:
1771:
1769:
1749:
1747:
76:. Otoplastic surgeons may reshape, move, or augment the
396:
the prominence of the middle third of the external ear.
1730:"Otoplasty: The Surgical Approach to Protuberant Ears"
1723:
1721:
1423:(2nd ed.). Philadelphia: Saunders. p. 1710.
1097:
Alteration of the position of the auricular upper pole
655:
independent of the tail of the helix (cauda helicis).
403:
Although most prominent ears are anatomically normal,
155:
139:
112:
2219:
2201:
2163:
2145:
1599:
1597:
1446:"Otoplasty â techniques, characteristics and risks"
1114:, addressing microtia (underdeveloped auricle) and
791:
Grade III microtia affecting the left ear of a boy.
534:
Protruding antihelix and protruding concha combined
47:
33:
1539:
1537:
1535:
1533:
2081:The Encyclopedia of Cosmetic and Plastic Surgery
138:knowledge and plastic surgery techniques of the
111:and is described in the medical compendium, the
2051:Thorne, Charles (2013). Thorne, Charles (ed.).
1215:, and which may permanently disfigure the ear.
300:for the anterior-correction of prominent ears.
231:(abnormally small ears), because of its great
2118:
1068:Combination of suturing and conchal excision:
8:
1491:
1489:
184:
126:). The book discussed otoplastic and other
39:
2125:
2111:
2103:
1407:] (in German). Leipzig: FA Brockhaus.
1348:The Oxford Dictionary of English Etymology
2020:
1997:"Postpartum splinting of ear deformities"
1968:sfn error: no target: CITEREFThorne2007 (
1922:sfn error: no target: CITEREFThorne2007 (
1877:sfn error: no target: CITEREFThorne2007 (
1780:sfn error: no target: CITEREFThorne2007 (
1758:sfn error: no target: CITEREFThorne2007 (
1513:
1469:
458:Cephaloauricular and scaphoconchal angles
1376:(3 ed.). Penguin. pp. 63â100.
1982:
1855:
1359:
1339:
1301:Postpartum Splinting of Ear Deformities
606:, and by the medial positioning of the
1963:
1917:
1872:
1775:
1753:
1397:Dieffenbach, Johann Friedrich (1845).
107:(surgery of the ear) was developed in
1230:Overcorrection and unnatural contour:
7:
1211:, a condition potentially requiring
311:Surgical anatomy of the external ear
1892:Ălvarez, Jorge (31 October 2019).
1692:British Journal of Plastic Surgery
1649:Plastic and Reconstructive Surgery
1606:Plastic and Reconstructive Surgery
1502:British Journal of Plastic Surgery
1444:Naumann, Andreas (14 March 2008).
1122:(auricular cartilage) or from the
929:Skin cancer and malignant melanoma
14:
2062:Lippincott Williams & Wilkins
2054:Grabb and Smith's Plastic Surgery
1350:. Oxford University Press p. 635.
610:, the synovial joint between the
1661:10.1097/00006534-195505000-00004
1618:10.1097/00006534-196311000-00003
1084:Correction of earlobe prominence
2083:. New York City: Facts on File.
1421:Reconstructive Plastic Surgery
1106:Types of otoplastic correction
584:The occurrence of a prominent
278:Incisionless Fritsch otoplasty
1:
1704:10.1016/S0007-1226(63)80120-4
1515:10.1016/S0007-1226(63)80100-9
1011:Antihelical fold manipulation
1001:Surgical otoplasty techniques
349:The superficial temporal and
168:
120:
60:), whether these defects are
767:can be repaired solely with
666:auricularis posterior muscle
351:posterior auricular arteries
345:Blood supply and innervation
195:Johann Friedrich Dieffenbach
2237:Auditory brainstem response
2013:10.1136/bmj.39063.501377.BE
692:, which is a branch of the
212:, at the back of the head.
156:
140:
113:
48:
34:
2284:
1372:Wujastyk, Dominik (2003).
1294:Physician-designed splints
1248:Incidence of ear deformity
1233:"technically perfect ear".
1016:Suturing of the cartilage:
960:who identified the defect.
686:posterior auricular artery
542:Protruding mastoid process
1938:"Ear Surgeon - Cryptotia"
1810:10.1007/s00266-008-9160-8
1798:Aesthetic Plastic Surgery
1346:Onions CT, editor (1996)
1041:Full-thickness incisions:
944:secondary reconstruction.
690:posterior auricular nerve
150:reported the practice of
85:Treacher Collins syndrome
40:
27:
977:, local anesthesia with
630:Protruding cauda helicis
119:(Sushruta's Compendium,
1496:Mustardé, J.C. (1963).
1400:Die operative Chirurgie
608:temporomandibular joint
359:greater auricular nerve
216:20th and 21st centuries
186:Die operative Chirurgie
1264:
1238:Non-surgical otoplasty
1147:Post-surgical recovery
792:
784:
576:
567:
559:
551:
477:
328:
320:
185:
175:
154:, as described in the
2242:Electronystagmography
1405:The operative surgery
1374:The Roots of Ayurveda
1323:Maxillofacial surgery
1262:
1219:Suture complications:
1034:of anterior abrasion:
948:Stahl's ear deformity
790:
782:
597:Hemifacial microsomia
573:
565:
557:
549:
474:The angles of the ear
472:
445:Stahl's ear deformity
326:
318:
166:
89:hemifacial microsomia
72:, etc.) or caused by
2079:Rinzler, CA (2009).
2064:. pp. 283â294.
989:that will affix the
698:sternomastoid muscle
580:Auricular prominence
147:Gentleman's Magazine
2232:Caloric reflex test
1966:, pp. 299â300.
1944:on January 4, 2014.
1126:(costal cartilage).
1032:Stenström technique
965:Surgical procedures
732:general anaesthesia
298:Stenström technique
282:Stenström technique
272:Merck stitch method
191:Operational Surgery
1279:gutta-percha latex
1265:
1158:outpatient surgery
1050:Conchal alteration
983:general anesthesia
793:
785:
738:Ear reconstruction
704:Surgical otoplasty
646:Protruding earlobe
577:
568:
560:
552:
478:
329:
321:
296:and the Chongchetâ
294:Converse technique
266:Mustardé technique
256:Mustardé technique
176:
2250:
2249:
1734:The Dermatologist
1430:978-0-7216-2682-6
1061:Conchal excision:
917:Question mark ear
909:Atypical microtia
899:Small concha type
861:Darwin's tubercle
640:connective tissue
453:Angles of the ear
439:Question mark ear
369:Otoplastic praxis
222:Harold D. Gillies
64:conditions (e.g.
2275:
2127:
2120:
2113:
2104:
2084:
2075:
2060:(7th ed.).
2059:
2035:
2034:
2024:
1992:
1986:
1980:
1974:
1973:
1961:
1955:
1952:
1946:
1945:
1940:. Archived from
1934:
1928:
1927:
1915:
1909:
1908:
1906:
1904:
1898:La BrĂșjula Verde
1889:
1883:
1882:
1870:
1859:
1858:, pp. 54â5.
1853:
1847:
1836:
1830:
1829:
1792:
1786:
1785:
1773:
1764:
1763:
1751:
1742:
1741:
1725:
1716:
1715:
1687:
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1680:
1644:
1638:
1637:
1601:
1592:
1585:
1579:
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1561:
1555:
1549:
1541:
1528:
1527:
1517:
1493:
1484:
1483:
1473:
1441:
1435:
1434:
1416:
1394:
1388:
1387:
1369:
1363:
1357:
1351:
1344:
1112:Ear augmentation
975:local anesthesia
954:Wildermuth's ear
744:costal cartilage
188:
173:
170:
159:
157:Sushruta Samhita
143:
141:Sushruta Samhita
125:
122:
118:
115:Sushruta Samhita
51:
45:
44:
37:
31:
2283:
2282:
2278:
2277:
2276:
2274:
2273:
2272:
2263:Plastic surgery
2253:
2252:
2251:
2246:
2215:
2197:
2188:Tympanocentesis
2159:
2141:
2131:
2098:Flash animation
2091:
2078:
2072:
2057:
2050:
2047:
2039:
2038:
2007:(7589): 366â8.
1994:
1993:
1989:
1981:
1977:
1967:
1962:
1958:
1953:
1949:
1936:
1935:
1931:
1921:
1916:
1912:
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1900:
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1850:
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1789:
1779:
1774:
1767:
1757:
1752:
1745:
1727:
1726:
1719:
1689:
1688:
1684:
1646:
1645:
1641:
1603:
1602:
1595:
1589:"J Aesthet Chir
1586:
1582:
1577:
1573:
1568:
1564:
1556:
1552:
1542:
1531:
1495:
1494:
1487:
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1442:
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1395:
1391:
1384:
1371:
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1345:
1341:
1336:
1318:Plastic surgery
1309:
1296:
1287:
1270:
1250:
1245:
1240:
1198:(inflammation).
1175:
1149:
1108:
1099:
1086:
1077:desired degree.
1003:
967:
843:Constricted ear
817:Cauliflower ear
761:
740:
706:
678:mastoid process
661:
648:
632:
599:
586:mastoid process
582:
544:
536:
492:
483:
460:
455:
412:Constricted ear
380:
371:
347:
334:
313:
218:
181:
171:
128:plastic surgery
123:
102:
97:
17:
12:
11:
5:
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2271:
2270:
2265:
2255:
2254:
2248:
2247:
2245:
2244:
2239:
2234:
2229:
2227:Epley maneuver
2223:
2221:
2217:
2216:
2214:
2213:
2207:
2205:
2199:
2198:
2196:
2195:
2190:
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2175:
2169:
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2161:
2160:
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2149:
2143:
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2132:
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2129:
2122:
2115:
2107:
2101:
2100:
2090:
2089:External links
2087:
2086:
2085:
2076:
2071:978-1451109559
2070:
2046:
2043:
2037:
2036:
1987:
1975:
1956:
1947:
1929:
1920:, p. 311.
1910:
1884:
1875:, p. 301.
1860:
1848:
1831:
1787:
1778:, p. 297.
1765:
1756:, p. 305.
1743:
1717:
1682:
1639:
1593:
1580:
1571:
1562:
1550:
1546:J Aesthet Chir
1529:
1485:
1436:
1429:
1389:
1382:
1364:
1362:, p. 151.
1352:
1338:
1337:
1335:
1332:
1331:
1330:
1328:Otolaryngology
1325:
1320:
1315:
1308:
1305:
1295:
1292:
1286:
1283:
1269:
1268:Tissue molding
1266:
1249:
1246:
1244:
1241:
1239:
1236:
1235:
1234:
1227:
1216:
1199:
1196:perichondritis
1174:
1171:
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1143:
1137:
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1080:
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1045:
1038:
1028:
1002:
999:
966:
963:
962:
961:
951:
945:
926:
920:
914:
913:
912:
902:
896:
890:
878:
870:
864:
854:
846:
840:
834:
813:
807:
760:
757:
739:
736:
722:
721:
718:
714:
705:
702:
660:
657:
647:
644:
631:
628:
598:
595:
581:
578:
543:
540:
535:
532:
527:
526:
522:
519:
507:
506:
503:
500:
491:
488:
482:
479:
459:
456:
454:
451:
450:
449:
442:
436:
426:
416:
401:
400:
397:
393:
379:
378:Prominent ears
376:
370:
367:
355:arterial blood
346:
343:
333:
330:
312:
309:
308:
307:
301:
287:
286:
285:
275:
269:
217:
214:
180:
177:
101:
98:
96:
93:
15:
13:
10:
9:
6:
4:
3:
2:
2280:
2269:
2266:
2264:
2261:
2260:
2258:
2243:
2240:
2238:
2235:
2233:
2230:
2228:
2225:
2224:
2222:
2218:
2212:
2211:Mastoidectomy
2209:
2208:
2206:
2204:
2200:
2194:
2193:Myringoplasty
2191:
2189:
2186:
2184:
2183:Tympanoplasty
2181:
2179:
2176:
2174:
2171:
2170:
2168:
2166:
2162:
2156:
2153:
2152:
2150:
2148:
2144:
2140:
2136:
2128:
2123:
2121:
2116:
2114:
2109:
2108:
2105:
2099:
2096:
2093:
2092:
2088:
2082:
2077:
2073:
2067:
2063:
2056:
2055:
2049:
2048:
2044:
2042:
2032:
2028:
2023:
2018:
2014:
2010:
2006:
2002:
1998:
1991:
1988:
1985:, p. 53.
1984:
1979:
1976:
1971:
1965:
1960:
1957:
1951:
1948:
1943:
1939:
1933:
1930:
1925:
1919:
1914:
1911:
1899:
1895:
1888:
1885:
1880:
1874:
1869:
1867:
1865:
1861:
1857:
1852:
1849:
1846:
1842:
1841:
1840:Prominent Ear
1835:
1832:
1827:
1823:
1819:
1815:
1811:
1807:
1803:
1799:
1791:
1788:
1783:
1777:
1772:
1770:
1766:
1761:
1755:
1750:
1748:
1744:
1739:
1735:
1731:
1724:
1722:
1718:
1713:
1709:
1705:
1701:
1697:
1693:
1686:
1683:
1678:
1674:
1670:
1666:
1662:
1658:
1654:
1650:
1643:
1640:
1635:
1631:
1627:
1623:
1619:
1615:
1612:(5): 509â18.
1611:
1607:
1600:
1598:
1594:
1590:
1584:
1581:
1575:
1572:
1566:
1563:
1560:
1554:
1551:
1548:, 6, 209-220.
1547:
1540:
1538:
1536:
1534:
1530:
1525:
1521:
1516:
1511:
1507:
1503:
1499:
1492:
1490:
1486:
1481:
1477:
1472:
1467:
1463:
1459:
1455:
1451:
1447:
1440:
1437:
1432:
1426:
1422:
1414:
1410:
1406:
1402:
1401:
1393:
1390:
1385:
1383:0-140-44824-1
1379:
1375:
1368:
1365:
1361:
1356:
1353:
1349:
1343:
1340:
1333:
1329:
1326:
1324:
1321:
1319:
1316:
1314:
1311:
1310:
1306:
1304:
1302:
1293:
1291:
1284:
1282:
1280:
1275:
1267:
1261:
1257:
1255:
1247:
1242:
1237:
1231:
1228:
1225:
1220:
1217:
1214:
1210:
1206:
1203:
1200:
1197:
1193:
1189:
1184:
1180:
1177:
1176:
1173:Complications
1172:
1170:
1167:
1161:
1159:
1156:either as an
1154:
1151:The internal
1146:
1141:
1140:Ear reduction
1138:
1135:
1131:
1128:
1125:
1121:
1117:
1113:
1110:
1109:
1105:
1103:
1096:
1094:
1090:
1083:
1075:
1074:Medialisation
1072:
1069:
1066:
1062:
1059:
1056:
1053:
1052:
1051:
1048:
1042:
1039:
1035:
1033:
1029:
1026:
1022:
1017:
1014:
1013:
1012:
1009:
1008:
1007:
1000:
998:
996:
992:
988:
984:
980:
976:
972:
964:
959:
955:
952:
949:
946:
942:
938:
934:
930:
927:
924:
921:
918:
915:
910:
906:
903:
900:
897:
894:
891:
888:
885:
884:
882:
879:
876:
875:
871:
868:
865:
862:
858:
857:Darwinian ear
855:
852:
851:
847:
844:
841:
838:
837:Cleft earlobe
835:
832:
827:
823:
819:
818:
814:
811:
808:
805:
801:
798:
797:
796:
789:
781:
777:
774:
770:
766:
758:
756:
752:
750:
745:
737:
735:
733:
728:
719:
715:
712:
711:
710:
703:
701:
699:
695:
691:
687:
683:
682:temporal bone
679:
675:
671:
667:
658:
656:
653:
652:morphological
645:
643:
641:
637:
636:cauda helicis
629:
627:
625:
621:
617:
613:
612:temporal bone
609:
605:
604:temporal bone
596:
594:
592:
591:plagiocephaly
587:
579:
572:
564:
556:
548:
541:
539:
533:
531:
523:
520:
517:
516:
515:
511:
504:
501:
498:
497:
496:
489:
487:
480:
475:
471:
467:
465:
457:
452:
446:
443:
440:
437:
434:
430:
427:
424:
420:
419:Cryptotic ear
417:
413:
410:
409:
408:
406:
398:
394:
390:
389:
388:
386:
377:
375:
368:
366:
364:
360:
356:
353:preserve the
352:
344:
342:
340:
331:
325:
317:
310:
305:
302:
299:
295:
291:
288:
283:
279:
276:
273:
270:
267:
264:
263:
261:
260:stitch method
257:
253:
250:
249:
248:
246:
242:
236:
234:
230:
225:
223:
215:
213:
211:
210:temporal bone
207:
204:
200:
196:
192:
187:
178:
165:
161:
158:
153:
149:
148:
142:
137:
133:
129:
124: 500 AD
117:
116:
110:
109:ancient India
106:
99:
94:
92:
90:
86:
81:
79:
78:cartilaginous
75:
71:
67:
63:
59:
55:
50:
43:
36:
30:
25:
21:
2178:Stapedectomy
2154:
2080:
2053:
2045:Bibliography
2040:
2004:
2000:
1990:
1983:Rinzler 2009
1978:
1959:
1950:
1942:the original
1932:
1913:
1901:. Retrieved
1897:
1887:
1856:Rinzler 2009
1851:
1838:
1834:
1804:(4): 620â3.
1801:
1797:
1790:
1737:
1733:
1695:
1691:
1685:
1655:(5): 411â8.
1652:
1648:
1642:
1609:
1605:
1591:, 6. 203-208
1588:
1583:
1574:
1565:
1559:. 105, 1-11.
1558:
1553:
1545:
1505:
1501:
1453:
1449:
1439:
1420:
1404:
1399:
1392:
1373:
1367:
1360:Rinzler 2009
1355:
1347:
1342:
1300:
1297:
1288:
1271:
1253:
1251:
1229:
1218:
1201:
1178:
1162:
1150:
1139:
1129:
1111:
1100:
1091:
1087:
1073:
1067:
1060:
1054:
1049:
1040:
1030:
1024:
1020:
1015:
1010:
1004:
995:conchal bowl
968:
953:
947:
940:
928:
922:
916:
908:
904:
898:
892:
886:
880:
872:
866:
856:
848:
842:
836:
815:
809:
799:
794:
762:
753:
741:
723:
707:
694:facial nerve
662:
659:Soft tissues
649:
633:
600:
583:
537:
528:
512:
508:
493:
484:
473:
463:
461:
444:
438:
429:Macrotic ear
428:
418:
411:
402:
381:
372:
363:vagus nerves
348:
335:
303:
289:
251:
237:
226:
219:
190:
182:
179:19th century
145:
104:
103:
82:
58:external ear
19:
18:
2268:Ear surgery
2173:Myringotomy
1964:Thorne 2007
1918:Thorne 2007
1873:Thorne 2007
1776:Thorne 2007
1754:Thorne 2007
1313:Ear shaping
1243:Indications
1213:debridement
1130:Ear pinback
958:neurologist
893:Concha type
887:Lobule type
822:cauliflower
759:Indications
620:hypoplastic
575:correction.
448:antihelix).
405:morphologic
332:The auricle
245:deformities
172: 1840
152:rhinoplasty
2257:Categories
2165:Middle ear
2135:procedures
2133:Tests and
1698:: 268â72.
1334:References
1224:granulomas
1209:chondritis
1205:cellulitis
1202:Infection:
1192:antibiotic
971:anesthesia
923:Scroll ear
831:othematoma
773:autologous
670:ponticulus
650:Given the
258:the Merck
233:histologic
206:periosteum
62:congenital
38:, "ear" +
2203:Inner ear
2155:Otoplasty
2147:Outer ear
2095:Otoplasty
1903:8 October
1845:eMedicine
1740:(10): 42.
1508:: 170â8.
1462:1865-1011
1456:: Doc04.
1417:cited by
1413:162724901
1274:estrogens
1179:Hematoma:
1134:antihelix
1055:Suturing:
991:antihelix
937:melanomas
933:Cancerous
850:Cryptotia
810:Cat's ear
800:Cagot ear
674:fascicles
481:Antihelix
423:Cryptotia
385:deformity
304:Group III
220:In 1920,
199:cartilage
193:, 1845),
105:Otoplasty
100:Antiquity
20:Otoplasty
2031:17303887
1826:24606100
1818:18414935
1712:14042756
1669:14384519
1634:42807787
1626:14078273
1524:13936895
1480:22073080
1307:See also
1254:in utero
1188:infected
1183:hematoma
1166:necrosis
1124:rib cage
1021:Mustardé
979:sedation
881:Microtia
874:Macrotia
826:hematoma
727:macrotia
624:mandible
616:mandible
614:and the
433:Macrotia
290:Group II
229:microtia
66:microtia
49:plĂĄssein
42:ÏλΏÏÏΔÎčÎœ
2137:on the
2022:1800995
1471:3199845
1164:to the
1153:sutures
1037:tissue.
997:areas.
987:sutures
941:in situ
867:Lop ear
769:sutures
765:earlobe
680:of the
252:Group I
241:defects
203:mastoid
136:medical
95:History
54:auricle
2068:
2029:
2019:
1824:
1816:
1710:
1677:244781
1675:
1667:
1632:
1624:
1522:
1478:
1468:
1460:
1427:
1411:
1380:
1285:Taping
1116:anotia
905:Anotia
749:tragus
490:Concha
74:trauma
70:anotia
2220:Tests
2058:(PDF)
1822:S2CID
1673:S2CID
1630:S2CID
1403:[
1025:Merck
981:, or
804:Cagot
132:noses
24:Greek
2066:ISBN
2027:PMID
1970:help
1924:help
1905:2021
1879:help
1814:PMID
1782:help
1760:help
1708:PMID
1665:PMID
1622:PMID
1520:PMID
1476:PMID
1458:ISSN
1425:ISBN
1409:OCLC
1378:ISBN
1023:and
993:and
824:. A
634:The
525:ear.
415:ear.
339:skin
243:and
87:and
2139:ear
2017:PMC
2009:doi
2005:334
2001:BMJ
1843:at
1806:doi
1700:doi
1657:doi
1614:doi
1510:doi
1466:PMC
1120:ear
183:In
91:).
35:oûs
29:ÎżáœÏ
2259::
2025:.
2015:.
2003:.
1999:.
1896:.
1863:^
1820:.
1812:.
1802:32
1800:.
1768:^
1746:^
1738:12
1736:.
1732:.
1720:^
1706:.
1696:16
1694:.
1671:.
1663:.
1653:15
1651:.
1628:.
1620:.
1610:32
1608:.
1596:^
1532:^
1518:.
1506:16
1504:.
1500:.
1488:^
1474:.
1464:.
1452:.
1448:.
1190:,
1181:a
973:â
863:).
734:.
700:.
169:c.
121:c.
68:,
46:,
32:,
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2126:e
2119:t
2112:v
2074:.
2033:.
2011::
1972:)
1926:)
1907:.
1881:)
1828:.
1808::
1784:)
1762:)
1714:.
1702::
1679:.
1659::
1636:.
1616::
1526:.
1512::
1482:.
1454:6
1433:.
1415:.
1386:.
435:)
425:)
189:(
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56:(
22:(
Text is available under the Creative Commons Attribution-ShareAlike License. Additional terms may apply.
