Case report

1. Case report: Post auricular skin flap
to correct constricted ear (microtia).
Dr. Paik Moo Hyun, PhD
Dr. Gerelmaa

2. External ear abnormalities.
• External ear abnormalities may affect ear
shape, size, prominence and degree of
development.
• May or may not associated with hear loss.

3. Microtia
• Congenital auricular abnormality.
• Range from small but well-formed auricle to
complete absence of external auricle (anotia).

4. Microtia incidence
• Globally, the incidence of microtia varies from 0.8 to 4.53 per 10
000 births,1 with some ethnic groups having a significantly higher
incidence than others. { 1in 2000 new borns} (1)
• In addition to race and genetic susceptibility, there are several
environmental and maternal risk factors.
An exposure to teratogens:
- Thalidomide
- mycophenolate mofetil
- retinoic acid
- isotretinoin during pregnancy is strongly associated with microtia.
Maternal illness, diabetes or anaemia may also be associated. (1)

5. Microtia- Constricted ear
• Auricular anomalies of the upper third of the
ear, whereby it seems that the rim of the ear
has been tightened as if by a purse string. (2)
• It is characterised by four features; lidding,
decreased vertical height of the ear,
protrusion and low ear position. (3)

6. Classification of constricted ear.
In 1975, Tanzer classified constricted ears
in three groups and two subgroups (3)
new classification (Table 3) based on
the present operative options. (4)

7. Our cases.
Hemifacial microsomia 7M Group IIA

8. Our cases.
Constricted ear 33M Group IIB

9. Our cases.
Microtia / Constricted ear 6M Group III

10. Our cases.
Constricted ear 10F Group III

11. Methods.
• Between 2018-2020, four patients with constricted ear
were treated with post auricular skin flap surgery
technique as a 1st step or one-time surgeries.
• A flap was elevated by undermining the postauricular
skin between the subcunateous soft tissue plane and
the …………….. Plane with curved blunt Metzenbaum
scissors (Fig.1).
• The postauricular skin flap was advanced anteriorly
and the defect edges were closed with subcutaneously
5-0 absorbable sutures, and skin with 6-0 nylon
running suture.

12. • Intra-operation and follow –up photographs at
1 -2 month postoperative period
are shown in following figures.

14. References
• 1. Auricular reconstruction Jonathan J Cubitt,1,2
Ling-Yun Chang,1 Derek Liang,1 John
Vandervord1 and Damian D Marucci1,3
• 2. T-bar reconstruction of constricted ears and a
new classification M. Kon a , M.P. van Wijk b, *
• 3. Tanzer RC. The constricted (cup and lop) ear.
Plast Reconstr Surg 1975;55:406e15.
• 4. Kon M, van Wijk MP, T-bar reconstruction of
constricted ears and a new classification, Journal
of Plastic, Reconstructive & Aesthetic Surgery
(2014)