A New Corrective Method for the Tanzer's Group IIB Constricted Ear: Helical Expansion Using a Free-Floating Costal Cartilage

Abstract

Background: The group IIB constricted ear, as defined by Tanzer, shows a short helical length and an accompanying deficiency of the upper antihelix or scapha, and a cup or tubular form. The author proposes in this article a new corrective method for the deformity. Methods: Ten ears in eight patients were corrected with the author's new method. Three small transverse skin incisions were made along the helix, and a subcutaneous helical tunnel was prepared through the skin incision sites. A piece of split eighth or ninth costal cartilage was inserted into the tunnel. In each case, two to four auxiliary procedures were performed to make an effective helical expansion, as follows: (1) the fasciocutaneous Grotting flap was transposed on an intentionally induced gap at the incision site of the otobasion superius; (2) a marginally based scapha skin flap was elevated and advanced toward the inserted helical cartilage; (3) to prevent an excessive widening of the inserted helical cartilage, an additional costal cartilage bar was inserted through the postantihelical tunnel and connected between points on the ascending and descending helices of the inserted cartilage; (4) to correct ear prominence, a 4-0 nylon mattress suture was placed between the descending helix and the conchal wall. Results: All reconstructed ears showed well-expanded helices. The reconstructed ears in unilateral cases showed the same shape and size as their opposite normal ears on follow-up views. Conclusion: The presented method was relatively simple and safe, and offered consistently effective results. (Plast. Reconstr. Surg. 123: 1209, 2009.)