Single-stage reconstruction of severe question mark ear with the absence of large portions of the lobule using affected cartilage graft and 3 flaps

Abstract

BackgroundQuestion mark ear is a congenital abnormality characterized by a prominent curve within the helix that resembles a question mark. Several surgical reconstruction techniques have been proposed to treat this deformity. In this study, we aimed to evaluate the cosmetic outcomes of a new cartilage and postauricular flap surgical reconstruction technique for patients diagnosed with severe QME. MethodFrom 2017 to 2023, 33 patients with severe QMEs were treated with a new reconstruction surgical technique at the Plastic Surgery Hospital of Peking Union Medical College. The perimeter, width, length, and auriculocephalic angles of both ears were measured and compared to assess the symmetry. The patient’s satisfaction with the surgical outcomes and the incidence of postoperative complications were also evaluated. The average follow-up duration was 15.48 months. ResultsThe auricular perimeter, width, and length changed significantly after surgery. The dimensions between the left and right ear did not vary significantly in both patients with unilateral or bilateral severe QME after surgery and at the end of one-year follow-up. The majority of patients (87.88%) or carers were satisfied with cosmetic outcomes after surgery. All patients underwent suture removal 14 days after surgery and exhibited excellent wound healing without any complications such as hematoma, infection, and flap necrosis. ConclusionOur new surgical reconstruction technique for severe QME resulted in good cosmetic outcomes, high patient satisfaction, fast recovery, and no post-operative complications.