"Tragus flap" combined with "Z" modification method in the surgical correction of congenital tragal deformity in children and literature review

Abstract

Objective:To explore the clinical effect of "tragus flap" combined with "Z" modification method in the surgical correction of congenital tragal deformity in children. Methods:The clinical data of 36 children with congenital tragal deformity who were operated in Children's Hospital of Nanjing Medical University from June 2016 to June 2021 were retrospectively summarized, 30 children（35 ears）with congenital tragal malformation had a natural "tragus flap" structure. During the operation, "tragus flap" combined with "Z" modification method was used to reconstruct the tragus. For the depressed deformity around the tragus, the cartilage and fascia tissue around the tragus were used for filling.In the other 6 cases （8 ears）, because the natural "tragus flap" structure was not found, the tragus was reconstructed by other methods, and a relatively satisfactory tragus structure was obtained. The overall effect was satisfactory. Results:No obvious complications were observed during and after the operation. No obvious scar and cartilage hyperplasia were found during the follow-up of 1-12 months. The reconstructed tragus has a good three-dimensional shape, and the depression at the tragus has been well corrected, which is close to the healthy side. The children with bilateral tragus deformity basically achieve bilateral symmetrical tragus, which is satisfactory to the children and their parents. Conclusion:Although the clinical manifestations of congenital tragal malformation are various， "tragus flap" combined with "Z" modification method for tragus reconstruction can be used for most cases. The method not only has shorter operation time, less skin scar and fewer complications, but also can obtain more natural tragus structure.