Ear Deformity Research Articles

Full anterior scoring otoplasty.

Lop ear deformity is the most common head and neck congenital malformation with an estimated incidence of 5% amongst newborns. Otoplasty is the surgical procedure designed for its correction. More than 200 surgical techniques have been described so far to treat this condition, most of them including a cartilage weakening maneuver to avoid the relapse of the original auricle shape a few months after surgery. Classic techniques, such as like Mustarde´s, describe this maneuver through scoring the posterior side of the cartilage and stabilizing the new shape with sutures. Cartilage biomechanical properties work against posterior scoring since cartilage folding occurs in the contralateral side of the scoring. This critical point may explain the high rates of relapse in the posterior scoring Otoplasty techniques. In this paper we present our surgical Otoplasty technique with anterior scoring and we discuss specific tips and its nuances. We believe that the anterior scoring otoplasty technique achieves natural ears with both low complication rates and significant reduced long-term relapses.

Ear Reconstruction for Auricle Defects Using an Expanded Neck Flap: A Case Report.

This case report describes a patient with a left ear deformity resulting from a flame burn sustained 20 years ago. The patient underwent an ear reconstruction procedure utilizing an expanded neck flap. The autologous rib cartilage was used as the framework, while an expanded neck flap served as the covering for the framework. The surgery was completed in 3 stages. Initially, tissue expanders were implanted and gradually inflated with water. After sufficient expansion, the expanders were removed, and the scar tissue was excised. Subsequently, the expanded flap was used to cover the defects, and the expanded neck flap was rotated to cover the autogenous costal cartilage framework obtained intraoperatively. Finally, the reconstructed ear was repaired by constructing the cephaloauricular sulcus, removing postauricular scars, and trimming the neck-flap pedicle. After a 1-year follow-up, the wound had healed satisfactorily with only minor complications. The shape of the reconstructed ear appeared realistic, and its function was maintained. Most of the scars were repaired, and the scarred alopecia was significantly improved. In patients with limited availability of the postauricular flap, especially burn patients, using an expanded neck flap can lead to superior outcomes.

Cutaneous tuberculosis of the pinna: A rare entity

IntroductionCutaneous tuberculosis (CTB) is a rare form of extrapulmonary tuberculosis (TB), accounting for only 1% to 2% of all extrapulmonary cases. It typically affects the face, and to a lesser extent, the neck or chest, with a higher incidence among young women. In Malaysia, TB is endemic; however, CTB involving the pinna is exceptionally rare. Consequently, there is often a delay in diagnosis and treatment due to frequent.AimThis case report aims to emphasize the presentation, diagnosis, and subsequent management of cutaneous pinna tuberculosis, supplemented by a review of the existing literature on this disease.Case studyWe present an 83-year-old patient with painful left auricular swelling and deformity and pus discharge for 4 months. His condition did not improve despite prolonged antibiotics treatment and multiple incision and drainage done.Results and discussionExamination under anaesthesia, wound exploration extended incision and drainage was performed, revealing auricular cartilage necrosis, tissue biopsy confirmed the presence of <i>Mycobacterium tuberculosis</i>.Conclusions(1) A non-healing auricular wound despite adequate antibiotics treatment should raise suspicion of TB. (2) Bactec is the most rapid and sensitive culture for tuberculosis. (3) Complications of pinna TB include pain, non-healing wound and permanent ear deformity.

Advances in the Application of Microsurgical Techniques in Repairing Traumatic Auricular Defects

Objectives: Auricular reconstruction is one of the most challenging procedures in plastic surgery. However, traumatic auricular defects present more uncertainty and complexity than congenital microtia with various surgical options in auricular reconstruction. The purpose of this article is to review advances in the use of microsurgical techniques for the treatment of traumatic ear defects. Methods: Three databases, PubMed, Web of Science, and Google Scholar, have been used to gather the most relevant papers discussing the topic. This paper searched for studies from 1980 to 2023: searching for a range of keywords such as “post-traumatic ear deformities,” “free flap,” and “free facial flap.” Using this method, studies related to free flaps in posttraumatic ear reconstruction were reviewed and discussed. Results: Fifty-four studies related to auricular reconstruction using different free flaps were obtained through screening. Conclusion: The microsurgical technique for auricular reconstruction requires both exceptional auricular reconstruction skills and microsurgical expertise due to its intricate nature. Nevertheless, microsurgical techniques remain a valuable avenue of investigation and can provide satisfactory surgical outcomes in appropriately selected patients. Level of Evidence Level V.

Treatment of an Overcorrected Ear After Previously Performed Otoplasty.

No single otoplasty technique can be applied to all prominent ear deformities. The factors determining the type of operative method are based on the surgeon's preference for and confidence in the technique as well as long-term results. However, all cutting or scoring techniques include a risk of development of undesired edges, defects, or deformities on the ear being operated on. One of the patients' complaints and dissatisfactions after otoplasty is an overcorrected ear in its upper half. This condition leads to the loss of helix and prominent and conspicuous crus superior and antihelix. The article presents a simple and successful surgical procedure for correction of the condition.

The Prevalence and Awareness of Congenital External Ear Deformity among the School-Age Group: A Cross-Sectional Study.

Congenital outer ear deformities stem from a sequence of disturbances during fetal auricular cartilage embryonic development. A significant gap exists in understanding their prevalence among the school-age group in Saudi Arabia. This cross-sectional study aims to address this knowledge gap to raise awareness about the impact of such disorders. This cross-sectional study targeted parents of children in the school-age group. A multistage cluster sampling technique was employed to ensure the representation of schools. A self-administered Google form survey was used. Data were analyzed using IBM SPSS Statistics for Windows, Version 28.0 (IBM Corp., Armonk, NY). Our study revealed that the majority were males (56.2%), aged 6 to 10 years (49.3%), and attended primary school (69.5%). Chronic illnesses were present in 7.1% of children, with hearing impairment most prevalent (25.9%). Congenital ear deformities affected 2.7% of children, primarily Stahl's ear (35.4%). Limited knowledge about these deformities was observed among respondents (30.3%), yet a significant majority (73.9%) expressed belief in the potential of community awareness to decrease deformity prevalence. The awareness levels were impacted by parental education but showed no significant association with the child's age, gender, or presence of chronic diseases. Our study underscores the noteworthy occurrence of congenital ear deformities among the school-age group, coupled with a notable lack of awareness. Parental education emerges as a key factor influencing awareness levels. It is imperative to prioritize initiatives to bolster awareness and early detection to promote child health.

A Subunit-Based Concept for Preoperative Design of the Cauliflower Ear.

Cauliflower ear is an ear deformity caused by a closed ear injury with varying severity. Several studies on the systematic reconstruction of cauliflower ear have been reported. Here, the authors aim to introduce a simplified subunit-based reconstruction concept for the cauliflower ear. The authors retrospectively analyzed all patients who underwent surgery to repair cauliflower ear in our department from April 2021 to April 2023. Patients' demographic information, clinical characteristics, and outcomes were recorded. All patients were followed up for 1 year. The authors assessed each subunit of the cauliflower ear in sequence in terms of the change in size and shape and decided whether tissue removal or grafting is needed. The surgical design was obtained by a combination of all subunits. The authors included a total of 5 patients with mild and moderate cauliflower ear repaired by the subunit-based method. The shape of all the involved ear subunits of our patients was almost restored. No patient needed the use of cartilage grafts and flaps. The authors summarized 5 common subunits with deformity: helix, scaphoid fossa, antihelix crura and triangular fossa, antihelix body, and concha. The pathology results reported a keloid in 1 case. All patients reported no recurrence and were satisfied with the surgery after 1 year. The authors reported a simplified subunit-based method of preoperative evaluation and design of cauliflower ear, as a new alternative option to complement the current clinical strategies. The authors also reported the first case of a keloid in cauliflower ear.

Cartilage-sparing otoplasty – 288 ears in 3 years

BackgroundStandard methods of otoplasty may risk anatomical distortion. Previous work showcased a novel, cartilage-sparing technique. This study aimed to confirm the safety and effectiveness of the method in a larger cohort. MethodsThis retrospective study included patients undergoing otoplasty by a single surgeon using a single technique between January 2021 and December 2023. Eligible patients were aged above 5 years and had prominent or constricted or cup ears, forming a 2cm distance from the mastoid. Surgical techniques included novel key-point sutures. Minimum follow-up was 6 months. Data on demographics, risk factors, perioperative management, and complications were collected from patient records. ResultsA total of 288 operated ears (147 patients) were included. The mean age was 17 years and 91 (61.9%) were female. The mean duration of follow-up was 24.3 months. Postoperative complications were generally minor and included PDS suture exposure (n=16, 5.5%), manageable postoperative pain (n=8, 2.7%), self-resolving swelling (n=8, 2.7%), minor bleeding (n=7, 2.4%), and superficial skin complications (n=4, 1.3%). Infections occurred in 4 ears (1.3%) and were treated effectively with topical/oral antibiotics. Cases of partial release of the ear resolved without intervention (n=4, 1.3%). Only 4 (1.3%) ears experienced loss of correction, with options for reoperation available as needed. Analysis showed no significant age differences in postoperative complications, and a nonsignificant trend towards higher postoperative swelling in males compared to females (10.7% vs 2.2%; P=0.054). ConclusionsThe data confirms that this technique offers a safe and rapid cartilage-sparing otoplasty with minimal complications and low recurrence rates. It ensures long-lasting and aesthetically pleasing results for prominent ear deformities. Level of evidenceLevel III

Treacher Collins Syndrome 2 caused by a novel pathogenic variant in PLOR1D: clinical report and literature review

Objective: To investigate the clinical features, molecular etiology, and treatment of a family with Treacher Collins Syndrome 2 (TCS2). Methods: Information of the proband (female, 8 years old) including medical history and family history was collected. Physical examination and examinations concerning laboratory, audiology, and radiology were performed on the proband. Physical examination was also performed on the family members. Genomic DNA of proband was extracted for whole exome sequencing, and then the genomic DNA of family members was extracted for Sanger sequencing. POLR1D and TCS2 related literatures published before August 31,2023 were searched and sifted in PubMed and CKNI databases. The clinical characteristics of TCS2 were summarized. Results: The proband had poor hearing since childhood, with pure tone audiometry indicating conductive hearing loss. She had a smaller jaw, bilateral preauricular fistulas and cup-shaped ear deformities. Temporal bone CT scan revealed deformities in the left external ear canal, bilateral middle ear and inner ear. A bone-conduction hearing aid device was surgically implanted, resulting in restoration of almost normal hearing levels. The proband's mother also had a slightly smaller jaw. Genetic analysis revealed a novel heterozygous variant NM_015972.4:c.38_47del in the POLR1D gene in the proband, which was inherited from her mother. A review of the literature revealed no clear evidence of genotype-phenotype correlation in TCS2. Conclusions: Molecular diagnosis plays a vital role in the diagnosis of TCS2. Patients with normal facial phenotype may be carriers of pathogenic variants in the POLR1D gene and have the risk of passing it to the offsprings with complete penetrance. Proper bone conductive hearing devices can improve the quality of life of TCS2 patients.

Comparison of Outcomes of V-Y Atasoy vs Pentagonal Advancement Flap in the Management of Fingertip Injuries Allen Type II and III in a Tertiary Hospital

Background: Fingertip injuries are the most common traumatic conditions of the hand, affecting productivity and livelihood due to a decrease in manual labor capabilities. The V-Y Atasoy advancement flap is typically effective in managing dorsal or transverse fingertip Allen type II and III injuries but may result in complications like dog ears, flap necrosis, paresthesia, and hook nail deformities. Objective: This paper aimed to describe the assessment, operative technique, and outcomes in patients with fingertip injury Allen type II and type III treated with the V-Y Atasoy advancement flap versus the pentagonal flap. We also aimed to compare the outcomes and complications associated with each technique. Methodology: A randomized controlled trial was done among patients with fingertip injury Allen type II and III who were admitted to a tertiary hospital. Results: There were no significant differences in the rates of immediate complications (flap necrosis, infection, dog ear deformity) or short-term outcomes (two-point discrimination, Semmes-Weinstein monofilament test) between the two groups. Most patients had excellent satisfaction and were able to return to work. Conclusion: Patients of the two groups had good to excellent outcomes and had minimal complications, with no significant differences between the groups. The pentagonal flap can be an alternative to the V-Y Atasoy flap in managing fingertip injuries, especially those with a larger surface area of injury.

A Retrospective Analysis of Pinnaplasty Outcomes: The Welsh Experience.

Prominent ears (PEs) are the most frequent congenital external ear deformity, occurring in ∼5% of the population. Although the deformity does not usually cause functional difficulties, it can significantly affect the patient's psychological and social health. The authors aim to present the Welsh experience of pinnaplasty, reviewing our outcomes and complications. A retrospective cross-sectional study was performed of all patients undergoing pinnaplasty in Morriston Hospital, Swansea, Wales. We represent the tertiary plastic surgery referral unit across Wales. We included all patients undergoing pinnaplasty between 2015 and 2022 inclusive. We excluded patients undergoing revision procedures or those who had no follow-up. Over the 7-year period, 236 pinnaplasties were performed and 203 were included in the analysis. Ninety-six percent of cases were performed using a cartilage-sparing approach, which represents the mainstay in our unit. The mean follow-up length for our cases was 12 months. Revision procedures were required in 4% of cases. Three hematomas (1.5%) and one (0.5%) wound dehiscence due to infection were recorded and required a return to the operating room. Suture extrusion was noted in 5% of cases (10 patients); 4.5% (9) cases were affected by either hypertrophic or keloid scarring. Across the United Kingdom, cosmetic procedures have come under scrutiny, namely, because of a difficult economic climate. In the era of tight fiscal control in health care, it is pertinent to analyze the outcomes and performance metrics of our operations regularly, thus aiding in the development of an established evidence base to advocate for our respective patients.

Investigation of morphometric features of auricle in newborns and etiology of auricle deformity

ABSTRACTImportanceThe diagnosis of congenital auricular deformity often relies on the clinical experience of clinicians, leading to a high incidence of misdiagnosis and missed diagnosis due to the lack of quantitative diagnostic criteria.ObjectiveTo characterize auricle morphology in newborns from southern China and explore the underlying etiology of congenital auricle deformity.MethodsA total of 636 neonates (1272 ears) with less than seven days old were included. The auricles of each infant were measured and photographed. The relationship between maternal factors and the occurrence of congenital auricle deformity was analyzed.ResultsThe incidence of auricular deformity in southern China was 79.87%. Helical rim deformity and mixed deformity had the highest incidence (17.30% each), while cryptotia had the lowest incidence (0.31%). Among mixed deformities, lop ear with conchal crus ear was the most common (22.73%). Each type of auricle deformity had distinct measurement indicators: the vertical distance of cephalo‐auricular was 73.97% longer and cephalo‐superaurale was 70.00% longer in protruding ears compared to normal auricle; the vertical distance of cephalo‐auricular was 10.96% less in lop ears, 15.07% less in conchal crus ears, and 41.1% longer in cup ears; the distance between helix and antihelix was 22.35% less in constricted ear, 12.94% greater in helical rim deformity, and 43.53% greater in Stahl's ear. Family history of hereditary ear deformity and paternal smoking were significant factors associated with ear deformity in southern China.InterpretationThe incidence of auricle deformities is high in southern China, with significant differences in the morphometric structures of different auricle types.

Classic ear moulding technique for a lop ear deformity: case report

Introduction and importance: Lop ear is a congenital auricular deformity (CAD) detected at birth. It can negatively impact aesthetic appearance and the mental health of both the parents and the infant. Therefore, a treatment initiated at an early age is imperative. Case presentation: A male newborn patient on his 11th week of his life presented with his mother to the Maxillofacial Prosthodontic Unit. The extraoral examination showed a pendulous upper part of the auricle covering the antihelix with no deficiencies. The newborn’s hearing function was normal and no associated syndrome was identified. The patient was diagnosed with congenital unilateral lop ear (Tanzer grade II constricted ear). A non-surgical correction with a classic ear moulding device was attempted at the 11th week after birth to reshape the abnormal ear. Clinical discussion: Congenital auricular deformities (CADs) are traditionally managed by an otoplasty at age 6. Unfortunately, this option can cause many unpredictable complications, such as anaesthesia risks and under-correction. Therefore, the classic non-surgical correction of congenital auricular deformities is a non-surgical and earlier alternative to otoplasty. Moreover, many patient present at an older age; an auricular moulding device can still be a successful treatment option for these older patients. Conclusion: Classic ear moulding is an early non-surgical alternative to otoplasty for managing congenital ear abnormalities. It can be initiated as early as 6 weeks after birth. Including an ear examination as a routine in every child’s immediate post-birth physical examination is crucial for early diagnosis and better outcomes.

A Technique of Autologous Costal Cartilage Graft Combined With Auricular Cartilage Folding to Correct Question Mark Ear in a Single Procedure.

Background: Question mark ear is a rare congenital deformity, mainly characterized the interruption of the natural continuity between the lower border of the helix and the earlobe. In severe cases, the earlobe may be absent. In addition, there may be protrusion and outward expansion of the upper part of the auricle, with partial or complete disappearance of the antihelix. This article aims to introduce a technique that combines autologous costal cartilage carving with auricular cartilage folding to achieve a stable and aesthetic auricle. Method: This study included 26 patients with sporadic question mark ear deformity who were treated at our clinical center from January 2020 to December 2022. Based on the different appearances of the lower part of the auricle, they were divided into 2 categories:11 cases showed a natural continuity interruption between the helix and the earlobe, while 15 cases showed the absence of the earlobe. All patients underwent corrective surgery using costal cartilage transplantation combined with the upper part of the auricular cartilage folding, performed by senior surgeons. Results: Question mark ear was effectively improved and with no significant rebound. The average follow-up period was 8.4 months (ranging from 6 to 12 months). A satisfaction survey showed that 23 patients (88%) were satisfied, 3 patients (12%) were partially satisfied, and no patients were dissatisfied. Most patients experienced temporary swelling after surgery, which resolved within 3 months to half a year. Conclusion: Autologous costal cartilage transplantation combined with folding of the auricular cartilage is an ideal surgical method to correct question mark ear.

A multicenter study of long-term outcomes of relapsing polychondritis in Iran

Relapsing polychondritis (RP) is a systemic immune mediated disease characterized by recurrent episodes of inflammation in various cartilage-rich areas. RP may cause extensive tissue destruction and is associated with significant morbidity and mortality. In this multicenter study, we considered the remission status and long-term outcomes of RP in patients who were followed-up in six referral rheumatology centers in Iran. Outcomes of disease was assessed by remission status and RP induced damage. A total of 29 patients with RP were examined for enrollment in the study, and 26 patients with a minimum follow-up period of 6 months were included in the RP outcome analysis. Median time to control of symptoms and sustained remission were 5 and 23 weeks, respectively. Prednisolone was discontinued in 8 (30.8%) patients and medication-free remission was achieved in 7 (23.1%) patients. Regarding the disease course, 34.6% of patients had a relapsing–remitting course, 42.3% had a monophasic course, and 23.1% had an always-active course. Despite extensive treatment with immunosuppressive medications, RP induced damage was developed in 21 (80.8%) patients. Ear deformity and osteoporosis were the most common RP induced damage. Long-term remission and medications-free remission in RP is accessible. However, RP related damage occur in majority of patients.

Effect of External Ear Deformity on Hearing in Wrestlers.

Cauliflower ear in wrestlers can lead to hearing impairment. This study primarily aims to assess the hearing of wrestlers with bilateral cauliflower ears and determine their external ear canal (EEC) resonance frequencies. Our second aim is to evaluate their hearing quality, speech, and spatial perception. This study included 28 male wrestlers aged 18-35 years with bilateral cauliflower ears, as well as 27 male participants in the control group with no wrestling history. The participants' hearing thresholds were determined across the frequency range of 125-16000 Hz for air-conduction and 500-4000 Hz for bone conduction. EEC resonance frequencies were measured. Additionally, all participants completed the Turkish version of the Speech, Spatial, and Qualities of Hearing Scale (SSQ) questionnaire. Wrestlers with cauliflower ears exhibited significantly higher hearing thresholds, particularly at frequencies above 4000 Hz (p < .05). Analysis of EEC resonance showed a shift to higher frequencies in the second resonance peak of the right ear (p < .001) and the first resonance peak of the left ear (p = .045). SSQ scores revealed that wrestlers had higher spatial perception (p = .046), hearing quality (p = .004), and general scores (p = .042) in comparison to the control group. Blunt traumas in wrestlers, leading to cauliflower ear, can result in hearing loss. Moreover, deformities in the external ear affect the resonance frequencies of the EEC. Therefore, it is crucial to advocate for the use of ear protection equipment among wrestlers. When fitting hearing aids, attention should be given to changes in the EEC resonance frequency.

Variability in Inner Ear Morphology Among a Family With Pendred Syndrome Due to a SLC26A4 Gene Variant.

Pendred syndrome, an autosomal recessive disorder, is often associated with pathogenic variants of the SLC26A4 gene that encodes the pendrin protein. Given its autosomal recessive inheritance, tracing the family history and screening siblings become crucial once a diagnosis of Pendred syndrome is confirmed. This case report aims to underscore the variability in inner ear morphology within a family diagnosed with Pendred syndrome, all carrying the same SLC26A4 gene mutation. A chart review and a review of the literature. We present a family of 4, all of whom possess sensorineural hearing loss due to the same homozygous SLC26A4 variant c.919-2A>G. Intriguingly, clinical manifestations, especially inner ear deformities, displayed variability among family members. Notably, 1 family member exhibited a normal cochleovestibular structure morphology, which was rarely reported in the literature. This report highlights the significance of genetic testing and familial consultation when a proband exhibits typical Pendred syndrome symptoms. It also underscores that the inner ear morphology can exhibit variability among family members, even with the same homozygous SLC26A4 variant.

Correction of Constricted Ear – Case Report

Introduction. Congenital deformities of the outer ear are common; reported incidence are from 1:6000 to 1:6830 newborns. Multitude of corrective procedures are described in the literature. Purpose of the case study. The adequate surgical treatment of the congenital constricted ear remains a challenge. Selected tailor made approach should be employed on case by case basis, thus, in this study we present our case of moderate constricted ear and the used surgical procedures done under general anesthesia, as well as the outcome of the treatment. Case report. A 6 year old girl presented in pediatric and plastic surgery department with complaint of right ear deformity from birth and additional psychological effects such as increased difficulty in social integration and lack of self- confidence. On clinical examination, we considered as constricted ear grade IIB by Tanzel. Two separate procedures under general anesthesia were done. In the first procedure, advancement of the helix and otoplasty was performed; an effective expansion, of about 1 cm in the length of the pinna was obtained. In the second procedure, about 0.5 cm expansion of the helix was performed, and also the breadth of the pinna. Conclusion. In our case, combination of Mustardé suture, helix advancement and helix cartilage graft in moderate constricted ear were a useful surgical option, producing aesthetically good results in a simple and effective way.

Management of patients with complex ear deformities

Complex ear reconstruction requires specialized multidisciplinary care. Most patients present with microtia, often associated with hearing disorders. The management of these disorders is a priority, and reconstruction of the external ear remains optional. Nowadays, auricular reconstruction is based on the subcutaneous implantation of either autologous cartilage or an allogeneic implant. Autologous reconstruction requires highly specialized surgical expertise and involves harvesting rib cartilage but carries a lower risk of exposure compared to allogeneic implants. Both techniques yield good results with a high success rate and have a positive impact on the social functioning and daily life of patients.

A CASE REPORT: EARLOBE RECONSTRUCTION ON CONGENITAL AURICULAR LOBE DEFECT USING Z-PLASTY

Highlights: Congenital ear defects typically result from growth failures during the fifth to ninth weeks of gestation or from mechanical stress during this period. Auricular lobuloplasty using the Z-plasty flap technique effectively addresses earlobe defects, resulting in optimal aesthetic outcomes with no keloid formation, minimal scarring, and no complications. Abstract: Introduction: Earlobe defects, often due to embryonal growth failure or injury, can affect aesthetics and social interactions despite not impacting hearing. Earlobe defect can be formed either from birth as congenital defect or secondary manifestation of other causes such as tumor and external factor such as earring usage or trauma. This study aimed to address these issues by performing auricular lobuloplasty using a Z-plasty flap technique. The procedure, crucial for protecting the auditory canal and facilitating eyeglass use, was successful in achieving the desired aesthetic outcome. Data on microtia prevalence, particularly in Indonesia, highlights the need for such reconstructive surgeries. Case Illustration: A 9-year-old boy underwent auricular lobuloplasty to correct a cleft earlobe deformity, which caused social discomfort. The surgery, performed under general anesthesia, utilized a Z-plasty technique to lengthen and reorient the scar. Postoperative care included wound dressing changes and oral pain medication. After two weeks, satisfactory results were observed with no reported complications. Discussion: The study on congenital ear deformities focuses on Z-plasty for earlobe reconstruction, detailing classifications, surgical techniques, and case results. The surgery was successful with minimal scarring and no keloid formation. Using Weerda's classification, the technique showed minimal scarring and no keloid formation. The approach, emphasizing proper skin envelope and alignment with Langer lines, offers effective aesthetic restoration, making it a valuable reference for future earlobe reconstruction cases. Conclusion: Utilizing Z-plasty for earlobe defect reconstruction aids in improving the earlobe's appearance with minimal to no complications.