Maintaining ear aesthetics in helical rim reconstruction

BACKGROUND: Wedge resections of the helical rim may result in a significant deformity of the ear with the ear not only smaller but cupped and prominent too. Our technique involves resection of the wedge in the scaphal area without extending into the concha followed by advancement of the helical rim into the defect. This technique is most suitable for peripheral defects of the helical rim, in the middle third. METHODS: Our modified surgical technique was applied to reconstruction of the pinna after resection of the tumor in 12 patients. Free cartilaginous helical rim, length of helical rim to be resected, and projection of the ear from the mastoid was measured. This was then compared with measurements after the operation, and the patient satisfaction assessed with a visual analog scale. RESULTS: The free cartilaginous rim was 91.67 +/- 5.61 mm. Of this, 21.92 +/- 3.78 mm was resected, which amounted to 23.84% +/- 3.35% of the rim. Although this resulted in a mean increase in ear projection of 6.42 +/- 1.68 mm, the aesthetic outcome was good (visual analog scale, 9.08 +/- 0.9). CONCLUSIONS: This technique reduces cupping and does not make the ear as prominent as it may do after a conventional wedge resection and results in high patient satisfaction