Severe cryptotia correction using an adjustable postauricular Z-skin flap combined with autologous conchal cartilage grafting: A retrospective study.

Abstract

Cryptotia is a common congenital auricular deformity among Asian populations, often involving cartilage malformations in the upper third of the auricle. Existing surgical techniques frequently yield unsatisfactory outcomes due to inadequate skin coverage or insufficient cartilage correction. This study introduces a modified technique combining a postauricular Z-shaped skin flap with autologous conchal cartilage grafting to address these issues. A retrospective analysis was conducted on 48 unilateral severe cryptotia cases treated between 2020 and 2023. All patients underwent corrective surgery using a postauricular Z-shaped skin flap with autologous conchal cartilage grafting. During the operation, the concha cartilage was transplanted to stretch the helix and support the antihelix, achieving a thorough and stable correction of the cartilage deformity. Surgical outcomes were evaluated using 3D scanning and visual analog scale (VAS) scores. The mean follow-up period was 17.67 ± 4.72 months. Significant improvements were observed in auricular perimeter, length, width, and vertical distance "D" between the highest point of the auricle and skull immediately postoperatively (P＜0.05), with no statistical differences compared to the contralateral ear (P＞0.05). These results remained stable and improved further at the final follow-up. VAS scores indicated high satisfaction among patients and their families. This modified technique effectively restores auricular contour and symmetry in severe cryptotia. Short-term follow-up revealed stability of the operative result with minimal complications and concealed scarring. It represents a safe and efficient option for surgical correction of severe cryptotia.