Helical Cartilage Inversion and V-Y Advancement Flap for Type IIB Constricted Ear Correction.

Abstract

A type IIB constricted ear is a common congenital auricular deformity. Traditional methods often require multistage surgeries or contralateral tissue transplantation. We hypothesized that helical cartilage inversion grafting combined with a V-Y advancement flap could achieve effective single-stage correction with comparable morphologic improvements to traditional methods, while significantly eliminating donor-site morbidity. This study aims to evaluate the clinical efficacy and safety of this technique. This retrospective analysis included 20 patients (23 ears) with type IIB constricted ear. Through a retroauricular approach, the excessively folded helical cartilage was transected to create a free cartilage graft, then inverted and reconnected. A retroauricular V-Y advancement flap provided soft tissue coverage. Surgical outcomes were assessed using auricular measurements, the Aesthetic Outcomes Scale (AOS), and the Visual Analog Scale (VAS). The mean patient age was 5.2±1.8 years with a 12-month follow-up. Postoperative ear vertical height increased from 40.3±3.5 to 50.5±3.8 mm (25.3% increase, P<0.001). AOS scores improved from 1.8±0.6 to 3.2±0.7 (P<0.001). VAS satisfaction scores increased from 2.1±1.2 to 8.3±1.4 (P<0.001). A total of 90% of patients achieved satisfaction scores ≥7, with 13.0% complication rate. Helical cartilage inversion grafting combined with V-Y advancement flap is a safe and effective single-stage correction method for type IIB constricted ear, characterized by minimal trauma, adequate soft tissue coverage, and low complication rates, providing a valuable clinical treatment option.