Arch Craniofac Surg.  2019 Jun;20(3):170-175. 10.7181/acfs.2019.00269.

Cryptotia recurrence lowering technique with additional acellular dermal matrix graft

Affiliations
  • 1Department of Plastic and Reconstructive Surgery, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea. eqatom@yuhs.ac

Abstract

BACKGROUND
Cryptotia is a congenital anomaly in which the upper part of the retroauricular sulcus is absent and buried underneath the temporal skin. Various surgical techniques have been reported for the correction of cryptotia following Kubo's V-Y plasty in 1933. Conventional methods using a local skin flap, skin grafting, tissue expansion, Z-plasty, and any of these combined approaches can result in skin deficiency of the upper auricle. The aim of this study was to develop a new method that improves cosmetic results and has fewer complications.
METHODS
This study involved four patients in whom five cryptotia deformities were corrected using V-Y plasty and Z-plasty. After elevation of the flap, acellular dermal matrix (ADM; MegaDerm) that was over 5 mm in thickness was applied to the cephalo-auricular angle and positioned to enhance the projection of the ear. Lastly, the flap was transposed to complete the repair.
RESULTS
Between January 2014 and February 2018, cryptotia correction with ADM graft was performed in four patients. None of the patients developed a recurrence of cryptotia, and there were no postoperative complications such as wound infection, seroma formation, and dehiscence. In addition, the procedures resulted in a favorable cosmetic appearance.
CONCLUSION
Based on these findings, i.e., no recurrence and a favorable cosmetic result, when using an ADM graft, it is suggested that this technique could be an alternative method of cryptotia correction. It could also lessen donor-site morbidity when compared to autologous cartilage grafting and be more cost-effective than using cartilage from a cadaver.

Keyword

Acellular dermal; Congenital abnormalities; Cryptotia, familial; Ear cartilage

MeSH Terms

Acellular Dermis*
Cadaver
Cartilage
Congenital Abnormalities
Ear
Ear Cartilage
Humans
Methods
Postoperative Complications
Recurrence*
Seroma
Skin
Skin Transplantation
Tissue Expansion
Transplants*
Wound Infection
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