Reconstruction of microtia with crus helicis transversal deformity using flap technique combined with ear cartilage transplantation: a retrospective study

Abstract Background The combination of crus helicis transverse deformity and microtia presents one of the most complex ear deformities. Historically, the surgical correction of this deformity has predominantly utilized rib cartilage for ear reconstruction. This study presents a method for correcting microtia with crus helicis transversal deformity, utilizing the flap technique in conjunction with cartilage transplantation. Methods From February 2017 to October 2023, a total of 42 patients with crus helicis transversal deformity and microtia were included in this retrospective study. The corrective surgery combines flap technique with cartilage transplantation. We collected the morphological data of ear, Visual Analogue Scale (VAS) satisfaction scores, and Aesthetic Outcomes Scale (AOS) aesthetic ratings of patients both prior to and 12 months following surgery. Results The average duration of follow-up was 13.71 ± 2.97 months. Following the operation, there has been a significant improvement in the length, width, and circumference of the ear, as well as in the differences in these measurements between the two ears compared to prior to the procedure. The average AOS score prior to surgery was 17.90 ± 1.41, while the average AOS score following surgery increased to 29.57 ± 1.51. The preoperative VAS satisfaction score was recorded at 1.95 ± 1.12, while the postoperative VAS score showed a significant increase to 8.23 ± 0.87. Conclusion The flap technique, combined with cartilage grafting, effectively corrects the crus helicis transversal deformity with microtia. The approach maximizes the use of deformity ear tissue while minimizing damage. Additionally, it creates a natural and aesthetically pleasing ear shape, resulting in high patient satisfaction. Level of evidence statement IV.