Auricle ear deformity and otoplasty ear plastic surgery
This is a family of rare congenital ear deformities where the rim of the ear is flattened and the upper portions deformed. The skin and cartilage are folded to different degrees that can result in a pointed upper edge even resembling a Vulcan (Star Trek) ear shape. It can appear in many degrees from mild to severe.
Very rare in Caucasians, Stahl's ear deformity is more common in Orientals. This malformation may have a hereditary component, studies have not been conclusive.
An abnormal fold of cartilage extends from the anthelix, through the scapha (scaphoid fossa) and up through the rim of the helix. The scapha is normally "scooped out" hollow or bowl with the deep part facing the back of the ear. In the Stahl's Ear Deformity, this cartilage is bent forward.
Left Drawing of Stahl Ear Deformity
Right Drawing of Stahl Ear Deformity viewing from edge
Notice how a fold through the scapha has flipped the bowl towards the front. The top rim of the helix has flipped up and flattened. The fold from the Stahl Ear Deformity can be mild to severe. The top of the ear can be flat or pointed.
The "Y" shaped anthelix can be deformed from missing the upper crux (fold) to 3 instead of 2 upper folds. The rigidity of this upper fold also varies.
Left Drawing of Stahl Ear Deformity with Scaphoid Fold Forward
Right Drawing of Stahl Ear Deformity with Scapha Flipped Backwards
In this drawing, the scapha can be easily flipped back into a normal posterior position. The helix rim reforms as the fold is reduced. Some patients have a much firmer fold deformity. In some cases the pointed shape is extreme enough that removing this fold does not result in a rounded shape.
Treatment options depend on many factors.
The Stahl ear deformity that may be treated within the first few weeks of life with non-surgical molding. Once the child is over about 6 weeks, the cartilage is no longer as soft and there is a lower success rate with splinting.
After the ear has grown surgical options depend on the specific deformity which must be determined during an in office examination. Since one of the factors is the stiffness of the fold, a hands on clinical examination is very important. What Dr. Bermant will recommend will depend on the specific Stahl ear deformity and how the tissue reacts during surgery. He uses a dynamic technique that may combine one or more of the following:
- cartilage bending sutures
- cartilage weakening maneuvers
- rotation or flipping a section of cartilage
- skin and cartilage excision and sculpture