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Conchal Cartilage Sandwich Graft for Repairing Recalcitrant Acquired Split Earlobe Deformity

Agarwal, Rajiv, M.D.; Chandra, Ramesh, F.R.C.S.

Plastic and Reconstructive Surgery: December 2009 - Volume 124 - Issue 6 - p 442e-443e
doi: 10.1097/PRS.0b013e3181bcf228
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Department of Plastic Surgery C.S.M. Medical University Lucknow, India(Agarwal, Chandra)

Correspondence to Dr. Agarwal A-15 Nirala Nagar Lucknow 226020, India drrajivagarwal@rediffmail.com

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Sir:

A torn earlobe is by far the commonest cosmetic problem of the ear requiring surgery. Many techniques have been published for the repair of earlobe tears.1–3 These techniques consist of simple suturing of the tear and use of flaps for preservation of the ear hole, in addition to description of many different types of flaps to provide strength to the earlobe below the repaired ear hole. All these surgical methods inadvertently tend to add to further scarring and weakening of the earlobe tissues, thus predisposing the earlobe to recurrent tears.

The reason for recurrent splitting of the earlobe lies in the anatomy of the earlobe, which is unique with regard to the direction of the split4 and also because of anatomical weakness of the earlobe. The earlobe consists of skin and subcutaneous tissue but no internal architectural support of either cartilage, muscle, or fascial tissue. The soft structure of the earlobe is thus not strong enough to withstand the continuous trauma associated with long-term earring use, with its attendant problems of superadded incidental trauma caused by inadvertent pulling of the earring or even surgical scarring, which is unwittingly exacerbated by repeated repairs of split earlobe. The direction of the split of the earlobe is also unique.

A new technique has been developed that strengthens the earlobe with locally available conchal cartilage (Fig. 1) and provides the necessary reinforcement of earlobe tissues, preventing further recurrence following surgery. This technique also allows simultaneous creation of a centrally located ear hole, thus eliminating the waiting period between ear hole repair and reperforation. This technique involves harvesting a disk of conchal cartilage and implanting this disk into the repaired earlobe. A new ear hole is then created at a central location on the repaired split earlobe across the center of this cartilage disk in the same sitting. The patients thus have the satisfaction of leaving the operating room with earrings on, completely eliminating any waiting period between repair and reperforation.

Fig. 1.

Fig. 1.

This technique thus allows durable repair of the earlobe by strengthening the tissues using conchal cartilage graft. It reduces the chance of recurrence and also facilitates simultaneous recreation of a central ear hole in the same setting (Fig. 2).

Fig. 2.

Fig. 2.

Rajiv Agarwal, M.D.

Ramesh Chandra, F.R.C.S.

Department of Plastic Surgery

C.S.M. Medical University

Lucknow, India

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DISCLOSURE

The authors have no financial or commercial interests in the current study with any company.

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REFERENCES

1. Pardue AM. Repair of torn earlobe with preservation of the perforation for an earring. Plast Reconstr Surg. 1973;51:472–473.
2. Hamilton R, LaRossa D. Method for repair of cleft earlobes. Plast Reconstr Surg. 1975;55:99–101.
3. Agarwal R. Repair of cleft earlobe using double opposing Z-plasty. Plast Reconstr Surg. 1998;102:1759–1760.
4. Agarwal R, Chandra R. The anatomy of the split ear lobe. J Plast Reconstr Aesthet Surg. 2008;61 (Suppl. 1): S114.

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