Proposal of a classification system for the assessment and treatment of prominent ear deformity
Open accessAbstract
Background Prominent ear is the most common external ear deformity. To comprehensively treat prominent ear deformity, adequate comprehension of its pathophysiology is crucial. In this article, we analyze cases of prominent ear and suggest a simple classification system and treatment algorithm according to pathophysiology.Methods We retrospectively reviewed a total of 205 Northeast Asian patients' clinical data who underwent an operation for prominent ear deformity. Follow-up assessments were conducted 3, 6, and 12 months after surgery. Prominent ear deformities were classified by diagnostic checkpoints. Class I (simple prominent ear) includes prominent ear that developed with the absence of the antihelix without conchal hypertrophy. Class II (mixed-type prominent ear) is defined as having not only a flat antihelix, but also conchal excess. Class III (conchal-type prominent ear) has an enlarged conchal bowl with a well-developed antihelix.Results Among the three types of prominent ear, class I was most frequent (162 patients, 81.6%). Class II was observed in 28 patients (13.6%) and class III in 10 patients (4.8%). We used the scaphomastoid suture method for correction of antihelical effacement, the anterior approach conchal resection for correction of conchal hypertrophy, and Bauer's squid incision for lobule prominence. The complication rate was 9.2% including early hematoma, hypersensitivity, and suture extrusion. Unfavorable results occurred in 4% including partial recurrence, overcorrection, and undercorrection.Conclusions To reduce unfavorable results and avoid recurrence, we propose the use of a classification and treatment algorithm in preoperative evaluation of prominent ear.Level of evidence iv This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
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In adult patients with rigid cartilage, the reshaping achieved through sutures tends to be less permanent, increasing the risk of recurrence.
“In adult patients with rigid cartilage, the reshaping achieved through sutures tends to be less permanent, increasing the risk of recurrence [23].”
From Comparative Analysis of Mustardé, Fascioperichondrial Flap, and Combined Otoplasty Techniques: Clinical Outcomes and Recurrence Rates in 365 Patients (2025) · cites this paper as [23]
Surgical success depends not only on the technique employed but also on patient- and procedure-specific factors, including patient age, cartilage rigidity, suture material, surgeon experience, and adequate preoperative evaluation of lobular prominence.
“Moreover, surgical success depends not only on the technique employed but also on a range of patient- and procedure-specific factors, including patient age, cartilage rigidity, suture material, surgeon experience, and adequate preoperative evaluation of lobular prominence [23,24].”
From Comparative Analysis of Mustardé, Fascioperichondrial Flap, and Combined Otoplasty Techniques: Clinical Outcomes and Recurrence Rates in 365 Patients (2025) · cites this paper as [23]
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- Authors
- Lee, Y., Kim, Y. S., Lee, W. J., Rha, D. K., & Kim, J.
- Affiliations
- Yonsei University (KR)
- Corresponding author
- Kim, Jiye
- Venue
- Aesthetic Plastic Surgery
- Published
- 2017-12-29
- Volume
- 42
- Issue
- 3
- Pages
- 759-765
- ISSN
- 0364-216X (ISSN-L)
- 1432-5241
- OpenAlex
- W2776918253
- Cited by
- 11
- References
- 14
- Citations by year
- 2026: 2 · 2025: 1 · 2024: 1 · 2023: 1 · 2022: 2 · 2021: 1 · 2020: 3
- FWCI
- 0.84
- Type
- journal article
- Language
- en
- Open access
- green
- link.springer.com
- Licence
- cc-by-nc-nd
- www.springer.com/tdm (unspecified)
- Locations
- Aesthetic Plastic Surgery (publishedVersion)
- PubMed (publishedVersion)
- YUHSpace (Yonsei University Medical Library) (submittedVersion, cc-by-nc-nd)
- Topics
- Health Sciences › Medicine › Surgery › Reconstructive Facial Surgery Techniques
- Health Sciences › Medicine › Genetics › Congenital Ear and Nasal Anomalies
- Health Sciences › Medicine › Surgery › Nasal Surgery and Airway Studies
- Keywords
- prominent ears, otoplasty, classification systems, antihelix, postoperative complications, recurrence, treatment algorithm
- MeSH terms
- Congenital Abnormalities, Adolescent, Adult, Age Factors, Esthetics, Female, Humans, Hypertrophy, Male, Middle Aged, Prognosis, Retrospective Studies, Sex Factors, Surgery, Plastic, Databases, Factual, Treatment Outcome, Risk Assessment, Asian People, Ear Auricle, Young Adult
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