Modified bilateral fasciaperichondrial flap for prominent ear correction
Open accessAbstract
OBJECTIVE: Various techniques have been described in the literature for prominent ear correction. These cartilage-preserving or cartilage-shaping techniques have their own advantages and disadvantages. We aim to achieve aesthetic and stable results with low complication rates using combinations of these methods. Herein, we present our results of prominent ear surgery with a modified bilateral fasciaperichondrial flap in combination with concha-mastoid and concha-scaphal sutures. METHODS: Patients whose surgeries included a modified bilateral fasciaperichondrial flap for prominent ear deformities were included in the study. Patients' demographic data, pre- and postoperative Concha-Mastoid Angle (CMA) and upper-middle Helix-Mastoid Distances (HMD), follow-up time, complications, secondary operations, and postoperative Visual Analogue Scale (VAS) results were evaluated. With a postauricular fish-mouth incision, the bilateral fasciaperichondrial flap was planned into two: proximal- and distal-based. They were then elevated from the cartilage subperichondrially on the proximal side and supraperichondrially on the distal side. Concha-scaphal sutures were used to form an antihelical rim along with concha-mastoid sutures to reduce the concha-mastoid angle. Conchal cartilage resection was done if needed. Then, the bilateral fasciaperichondrial flaps were sutured together to cover the concha-mastoid and concha-scaphal sutures. RESULTS: Between May 2017 and May 2021, 32 ears of 17 patients were operated on due to prominent ear deformity. No hematoma or infection was observed in any patient, and there were no instances of recurrence, suture exposure, hypertrophic scars, or keloids. The satisfaction level of all patients was 8.2 ± 0.9 points on average according to the VAS. In the anthropometric measurements, a statistically significant difference was found between preoperative and postoperative sixth month CMA and HMD values. CONCLUSION: A combination of suture techniques and a modified bilateral fasciaperichondrial flap may be used in prominent ear cases, with low recurrence rates and high patient satisfaction. LEVEL OF EVIDENCE: III.
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Supportive techniques aim to reduce both recurrence and suture-related complications by providing a well-vascularized tissue barrier over the suture line.
“To address these limitations, several supportive techniques have been introduced, with particular emphasis on the postauricular fascial flap and its variations (e.g., perichondrio-adipo-dermal flap and modified bilateral fascioperichondrial flap). These methods aim to reduce both recurrence and suture-related complications by providing a well-vascularized tissue barrier over the suture line [15,16”
From Comparative Analysis of Mustardé, Fascioperichondrial Flap, and Combined Otoplasty Techniques: Clinical Outcomes and Recurrence Rates in 365 Patients (2025) · cites this paper as [18]
The Discussion says the postauricular fascial flap covers permanent sutures and helps reduce recurrence and complications, including suture exposure. It does not describe the covering tissue as well vascularized, so that specific part of the proposed mechanism is unsupported by our copy. (LLM, conf=0.84)
Experimental — accuracy not yet measuredCombined techniques have been shown to reduce recurrence rates compared with the Mustardé method alone, although they may not be as effective as the fascioperichondrial flap technique.
“According to the literature, combined techniques have been shown to reduce recurrence rates compared with the Mustardé method alone, although they may not be as effective as the fascioperichondrial flap technique [18,19].”
From Comparative Analysis of Mustardé, Fascioperichondrial Flap, and Combined Otoplasty Techniques: Clinical Outcomes and Recurrence Rates in 365 Patients (2025) · cites this paper as [18]
The Discussion (page unavailable) says that adding a postauricular fascial flap to suture methods helps reduce recurrence, and the Conclusion reports no recurrence with the authors’ combined approach. The paper does not compare recurrence rates against Mustardé alone or show that a combined technique is less effective than a fasciaperichondrial flap technique. (LLM, conf=0.84)
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References 21 · Cited by 3
- Authors
- Aysel, A., Karatan, B., Ergün, U., & Müderris, T.
- Affiliations
- Bakırçay Üniversitesi (TR)
- Sağlık Bilimleri Üniversitesi (TR)
- Corresponding author
- Ergün, Uğurtan
- Venue
- Brazilian Journal of Otorhinolaryngology
- Publisher
- Elsevier BV
- Published
- 2023-01
- Volume
- 89
- Issue
- 1
- Pages
- 152-158
- ISSN
- 1808-8686 (ISSN-L)
- 1808-8694
- PMC
- PMC9874352
- OpenAlex
- W4212994115
- Cited by
- 3
- References
- 21
- Citations by year
- 2026: 1 · 2025: 1 · 2023: 1
- FWCI
- 0.48
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- Brazilian Journal of Otorhinolaryngology (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Topics
- Health Sciences › Medicine › Surgery › Reconstructive Facial Surgery Techniques
- Health Sciences › Medicine › Surgery › Nasal Surgery and Airway Studies
- Health Sciences › Medicine › Genetics › Congenital Ear and Nasal Anomalies
- Keywords
- prominent ears, otoplasty, postoperative complications, patient satisfaction
- MeSH terms
- Ear Diseases, Humans, Otologic Surgical Procedures, Surgical Flaps, Suture Techniques, Plastic Surgery Procedures, Ear Auricle
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