Surgical correction of cryptotia with V-Y advancement of a temporal triangular flap

A new approach is introduced for the correction of cryptotia using a large triangular flap designed on the temporal scalp and skin over the auricle.

The posterior limb of the triangular flap was continued to the mastoid area at the midportion of the auricle. The abnormal insertion of the auricular intrinsic muscles was detached. A sharply curved antihelical crus or a contraction of helical cartilage was corrected. After ample skin was provided to maintain the auriculocephalic sulcus by inferior advancement of the flap, the donor site was closed primarily.

From 1999 to 2003, a total of 13 cases of 11 patients with cryptotia were treated. Nine patients had unilateral cryptotia and two had bilateral cryptotia. The follow-up period was 3 months to 1 year, with relatively favorable results. The length of the helix was extended, and it was possible to increase the width of the upper third of the auricle. There were no postoperative complications, such as necrosis or flap infection.

The main advantages of this proposed technique are simple and easy design, provision of enough skin to the upper and posterior portions of the auricle, sufficient depth of the auriculocephalic sulcus, correction of cartilage deformities with unrestricted access, and no additional skin grafting. Problems encountered were the development of a visible scar on the donor site and lowered hairline because of advancement of the temporal triangular flap.