Surgical correction of cryptotia with the square flap method: a preliminary report

Cryptotia is the fourth most common congenital auricular deformity, and it is more prevalent among Asians. A number of techniques for its correction have been introduced, and relatively favourable results have been achieved. We describe our experience with a technique for its correction using the square flap method designed on the temporal scalp and skin over the auricle. From 2001 to 2006 a total of 19 examples in 12 patients were treated. Seven patients had bilateral, and five had unilateral, cryptotia. Traction was applied to the upper part of the auricle to draw it away from the scalp, and the square flap method, consisting of two triangular flaps and one square flap, were designed on the temporal scalp and skin over the auricle. After the skin had been incised, the three flaps were freed completely, and the abnormal insertion of the auricular intrinsic muscles was detached. The flaps were then transposed, advanced, and sutured. There were no problems of viability in any patient, and all healed well. The follow-up period was 3 months to 2 years, with relatively favourable results. Function and appearance were satisfactory in all patients. The length of the helix was extended, and it was possible to increase the width of the upper part of the auricle. This technique is indicated in cases of mild to moderate cryptotia, and has many advantages, including simple and easy design, provision of enough skin for the upper and posterior portions of the auricle, sufficient depth of the auriculocephalic sulcus, and no additional skin grafting.