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Teratogenicity

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The ability of a drug to produce structural deformations and functional abnormalities in the developing embryo or the fetus is called teratogenicity, and the drug producing this effect is known as a teratogen. Teratogenic effects include stillbirth, miscarriage, intrauterine growth restriction, and neurocognitive delay. A teratogen may affect the embryo at different stages of development, which is important in determining the type and extent of the damage. During blastocyst formation, the early...
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Major Tragal Malformations: Structural Feature, Classification, and Reconstruction.

Jin Sik Burm1, Jungil Hwang2, Hea Sol Na1

  • 1Department of Plastic Surgery, Kyung Hee University Hospital, Kyung Hee University College of Medicine.

The Journal of Craniofacial Surgery
|February 19, 2026
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Summary

This study introduces a new classification and surgical method for major congenital tragal malformations, focusing on tragal cartilage for better reconstruction. The approach achieved high patient satisfaction and natural-looking results with minimal scarring.

Keywords:
Classificationcongenital abnormalitiesear auriclemalformationreconstruction

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Area of Science:

  • Plastic Surgery
  • Otolaryngology
  • Congenital Malformations

Background:

  • Major congenital tragal malformations involve tragal and external auditory canal (EAC) cartilages, often with accessory auricle (AA).
  • Existing classifications and surgeries primarily address the AA cartilage, neglecting the tragal component.

Purpose of the Study:

  • To propose a novel classification system based on tragal cartilage morphology and connectivity.
  • To develop type-specific surgical techniques for reconstructing both inner (EAC) and outer (tragal, AA) frameworks.

Main Methods:

  • Retrospective analysis of 258 ears in 247 patients undergoing surgical reconstruction (2013-2023).
  • Identification of key structural components: AA cartilage, deformed tragal cartilage, and conchal protrusion with deformed EAC cartilage.
  • Classification into Type I (50.8%), Type II (34.5%), and Type III (14.7%) based on these components.

Main Results:

  • Surgical strategies involved EAC cartilage repositioning with transposition flaps or free grafts from tragal/AA cartilage.
  • High parental satisfaction (95%) reported at final follow-up.
  • Inconspicuous scarring achieved in most cases.

Conclusions:

  • The novel classification system and surgical approach highlight the importance of tragal cartilage in reconstruction.
  • Addressing both inner and outer framework deformities leads to natural tragal contour and minimal scarring.
  • This method offers insights into the pathologic anatomy and embryologic development of the tragus.