Minimally Invasive Combined Procedures for Cryptotia With Helical Adhesion

Cryptotia is a congenital auricular deformity in which the superior portion of the auricle is embedded in the temporal region, causing loss of the auriculotemporal sulcus. The condition is frequently accompanied by helical adhesion. In cases with helical adhesion, conventional treatment often involves dissection from a posterior auricular incision to the anterior surface, release of the helical cartilage, and reconstruction using techniques such as conchal cartilage grafting. However, these procedures require a large skin flap to cover the expanded helix and extensive undermining, which increases the risks of postoperative hematoma, skin necrosis, and skin perforation. We performed a combined minimally invasive procedure for cryptotia with helical adhesion, integrating 2 components: intraoperative tissue expansion through a small superior incision with superior auricular muscle transposition, and an anterior approach using a conchal composite graft. Each component technique was minimally invasive and associated with low morbidity. We present representative cases and surgical outcomes.