[Subperichondrial undermining in the anterior scoring otoplasty technique (Stenström)]

In the otoplasty described by Stenström (1963), the scoring of the cartilage needs a very cautious undermining of the perichondrium. The electronic microscopy states very precisely the connexion between the perichondrium, the cartilage and the skin of the helix: there is a fibroblast coat (with a high density of fibers and connective tissue) which stays close to the cartilage strut: the author describes a special elevator which allows to undermine more safely this layer without wearing away the dermis.