Stahl's ear caused by an abnormal intrinsic auricular muscle

Stahl's ear in a 12-year-old girl was treated surgically. During the operation, we discovered that the transverse muscle had an abnormal course, and we concluded that this muscle had caused the deformity. Treatment was accomplished by cartilage incision and transposition of the muscle to its normal position. After 3 years of follow-up, the reconstructed ear has maintained a good appearance. The etiology of Stahl's ear is unknown. Although various techniques have been reported for the reconstruction of Stahl's ear, the course of the intrinsic auricular muscles have not been confirmed by surgeons during the operation. We think that this case provides insight into the etiology of Stahl's ear and provides guidance for a new surgical treatment.