Upper auricular adhesion malformation: definition, classification, and treatment.

BACKGROUND: During treatment of upper auricular malformations, the author found that patients with cryptotia and patients with solitary helical and/or antihelical adhesion malformations showed the same anatomical finding of cartilage adhesion. The author defined them together as upper auricular adhesion malformations.

METHODS: Between March of 1992 and March of 2006, 194 upper auricular adhesion malformations were corrected in 137 patients. All of these cases were retrospectively studied and classified. Of these, 92 malformations in 68 recent patients were corrected with new surgical methods (these were followed up for more than 6 months).

RESULTS: The group of solitary helical and/or antihelical cartilage malformation patients was classified as group I and the cryptotia group as group II. These two groups were subdivided according to features of cartilage adhesion and classified into seven subgroups. Thirty-two malformations were classified as belonging to group I and 162 malformations to group II. There were 61 patients with bilateral upper auricular adhesion malformations. Nineteen patients (31 percent of the patients with bilateral malformations) showed malformations belonging to both groups I and II on both ears. On postoperative observation in patients corrected with new methods, it was noticed that the following unfavorable results had occurred in 18 upper auricular adhesion malformation cases (20 percent): venous congestion or partial skin necrosis of used flaps, "pinched antitragus," low-set upper auricle, hypertrophic scars, and baldness.

CONCLUSIONS: The new consideration for, and the singling out of, upper auricular adhesion malformation can lead to better understanding of the groups of upper auricular malformations to which it belongs, the decision for treatment, and, possibly, clarification of the pathophysiology in the future.