5-year series of constricted (lop and cup) ear corrections: Development ofthe mastoid hitch as an adjunctive technique

Despite the multitude of corrective procedures described, adequate surgical correction of the congenital constricted ear remains a challenge. The main tenance of the shape and elevation of the reconstructed upper neohelix pose s a particular problem. In the present series, experiences with lop ear cor rection utilizing standard techniques and the use of the mastoid hitch as a useful adjunct to these procedures are described. A total of 19 ears were reconstructed. There were three type 1, eight type 2a, seven type 2b, and o ne type 3 deformities (Tanzer classification). A graded sequence of procedu res was adopted. Mild deformities were corrected by cartilage scoring techn iques; a V-Y advancement of the helical foot was added for moderate deformi ties. Cartilage expansion by a banner flap was required for more severe def ormities. A mastoid hitch, whereby the refashioned upper neohelix is suture d to the mastoid fascia, should be used as an adjunct to these procedures t o maintain helical elevation and prevent recurrence. Severe type 3 deformit ies may require autologous auricular reconstruction. Mean follow-up time wa s 1 year. There were six excellent, seven good, four fair, and two poor res ults. Two patients who had not had mastoid hitch procedures developed a rec urrence of the lop deformity. Adequate surgical correction of constricted e ar deformities requires a variety of surgical techniques. The mastoid hitch being used for constricted ear correction has not been described elsewhere . The mastoid hitch is a useful adjunctive procedure that may be used effec tively in combination with other procedures.