Total Reconstruction of the Auricle: Our Experiences on Indications and Recent Techniques
Table 1
Weerda’s classification of auricular malformations based on an increasing severity of the malformation (shortened) [3].
Degree of dysplasia
Definition
Subgroup
I: Low-grade malformations
General: most of the structure of a normal auricle are present Surgical: additional skin and cartilage are only occasionally required for reconstruction
(i) Prominent auricle (ii) Macrotia (iii) Cryptotia (pocket ear) (iv) Cleft ear (transverse cleft) (v) Scaphoid ear (vi) Stahl’s ear (vii) Satyr ear (viii) Small deformities (ix) Lobule deformities (x) Tanzer’s types I, IIA, and IIB cup-ear deformities
II: Grade II microtia; moderate malformations
General: the auricle still displays some structure of a normal auricle Surgical: additional skin and cartilage required for partial reconstruction
(i) Tanzers’s type III cup-ear deformity (ii) Miniear (Hypoplasia of the upper, middle of lower auricle)
III: Grade III microtia with anotia; severe malformations
General: structures of a normal auricle no longer present Surgical: additional skin and cartilage required for total reconstruction
(i) Unilateral Grade III microtia (Nagata’s lobule type microtia) (ii) Bilateral Grade III microtia (iii) Anotia (iv) Normally congenital aural atresia will be found