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