Medially based conchal cartilage flap: an addition to cartilage-preserving otoplasty and its cognitive-perceptual outcomes

Prominent ear is the most common congenital deformity of the auricle, for which a variety of surgical and nonsurgical methods have been tried to correct it. Thus, this study aimed to reduce the conchal bowl height, while preserving the conchal cartilage and to prevent wrinkling of anterior skin of auricular concha of prominent ear. This prospective case series was conducted on 26 patients (49 prominent ears), from March 2021 to December 2023 at Shar Private Hospital, Erbil, Iraq. Initially, patients’ demographic data were collected, followed by their clinical data. Then, they were operated under local anaesthesia, using cartilage-sparing with cartilage-cutting techniques. After that, they were followed up for 1 week, 6 months, 1 year, and one year or more to report postoperative complications and their satisfaction with the outcomes. Additionally, the psychological dimension was integrated as a primary metric for evaluating the surgical outcomes of this technique, as well as to investigate the impact of this novel surgical approach on the patients’ internal constructs, specifically focusing on self-image, self-esteem, and their overall outlook on life. Among operated patients ( n = 26), 23 presented with bilateral prominent ears and 3 with unilateral prominent ears. Patients’ ages ranged between 6 and 43 years, and all of them had hypertrophic concha, regardless of the antihelical fold definition. The operative time ranged from 60 to 120 min. After one year of follow-up, all patients and/or their guardians were satisfied with the results (100%). Additionally, 8 cases (18.6%) were reported to have postoperative complications. The applied technique helps reduce and prevent the recurrence rate of prominent ears. It also preserves the conchal cartilage and prevents wrinkling of the anterior skin of the auricular concha. The patients’ psychological status also improved after otoplasty.