Correction of Tanzer Type IIB Constricted Ears via Z-shaped Double V-Y Advancement Flaps

Background Correction of Tanzer type IIB constricted ears requires sufficient expansion of the auricular skin to cover the reconstructed cartilaginous framework. To obtain an adequately sized skin cover, skin flap transposition from periauricular donor sites has been described; however, it remains challenging to obtain enough skin to enable satisfactory reconstruction. Herein, we describe a novel method that uses 2 local flaps comprising superoauricular, retroauricular, and preauricular soft tissue to expand the skin cover and correct Tanzer type IIB deformity. Methods Fifteen constricted ears in 15 patients were treated via this novel method from June 2013 to July 2017. Two adjoining V-Y advancement flaps shaped like a backward "Z" were created to expand the skin envelope of the upper one-third of the ear. The advancement of these 2 flaps toward each other expanded the skin of the upper one-third of the ear by creating a skin arch, which was then used to wrap the reconstructed cartilaginous framework. The auricular cartilage was refashioned via a method that combined several previously reported techniques. Results A satisfactory outcome was achieved in all 15 constricted ears, with resultant improvements in size and shape, and an elevated auricular position. Conclusions The preauricular, superoauricular, and retroauricular skin areas can be used to successfully expand the skin envelope of the upper auricle via the creation of 2 adjoining V-Y advancement flaps. This results in an ample skin cover with which to accommodate the auricular cartilaginous framework reconstructed by multiple techniques. This novel Z-shaped double V-Y advancement flap method can effectively correct Tanzer type IIB constricted ears.

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