Correction of Stahl's Ear

Abstract

Stahl's ear is a rare congenital anomaly difficult to correct surgically. This report presents the experience of the Division of Plastic Surgery, University of São Paulo Medical School for managing this anomaly. From January 1994 to September 1999, 15 patients underwent surgery (17 ears). Ages ranged from 7 to 22 (mean 15 years). Six patients were female. Four subjects were of Oriental descent, four were Negroes, and seven were Caucasians. Deformities included two bilateral, four on the left ear, and nine on the right one. Different methods were utilized for correction depending on the elasticity of the cartilage. In the presence of an elastic cartilage, sutures only are employed, otherwise the cartilage is repositioned, as described by Sugino et al. No standard characteristics were noted regarding gender or race, however, there were more unilateral cases and more on the right ear. The results were adequately satisfactory, with the two methods enabling us to recommend these surgical techniques for correction of Stahl's ear.

Stahl syndrome (Satiro's ear)

“…In addition to the hereditary-familial hypothesis, a second hypothesis posits that the cartilaginous deformity is connected to the altered growth of an intrinsic muscle of the ear, the transverse muscle. 1,2 The solution to the deformity is surgical. Cartilage bending sutures, cartilage weakening maneuvers, rotation or flipping a section of cartilage, skin and cartilage excision, and sculpture techniques may be used to correct the deformity.…”

“…The pathogenetic origin of this deformation is thought to have a hereditary, familial character, which is confirmed by the diffusion of this deformation within families, reaching its highest expression in identical twins, who account for about 75% of all cases. In addition to the hereditary‐familial hypothesis, a second hypothesis posits that the cartilaginous deformity is connected to the altered growth of an intrinsic muscle of the ear, the transverse muscle 1 , 2 …”

An Alternative Approach for Correction of Stahl???s Ear

“…Aki et al 1 placed nonabsorbable sutures in the cartilage using Mustarde's retro-auricular approach for correction of prominent ears. However, this technique is only suitable for young children with very elastic cartilage.…”

Stahl Ear Correction Using the Third Crus Cartilage Flap

“…1). 1,[4][5][6][7] As the severity and components of the deformity are variable in each patient, several different treatment options have been published. [4][5][6][7][8][9][10][11][12][13][14] They mainly focus on the elimination of the third crus, which is the most common and striking part of the deformity, and the creation of a superior crus.…”

“…1,[4][5][6][7] As the severity and components of the deformity are variable in each patient, several different treatment options have been published. [4][5][6][7][8][9][10][11][12][13][14] They mainly focus on the elimination of the third crus, which is the most common and striking part of the deformity, and the creation of a superior crus. 2,4,5,9,[12][13][14][15][16] However, if the patient presents with all the components of the deformity, these techniques may not satisfactorily correct Stahl ear.…”