Distortion of the Auriculocephalic Angle Following Rhytidectomy: Recognition and Prevention

Jp, Newman; Rj, Koch; Rl, Goode; Hg, Brennan

doi:10.1001/archotol.1997.01900080050005

Cited by 5 publications

(1 citation statement)

References 8 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…These telltale signs include visible scars, a distorted hairline, lateral sweep caused by overtightening of the lower face, and the "pixie ear" deformity (pseudoptosis). [7][8][9] This auricular deformity is characterized by a tethered appearance of the earlobe as the ear becomes displaced inferior and anterior during wound healing with forward rotation. 10,11 The cause of this deformity and all auricular deformities is believed to be an asynchronous balance between horizontal and vertical vectors and tractional distortions of the SMAS and subsequent over resection of skin.…”

mentioning

confidence: 99%

Arcade Sutures to Minimize Ear Displacement in Rhytidectomy

et al. 2022

View full text Add to dashboard Cite

Ear deformities after rhytidectomy are not uncommon and have a significant impact on cosmetic success. We postulate the use of horizontal mattress suspension sutures in the anterior face anchored to the deep temporalis fascia (DTF) during rhytidectomy allows for a vertical lift while minimizing the risk to the frontal branch of the facial nerve and decreasing forward rotation of the ear. To compare auricular displacement during rhytidectomy using an arcade of horizontal mattress suspension sutures anchored to the DTF instead of the preauricular pre-parotid fascia, and evaluate outcomes with this modification at 1 year. This was a proof of concept prospective cohort study of 20 patients (40 sides) undergoing rhytidectomy by a single plastic surgeon (level of evidence 4). Intraoperative measurements were taken to determine the amount of auricular displacement with suspension sutures placed in the preauricular fascia compared with the DTF. To confirm longevity, we compared ear position preoperatively and at 1 year after rhytidectomy with our technique. There was significantly less auricular displacement when superficial musculoaponeurotic system (SMAS) suspension sutures were placed in the DTF 0.75 ± 0.69 mm compared with the preauricular fascia 9.71 ± 2.57 mm (p < 0.00001). With our technique at an average follow-up of 370.3 days, there was no significant change in auricular rotation compared with preoperative photos (p = 0.125).Our simple rhytidectomy modification allows for vertical resuspension of the SMAS in the anterior face in a safe manner while minimizing displacement of the auricle.

show abstract

mentioning

confidence: 99%