Keywords
conchal deformation
concave concha
surgical correction
How to Cite
Abstract
Introduction. Congenital auricular anomalies are observed in approximately 30% of newborns and represent the most frequent craniofacial defects, with an overall incidence of 1 in 6000 live births; 15–20% resolve spontaneously. If diagnosed early, most such deformities can be corrected conservatively by splinting; after the neonatal period surgery is usually required. Mozart ear is a rare deformity characterized by inversion of the cavum conchae with a slit-like narrowing of the external auditory meatus.
Aim. To present a rare case of surgical treatment of Mozart ear and describe the modified technique, intraoperative challenges and short-term results.
Materials and methods. A 23-year-old male presented with a unilateral inverted right auricle and slit-like stenosis of the external auditory meatus identified in early childhood, accompanied by cerumen impaction and difficulty retaining in-ear headphones. Under general anaesthesia, correction of the cavum conchae was performed, comprising resection and reversal of the conchal cartilage, its re-implantation as a free graft, and enlargement of the meatus with Mustardé sutures. The postoperative course was uneventful.
Results. Improvement of the auricular contour was evident within the first postoperative week, and an optimal concave shape with a widened meatal opening was achieved by one month. During 6 months of follow-up the correction remained stable, posterior symmetry was restored, comfortable use of headphones was regained, and the patient was satisfied with the outcome.
Conclusions. Mozart ear is a rare deformity causing primarily aesthetic and, occasionally, functional concerns. Early diagnosis allows non-surgical management; after the neonatal period surgery remains the option of choice. The procedure should be tailored to the severity of the deformity and the patient’s expectations.
References
Baklaci, D. (2018). Inverted concha, a rare auricular deformity with literature review. ENT Case, 3, 434. Available from: https://entcase.org/manuscript/434/makale/otoloji/inverted-concha-a-rare-auricular-deformity-with-literature-review.htm
Byrd, H. S., Langevin, C. J., & Ghioni, L. A. (2010). Ear molding in newborn infants with auricular deformities. Plastic and Reconstructive Surgery,126(4), 1191–1200. https//doi.org/10.1097/PRS.0b013e3181e617bb
Daniali, L. N., Rezzadeh, K., Shell, C., Travato, M., Ha, R., et al. (2017). Classification of newborn ear malformations and their treatment with the EarWell Infant Ear Correction System. Plastic and Reconstructive Surgery, 139(3), 681–691. https//doi.org/10.1097/PRS.0000000000003150
Garcia-Cruz, D., Sanchez-Corona, J., Ruenes, R., et al. (1980). A syndrome with mixed deafness, Mozart ear, middle and inner ear dysplasias. Journal of Laryngology and Otology, 94, 773–778. https//doi.org/10.1017/s0022215100089520.
Hong, P. (2012). Reconstruction of congenital inverted conchal bowl deformity: Our experience in two of four children. Clinical Otolaryngology, 37(5), 409–411. https//doi.org/10.1111/j.1749-4486.2012.02520.x
Olshinka, A., Ad-El, D. D., & Yaacobi, D. S. (2022). The outward curved concha, an unfamiliar congenital auricular deformation: A novel protocol for nonsurgical management. Journal of Craniofacial Surgery, 33(4), e392–e396. https//doi.org/10.1097/SCS.0000000000008301.
Olshinka, A., Yaacobi, D., & Ad-El, D. (2020). Congenital convex concha—An unfamiliar auricular deformation and a novel non-surgical management protocol. Otorhinolaryngology–Head and Neck Surgery, 5, 1-5. https://doi.org/10.15761/OHNS.1000229.
Osmani, O. A., & Matthews, R. (2016). An original technique for the correction of congenital inverted conchal bowl deformity in an adult. European Journal of Plastic Surgery, 39(6), 449–452. https//doi.org/10.1007/s00238-016-1207-5.
Porter, C. J., & Tan, S. T. (2005). Congenital auricular anomalies: Topographic anatomy, embryology, classification, and treatment strategies. Plastic and Reconstructive Surgery, 115(6), 1701–1712. https//doi.org/10.1097/01.prs.0000161454.08384.0a
Schönauer, F., Di Martino, A., & Gault, D. T. (2015). Anteverted concha: A new ear deformational anomaly. JPRAS Open, 5, 46–50. https://doi.org/10.1016/j.jpra.2015.06.004.
Schönauer, F., La Rusca, I., & Molea, G. (2009). Non-surgical correction of deformational auricular anomalies. Journal of Plastic, Reconstructive & Aesthetic Surgery, 62(7), 876–883. https//doi.org/10.1016/j.bjps.2007.11.072
Scutt, F., Mahmood, A., & Greenhowe, J. (2021). Bilateral anteverted conchal bowls: Surgical correction of a rare anomaly. Cureus, 13(11), e19841. https//doi.org/10.7759/cureus.19841
Shetty, S. C., Gupta, S., Hasan, S., Cherian, M., Joseph, V., & Guido, N. (2000). Reverse (convex) conchal bowl: Report of eight cases and its correction by modified conchoplasty technique. Canadian Journal of Plastic Surgery, 8(6), 233–238. https://doi.org/10.1177/229255030000800605
Tan, S. T., Shibu, M., & Gault, D. T. (1994). A splint for correction of congenital ear deformities. British Journal of Plastic Surgery, 47(8), 575–578. https//doi.org/10.1016/0007-1226(94)90144-9
Telich-Tarriba, J. E. (2017). Mozart ear deformity: A rare diagnosis in the ear reconstruction clinic. Journal of Craniofacial Surgery, 28(5), 482–484. https://doi.org/10.1097/SCS.0000000000003794
Ullmann, Y., Blazer, S., Ramon, Y., Blumenfeld, I., & Peled, I. J. (2002). Early nonsurgical correction of congenital auricular deformities. Plastic and Reconstructive Surgery, 109(3), 907–913. https//doi.org/10.1097/00006534-200203000-00013
Wang, R., Earl, D., Ruder, R., & Graham, J. (2001). Syndromic anomalies and renal ultrasounds. Pediatrics, 108(2), e34. https//doi.org/10.1542/peds.108.2.e32
Yamashita, K., Yotsuyanagi, T., Gonda, A., et al. (2014, September). Abnormality of auricular muscles in congenital auricular deformities. Presented at the 1st Congress of ISAR, Paris.
Yamashita, K., Yotsuyanagi, T., Saito, T., Isogai, N., Mori, H., & Itani, Y. (2011). Mozart ear: Diagnosis, treatment, and literature review. Annals of Plastic Surgery, 67(5), 547–550. https//doi.org/10.1097/SAP.0b013e31820944d7
Yii, N. W., & Walker, C. C. (1996). Unusual conchal deformity in otherwise normal ears. Plastic and Reconstructive Surgery, 98(4), 726–729. https://www.ovid.com/jnls/plasreconsurg/abstract/00006534-199609020-00022~unusual-conchal-deformity-in-otherwise-normal-ears?redirectionsource=fulltextview
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.