Correction of Tanzer II Constricted Ear: A Framework Approach With Costal Cartilage Graft and Auricular Cartilage Release.

BACKGROUND

Surgical correction of Tanzer type II constricted ear remains challenging due to the multidimensional deficiency of the auricular framework and skin envelope. This study evaluates the clinical efficacy and patient-reported outcomes of a framework-based approach combining autologous costal cartilage grafting with auricular cartilage release.

METHODS

A retrospective study was conducted on 74 patients (90 ears) with Tanzer type II constricted ear treated between 2021 and 2023. The surgical technique involved radial chondrotomies of the constricted cartilage and rigid fixation of a sculpted eighth costal cartilage graft to expand the helical rim and restore vertical height. Patient-reported outcomes were assessed using the validated EAR-Q questionnaire (Appearance, Psychological, and Adverse Effects scales). Complications were systematically monitored.

RESULTS

The cohort comprised 42 males and 32 females (mean age: 8.2 y) with a mean follow-up of 12 months. Postoperative median EAR-Q interval-scaled scores were 86.0 for the Psychological Scale, 74.0 for the Ear Adverse Effects Scale, and 62.0 for the Ear Appearance Scale. Complications occurred in 9 patients (12.2%), including localized hematoma (n=4), cartilage exposure (n=3), impaired wound healing (n=1), and partial flap necrosis (n=1), all of which were successfully managed through secondary interventions.

CONCLUSIONS

Combining autologous costal cartilage grafting with native framework release provides a stable and reliable solution for Tanzer type II constricted ears. While aesthetic scores are moderate, the technique yields high psychosocial benefits and a manageable complication profile.