Posterior Z-plasty and J-Y antihelixplasty for correction of Stahl's ear deformity

SummaryThe bifurcated Y-shaped antihelix characterises the normal human ear and gives it an aesthetically pleasing appearance. In Stahl's ear congenital anomaly an aberrant crus usually replaces the superior crus, crossing the scaphoid fossa from the site of the normal bifurcation of the antihelix posteriorly towards the helix, giving the antihelix an abnormal J-shape. A technique is described to correct Stahl's ear deformity adding a simple Z-plasty to the incision to lengthen the skin on the posterior surface, together with making use of the aberrant crus to reconstruct the superior crus without reducing the ear size using a modified Mustardé technique. This is achieved by posterior scoring and suturing without any cartilaginous excisions converting the ‘J’ antihelix into a ‘Y’. Out of a series of eight cases examined, four unilateral and one bilateral cases were operated on (six ears). The first two unilateral cases were performed without Z-plasty, which was used in the third case on with very satisfactory results in different types and severities of Stahl's ear deformity. I believe that the technique detailed in this paper fulfils the main principles necessary for correction of Stahl's ear deformity and may be used in cases where the aberrant crus is reducible regardless of its shape.