The conchal flap: an adjunct in otoplasty.

When the protruding ear is caused in whole or in part by an enlarged or abnormally angulated concha, the conchal set-back is a recognized technique in corrective surgery. The authors describe a modification of this procedure in which a posterior flap of cartilage, based laterally adjacent to the antihelix, is elevated and sutured to the mastoid process. The maneuver serves to bring the concha closer to the scalp and thus reduces the protrusion. The residual deformity in the conchal bowl, resulting from the development of this cartilage flap, is negligible. The authors stress the need for correct analysis of the original deformity and usually employ this maneuver in conjunction with a suture technique for creating or accentuating a poorly defined antihelix.