title: Effective scoring of scapha prevents helix irregularity in prominent ear correction - a biomechanical study.
abstract: BACKGROUND
  As the antihelix is created in the operation for prominent ear, the helix often presents irregularities. This biomechanical study aims to elucidate effective techniques to prevent these irregularities.
  
  
  METHODS
  Finite element models were produced simulating 10 prominent ears. The scaphas of the 10 models were thinned to simulate scoring or abrasion of the cartilage. The thinning was conducted in four fashions. In the first group, no thinning was conducted (Non-Scoring Models); in the second group, the upper half of the scapha was thinned (Upper-Scoring Models); in the third group, the lower half of the scapha was thinned (Lower-Scoring Models); in the fourth group, the whole scapha was thinned (Whole-Scoring Models). Mattress sutures were applied to create the antihelix to simulate Mustarde's in-suture technique. Thereafter, transformation of the helix's contour was evaluated.
  
  
  RESULTS
  Irregularity developed on the upper region of the helix with Non-Scoring and Lower-Scoring Models; the degree of the upper-region's irregularity was reduced with Upper-Scoring Models and Whole-Scoring Models. Although the edge of the helix moved in the posterior-medial direction with other type models, it moved in the anterior direction with Whole-Scoring Models.
  
  
  CONCLUSIONS
  Irregularity of the upper region of the helix can be prevented by performing scoring or abrasion of the upper part of the scapha. The prominence of the helix and width of the auricle are adjustable by varying the areas of the scapha receiving scoring or abrasion. These findings are useful in improving operative outcomes in the treatment of prominent ears.
authors.affiliation: Department of Plastic and Reconstructive Surgery, School of Medicine, Keio University, Tokyo, Japan. Electronic address: nagasao@sc.itc.keio.ac.jp.
authors.forename: Tomohisa
authors.initials: T
authors.lastname: Nagasao
authors.affiliation: Department of Plastic and Reconstructive Surgery, School of Medicine, Keio University, Tokyo, Japan.
authors.forename: Junpei
authors.initials: J
authors.lastname: Miyamoto
authors.affiliation: Department of Plastic and Reconstructive Surgery, School of Medicine, Keio University, Tokyo, Japan.
authors.forename: Yusuke
authors.initials: Y
authors.lastname: Shimizu
authors.affiliation: Department of Plastic Surgery, Japanese National Center of Child Health and Development, Tokyo, Japan.
authors.forename: Shogo
authors.initials: S
authors.lastname: Kasai
authors.affiliation: Department of Plastic and Reconstructive Surgery, School of Medicine, Keio University, Tokyo, Japan.
authors.forename: Kazuo
authors.initials: K
authors.lastname: Kishi
authors.affiliation: Department of Plastic Surgery, Japanese National Center of Child Health and Development, Tokyo, Japan.
authors.forename: Tsuyoshi
authors.initials: T
authors.lastname: Kaneko
mesh_terms: D001696:Biomechanical Phenomena; D054644:Ear Auricle / Q000601:surgery; D004425:Ear Cartilage / Q000601:surgery*; D004431:Ear, External / Q000002:abnormalities / Q000601:surgery*; D020342:Finite Element Analysis; D006801:Humans; D021621:Imaging, Three-Dimensional / Q000379:methods; D008953:Models, Anatomic; D019651:Plastic Surgery Procedures / Q000379:methods*; D013536:Suture Techniques