IDEAS AND INNOVATIONS
An original technique for the correction of congenital
inverted conchal bowl deformity in an adult
Omer Ahmed Osmani
Received: 28 March 2016 /Accepted: 10 May 2016 /Published online: 6 June 2016
Springer-Verlag Berlin Heidelberg 2016
Abstract Common congenital deformities of the ear include
varying degrees of prominent ears and of microtia. Inverted
conchal bowl is a very rare congenital deformity. In this con-
dition, the anterior concavity of the concha is replaced by
convexity, resulting in an abnormal appearance, as well as
functional problems in the of use earpiece devices. This con-
dition has been reported only once in a series of four paediatric
cases, wherein a cartilage scoring technique, suitable for pli-
able cartilage in that age group, is described. No cases have
been reported in an adult. We describe a simple and effective
technique of managing this rare deformity in an adult, for the
first time. The principle of the technique is the use an autolo-
gous cartilage graft.
Level of Evidence: Level V, therapeutic study.
Keywords Congenital inverted conchal bowl
Autologous cartilage graft
Approximately 5 % of the population has some ear malforma-
tion. Prominent ears and microtia are the two most frequently
encountered congenital ear problems in plastic surgery.
Inverted conchal bowl is a very rare congenital anomaly.
Hong described reconstruction of this defect in children .
We describe a simple and effective technique for correction of
this deformity in adults.
Whereas posterior conchal scoring, reversion and suture
to the mastoid concha had been successful for the thin-
ner, more malleable paediatric cartilage in the two pre-
viously reported cases , it was considered that this
would have a significant chance of failure in thicker,
less compliant adult cartilage.
The setup is the same as for other adult pinnaplasty
procedures and 2 % Xylocaine local anaesthesia com-
bined with 1:200,000 Adrenaline is infiltrated. A medi-
ally based skin flap is reflected off the posterior aspect
of the ear to reveal an area slightly larger than the base
of the posterior surface of the abnormal cartilage
(Fig. 1). The abnormal cartilage is then incised through
its full thickness, all round its base (Fig. 1), and the
* Omer Ahmed Osmani
Department of Plastic Surgery, University Hospital, Clifford Bridge
Road, Coventry CV2 2DX, UK
Department of Plastic Surgery, Nuffield Health Warwickshire
Hospital, Old Milverton Lane, Leamington Spa CV32 6RW, UK
Eur J Plast Surg (2016) 39:449–452