الفهرس 
INTRODUCTIONOnly 14 pages are availabe for public view
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Abstract
Stahl ear is a rare congenital auricular anomaly. It is more common in Asian populations and is bilateral in 20% of cases. The congenital defect is characterized by the presence of horizontally oriented third crus that extends across the upper scaphoid fossa. The abnormal third crus is often escorted by misrepresentations to the spiral, scapha, perpendicular, and flat forecasts. These include an abnormal helical rim contour manifesting in superior pole unfurling and a sharp prominence, a diminutive superior crus with increased angle obliquity, and increased superior pole projection of the ear.
The aim of this education remained to liken the artistic outcomes of the original technique of Kaplan & Hudson of using the third crus as an onlay graft to recreate the superior crus with a modified technique of using a pedicled third crus flap for the treatment Stahl’s ear deformity.
from September 2019 through September 2020, 10 patients with SE underwent surgery at the Unit of Plastic and Reconstructive Surgery, Faculty of Medicine, Alexandria University. Their ages ranged between 7 and 22 ages by an even of 12 years, they were seven males, and three females. Two patients had bilateral Stahl’s ear, while eight patients had a unilateral condition (six patients on the left side, and two patients on the right side).A total of 12 ears were operated upon.
In six ears the original technique of Kaplan and Hudson was applied (group A), while in the other six ears a modified technique was used in which a cartilaginous flap was used instead of the classical use of the onlay cartilage graft (group B). The cartilage flap was transferred to the desired site of the larger crus in a retro-cartilaginous position and then sutured in place. 2-3 Mustardee sutures were used to create a larger crus and the desired projection.
There were no immediate post-operative complications such as hematoma, skin necrosis, or infection in both groups. Mean follow-up was 6.4 months with a range from 2-12 months. The helical rim incision healed uneventfully in all patients and improved significantly with the passage of time. None of the patients complained of the scar.
Eight patients in both groups (4 patients in each group) achieved favorable results with aesthetically pleasing ears. Patients and or their parents were satisfied with the results.
One patient in group (A) with a unilateral Stahl’s ear had a post-operative visible depression at the site of third crus excision. The depression improved gradually with time but resulted in slight contour irregularity.
Another patient in group (B) with a unilateral affection was not quite satisfied with the aesthetic outcome. In this particular patient, the broadened scapha and long helical rim were not properly addressed.
According to the photographic assessment protocol described by Daniali et al (16), eight ears (four in both groups) achieved excellent results, while four ears (two in both groups) had good results.
Both techniques achieved favorable results with aesthetically pleasing ears, and with minimal incidence of complications and untoward sequelae