Clinical analysis, repair and aetiology of question mark ear

Summary The question mark ear is a malformation involving a cleft between the helix and the earlobe. The upper portion of the ear appears protruding and the scapha is absent from the affected region. The severity of this ear malformation varies from a small notch in the helix to complete separation of the helix and the lobe. In this article, we classify the question mark ear according to the severity of the malformation and propose two different methods of correction. In addition, we review the aetiology of the question mark ear and hope this can enhance the understanding of the pathology. Methods In the repair of moderate question mark ears, the local chondrocutaneous flap is used. In severe cases, tissue expander and autogenous rib cartilage are applied to reconstruct the deficiency of the lower part of the ear. Results There were 32 cases of question mark ears from July 2003 to December 2007. Thirty cases were sporadic and two cases had familial history. Twenty-two moderate question mark ears were repaired using chondrocutaneous flap transposition and ten severe question mark ears were repaired using tissue expander and autogenous cartilage. Conclusions In moderate question mark ears, the corrected auricle showed a shape similar to that of the unaffected auricle, but the size was a little smaller. Most of the reconstructed severe question mark ears showed excellent contour.