A Subunit-Based Concept for Preoperative Design of the Cauliflower Ear.

PURPOSE Cauliflower ear is an ear deformity caused by a closed ear injury with varying severity. Several studies on the systematic reconstruction of cauliflower ear have been reported. Here, the authors aim to introduce a simplified subunit-based reconstruction concept for the cauliflower ear. METHODS The authors retrospectively analyzed all patients who underwent surgery to repair cauliflower ear in our department from April 2021 to April 2023. Patients' demographic information, clinical characteristics, and outcomes were recorded. All patients were followed up for 1 year. TECHNIQUE The authors assessed each subunit of the cauliflower ear in sequence in terms of the change in size and shape and decided whether tissue removal or grafting is needed. The surgical design was obtained by a combination of all subunits. RESULTS The authors included a total of 5 patients with mild and moderate cauliflower ear repaired by the subunit-based method. The shape of all the involved ear subunits of our patients was almost restored. No patient needed the use of cartilage grafts and flaps. The authors summarized 5 common subunits with deformity: helix, scaphoid fossa, antihelix crura and triangular fossa, antihelix body, and concha. The pathology results reported a keloid in 1 case. All patients reported no recurrence and were satisfied with the surgery after 1 year. CONCLUSIONS The authors reported a simplified subunit-based method of preoperative evaluation and design of cauliflower ear, as a new alternative option to complement the current clinical strategies. The authors also reported the first case of a keloid in cauliflower ear.