The union between cartilage and perichondrium is always slow, requiring about three weeks in the traumatic variety and often months in the noninflammatory form.
Be the enlargement due to whatever cause, the patient not infrequently presents himself for a correction of the deformity.
The slightest of such deformities is a tiplike enlargement of the outer and upper angle of the helix, most commonly unilateral. This has been termed “fox ear.”
In this condition there is more or less loss of the curl of the helix, with flattening beginning well down in the fossa, extending upward, and terminating in a triangular cartilaginous tip resembling the ear of an animal, hence the name.
The correction of this fault is quite simple. An incision somewhat larger than the base of the cartilaginous triangle is made under a local anesthetic about one fourth inch below and back of the line corresponding to the superior border of the helix. The cartilage is exposed through this incision and excised with a fine curved scissors without wounding the anterior skin of the helix, and the incision neatly sutured, leaving the now redundant skin to contract.
In this manner the fault is corrected without any appreciable scar.
The sutures can be removed in three or four days.
In the correction of macrotia various surgical methods may be employed, yet none can be emphasized, as exclusively indicated, inasmuch as the enlargements may involve one or the other part of the pinna.
The greatest fault with most of these ears lies in the overdevelopment of the triangular antihelix or that area lying posterior to the fossa of the antihelix and the fossa of the helix, although in many cases the greatest malformation is found in the concha itself.