Author’s Method.—The latter operation is most successful where the upper part of the pinna is unusually flat. It does not correct this flatness, however, which is often an objection, hence the author suggests excising a section of the entire thickness of the ear from the fossa somewhat in the form shown in [Fig. 134], curving the two deeper invading incisions, so that when the parts are brought together a concavity will be given the antihelix, as in the natural auricle.
Fig. 134. Fig. 135.
Author’s Method.
The rearrangement of the parts in this event is shown in [Fig. 135]. The only objection to the above may be found in the two linear scars across the antihelix entirely overcome by the Parkhill operation, wherein the line of union falls just below the rim of the helix and into the groove commonly found there, yet any of these scars shows little in well-done operations and when union takes place by first intention.
There will always appear a notchlike depression where the newly cut ends of the helix are brought together, owing to the cicatrix involving the space between the cartilaginous borders.
Inasmuch as this notch necessarily shows the most prominent part of the ear, the author advocates the following method in which the notch is brought anterior to the fossa of the antihelix; in other words, near to the point of the union of the helix with the skin of the face about on a line with the superior border of the zygomatic process; a point where the hair is in close proximity with the ear and where the scar can be more easily covered.
The form of incision is somewhat sickle shaped, the upper curvature of the incision following the inferior border of the helix and extending well into the fossa of the helix, as shown in [Fig. 136]. Where the antihelix is particularly large a triangular section may be removed, as shown at A, with a corresponding shortening of the helix flap at B. The latter gives more contour to the ear as well.
