Fig. 121. Fig. 122.
Correction of Attached Lobe.
The wound is then sutured with fine silk, as shown in [Fig. 122], and allowed to heal. The result is very gratifying in most cases.
MALFORMATION OF THE AURICLE
Malformations of the ear are due to the arrest of development, termed microtia, excessive development, or macrotia, and malposition.
Microtia
The total absence of the auricular appendage is quite rare. One or the other part of the ear is usually found, either partially or fully developed, giving to the ear an irregular rolled-up appearance. This defect may be unilateral or bilateral.
It may be associated with congenital fistula (Fistula auris congenita), varying in length from one fourth to one inch, and secreting a serouslike fluid. These fistulæ are usually found anteriorly and above the tragus, the lobule, or more rarely at the crus helix, or even behind the ear. Sometimes these fistulæ communicate with the middle ear or even the esophagus. They are due to imperfect development in utero. In microtia little can be done surgically, since the malformation is usually so pronounced as to exclude all methods of restoration.