Modified Valente Technique for Cauliflower Ear: Outcomes in Children at Two-Year Follow-Up : New Surgical Technique for Cauliflower Ear

Luca D'Ascanio; Eleonora Gostoli; Giampietro Ricci; Pietro De Luca; Gino Latini; Michael J Brenner; Arianna Di Stadio

doi:10.1007/s00266-024-03914-5

Modified Valente Technique for Cauliflower Ear: Outcomes in Children at Two-Year Follow-Up : New Surgical Technique for Cauliflower Ear

Aesthetic Plast Surg. 2024 Mar 18. doi: 10.1007/s00266-024-03914-5. Online ahead of print.

Authors

Luca D'Ascanio^#¹, Eleonora Gostoli², Giampietro Ricci², Pietro De Luca³, Gino Latini¹, Michael J Brenner⁴, Arianna Di Stadio^#⁵

Affiliations

¹ Department of Otolaryngology, Azienda Ospedaliera Ospedali Riuniti Marche Nord, Pesaro-Fano, Italy.
² Department of Otolaryngology, University of Perugia, Perugia, Italy.
³ 3Department of Otolaryngology, Isola Tiberina Hospital - Gemelli Isola, Rome, Italy.
⁴ Department of Otolaryngology - Head and Neck Surgery, University of Michigan Medical School, Ann Arbor, Michigan, USA.
⁵ Department GF Ingrassia, Otolaryngology Unit, Catania, Italy. ariannadistadio@hotmail.com.

^# Contributed equally.

PMID: 38499875
DOI: 10.1007/s00266-024-03914-5

Abstract

Background: Cauliflower ear deformity, a common sequela of auricular trauma, presents an esthetic and reconstructive challenge. Existing surgical techniques have limitations, including complexity, donor site morbidity, and variable long-term outcomes.

Materials and methods: In this case series, we present a novel and minimally invasive surgical approach for the correction of cauliflower ear deformity that adapts the Valente otoplasty technique; it combines cartilage debulking with helical rim release and Mustardé mattress stitches to restore ear contour and reduce the risk of recurrence. The procedural steps include bielliptic post-auricular skin and soft tissue incision, release of the cartilaginous spring, removal of excess fibrocartilaginous tissue, cartilage reshaping with suture to restore contour, and tissue redistribution to promote adherence of skin to the cartilage framework.

Results: Outcomes were evaluated in 7 patients (9 ears) with cauliflower ear deformity, assessing surgical duration, complications, patient satisfaction, and esthetic outcomes at two years after surgery. The mean surgical duration per patient was 52 ± 17 minutes, including 2 bilateral procedures. Follow-up at 24 months showed favorable esthetic outcome in all patients with sustained improvements in auricular contour and symmetry with neither loss of the shape nor recurrence of deformity. Patients reported high satisfaction and improved quality of life, with mean Glasgow Children Benefit Questionnaire scores of 99.3 ± 6.3.

Conclusions: This technique thus demonstrated lasting correction of cauliflower ear with favorable cosmetic outcomes, low risk of complications, and high patient satisfaction. Further investigations and longer-term follow-up are warranted to validate the technique's durability and expand its application to older and more diverse patient populations.

Level of evidence iv: This journal requires that authors assign a level of evidence to each article. For a full description of these evidence-based medicine ratings, please refer to the Table of contents or the online Instructions to Authors www.springer.com/00266 .

Keywords: Cauliflower ear; Ear malformation; Esthetic results; Follow-up; Reconstruction; Surgery.