International Journal Dental and Medical Sciences Research

Volume 4, Issue 6, Nov-Dec 2022 pp 345-348 www.ijdmsrjournal.com ISSN: 2582-6018

Auricular Lobuloplasty - A Case Report

Dr. Akhil Satya Pedapalli, Dr. Gummadala Swapna Priya,
Consultant Facio-Maxillary Surgeon, Srikakulam, India.
Post graduate, Department of OMFS, Narayana Dental College and Hospital, Nellore, India

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Submitted: 15-11-2022 Accepted: 20-11-2022
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ABSTRACT: Case report:
one of the most aesthetic soft tissue structures in A 20-year-old patient visited our clinic
the face is the ear lobule. Ear lobule sagging and with a chief complaint of torn left ear lobule 2
clefting is commonly seen in south Indian years ago. She gives history of trauma where her
populations following prolonged wearing of heavy earring was forcefully wrenched out of the piercing
earrings/ trauma. This type of clefting can be following which the ear lobule was completely slit.
complete or partial. Here we report a case of a 20- On clinical examination there was a
year-old female patient reported to us with complete clefting of the ear lobule measuring
complete clefting of the ear lobule operated with 1×1CMs in size. (FIG-1). Both the ends of the cleft
auricular lobuloplasty. There were no postoperative were fully epithelialized. The patient was medically
complications and the outcome was satisfactory. stable with no systemic conditions including
bleeding disorders. We suggested an auricular
I. INTRODUCTION: - lobuloplasty for the patient under local anesthesia
The facial aesthetics is governed by the as the procedure can be performed as a day care
harmony between hard and soft tissue structures of procedure on outpatient basis.
the facial skeleton. Ear lobule is an important
aesthetic structure which is either round or conical Surgical procedure:
in shape. It is a highly vascularized structure and Lobuloplasty was performed under local
offers a prime function of bearing the earrings. anesthesia. 2% Lignocaine with Adrenaline
Sagging or complete slit in the ear lobule (1:80000) was infiltrated into the surgical site.
is a prime cosmetic deformity and is a very Surgical site was disinfected with betadine
common occurrence in the Indian populations. This painting. Marking was done and a 15-number
is because of the expansion of the hole/piercing surgical blade was used to incise the ends of the
overtime due to the effect of gravity or accidental lobular cleft to create a raw surface. (FIG-2). After
trauma. Ear lobule clefting can be two types – achieving hemostasis by applying pressure a two
congenital and acquired. layered closure was done using 4-0 vicryl and 4-0
Congenital cleft earlobe is a rare clinical prolene (FIG-3) followed by Betadine-gauze
entity that results from failure of fusion during dressing.
embryologic development. Congenital defects are The patient was put on Antibiotics and analgesics
usually associated with tissue loss, thereby for 5 days and called back for suture removal after
complicating surgical repair [1]. however, acquired 7 days. The healing was uneventful, and the
clefts are usually treated as a day care procedure outcome was satisfactory and aesthetic. (FIG-4).
under local anesthesia.
In Africa, the lobules of Ivan and Kayan II. DISCUSSION:
become wide, sag and tear as they wear heavy and Deformities of the auricular lobule is a
large earrings. [2]. According to American Society common problem necessitating lobuloplasty.
for Aesthetic Plastic Surgery in 2015, Auricular lobule clefts are classified by many
approximately 40,000 people undergo ear surgery ways. Lobule clefts are classified into two groups
for cosmetic purposes per year for ear defects as congenital clefts and acquired clefts, by Sharma
developing because of trauma or wearing heavy et al,[4] they further divided acquired clefts into
earrings.[3] two groups such as partial and complete clefts.
Here we report a case of a 20-year-old female Based on the distance between the original hole
patient reported to us with complete clefting of the and the lower limit of the lobule Blanko-Davila and
ear lobule operated with auricular lobuloplasty. Vasconez [5] Classified the partial lobule clefts.
Boo-Chai [6] divided the lobule defects into two

DOI: 10.35629/5252-0406345348 |Impact Factorvalue 6.18| ISO 9001: 2008 Certified Journal Page 345
 International Journal Dental and Medical Sciences Research
Volume 4, Issue 6, Nov-Dec 2022 pp 345-348 www.ijdmsrjournal.com ISSN: 2582-6018

groups as congenital and acquired and called the 2018 - Volume 29 - Issue 8 - p 2310-2311
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DOI: 10.35629/5252-0406345348 |Impact Factorvalue 6.18| ISO 9001: 2008 Certified Journal Page 346
 International Journal Dental and Medical Sciences Research
Volume 4, Issue 6, Nov-Dec 2022 pp 345-348 www.ijdmsrjournal.com ISSN: 2582-6018

Figures:

Figure :1 – Clinical Picture of the lobular cleft

Figure :2 – Deepithelialisation of the cleft walls and creation of a raw defect

DOI: 10.35629/5252-0406345348 |Impact Factorvalue 6.18| ISO 9001: 2008 Certified Journal Page 347
 International Journal Dental and Medical Sciences Research
Volume 4, Issue 6, Nov-Dec 2022 pp 345-348 www.ijdmsrjournal.com ISSN: 2582-6018

Figure : 3 – Bilayered closure of the defect using 4-0 vicryl and 4-0 prolene

Figure : 4 – one week post-operative follow up – clinical picture showing satisfactory results

DOI: 10.35629/5252-0406345348 |Impact Factorvalue 6.18| ISO 9001: 2008 Certified Journal Page 348