Seyhan Ahmet
Private Practice, Kültür Mah., Plevne Bulvarı, Ocakoğlu Apt, No: 3, D: 6, 35220, Alsancak, İzmir, Türkiye.
Aesthetic Plast Surg. 2024 Dec 24. doi: 10.1007/s00266-024-04611-z.
Human ear growth continues beyond puberty, resulting in ears that are typically approximately 10 millimeters (mm) larger in older individuals compared to their younger counterparts. Not only is the overall growth of the ear an indicator of age, but also the disproportionate growth of its parts. The largest part, the concha, shows the slowest growth rate, while the smallest part, the earlobe, shows the greatest growth rate. Thus, over time, the net increases in the scapha, concha, and earlobe become nearly equal. Therefore, it is appropriate to make approximately equal reductions from each unit in order to restore a youthful balance to the ear.
Aged and large, but otherwise normal, ears were selected for use of the "rule of threes" technique. This technique involves reducing the height of each of the three units (scapha, concha, and earlobe) by approximately 3 mm. Depending on individual needs, reductions were also applied to two units or just one unit as necessary. Adjustments in reduction amounts were made for previously disproportionate ears.
A total of 32 ears from 16 patients were included in the study. Scapha reduction was performed on six patients, scapha and concha reduction on five patients, combined (including earlobe) reduction on two patients, and isolated earlobe reduction on three patients. All patients were followed up for at least 6 months. The planned reduction target was achieved in all cases, resulting in balanced youthful ears. Two skin sloughs in the earlobe, one requiring revision, and bilateral hypertrophic scarring behind the earlobe were observed in one case.
The described ear reduction technique yields satisfactory results when performed with precision. Each ear should be assessed individually, allowing for some flexibility rather than strict adherence to the proposed amounts of reduction. Care must be taken not to disrupt the blood supply to the ear structures. Achieving harmony at junction lines requires careful planning and meticulous technique.
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人类耳朵的生长在青春期后仍会持续，导致老年人的耳朵通常比年轻人的耳朵大约大10毫米（mm）。耳朵的整体生长不仅是年龄的一个指标，其各部分的不均衡生长也是。耳朵最大的部分——耳甲，生长速度最慢，而最小的部分——耳垂，生长速度最快。因此，随着时间的推移，耳舟、耳甲和耳垂的净增长几乎相等。所以，为了使耳朵恢复到年轻时的平衡状态，对每个部位进行大致相等的缩减是合适的。
选择年龄较大且耳朵较大但其他方面正常的耳朵，采用“三分法”技术。该技术包括将三个部位（耳舟、耳甲和耳垂）的高度各减少约3毫米。根据个体需求，必要时也可对两个部位或仅一个部位进行缩减。对于之前比例失调的耳朵，会对缩减量进行调整。
本研究共纳入了16例患者的32只耳朵。对6例患者进行了耳舟缩减，5例患者进行了耳舟和耳甲缩减，2例患者进行了联合（包括耳垂）缩减，3例患者进行了单独的耳垂缩减。所有患者均随访至少6个月。所有病例均达到了计划的缩减目标，使耳朵恢复到了年轻且平衡的状态。1例患者出现了耳垂处两处皮肤脱落，其中一处需要修复，以及耳垂后方双侧增生性瘢痕。
所描述的耳部缩减技术在精确操作时能产生令人满意的效果。每只耳朵都应单独评估，允许有一定的灵活性，而不是严格遵循建议的缩减量。必须注意不要破坏耳部结构的血液供应。在交界线处实现和谐需要精心规划和细致的技术。
证据等级IV：本刊要求作者为每篇文章指定证据等级。有关这些循证医学评级的完整描述，请参阅目录或在线作者指南www.springer.com/00266。
