{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,16]],"date-time":"2026-06-16T22:00:19Z","timestamp":1781647219828,"version":"3.54.5"},"reference-count":24,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2026,4,11]],"date-time":"2026-04-11T00:00:00Z","timestamp":1775865600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T00:00:00Z","timestamp":1777420800000},"content-version":"vor","delay-in-days":18,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"the Fundamental Research Funds for the Central Universities","award":["3332025167"],"award-info":[{"award-number":["3332025167"]}]},{"name":"the Fundamental Research Funds for the Central Universities","award":["3332024055"],"award-info":[{"award-number":["3332024055"]}]},{"name":"Beijing Natural Science Foundation","award":["7254412"],"award-info":[{"award-number":["7254412"]}]},{"name":"Beijing Natural Science Foundation","award":["7262104"],"award-info":[{"award-number":["7262104"]}]},{"name":"CAMS Innovation Fund for Medical Sciences","award":["2021-I2M-C&T-B-076"],"award-info":[{"award-number":["2021-I2M-C&T-B-076"]}]},{"name":"CAMS Innovation Fund for Medical Sciences","award":["2021-I2M-1-052"],"award-info":[{"award-number":["2021-I2M-1-052"]}]},{"DOI":"10.13039\/501100012166","name":"National Key R&D Program of China","doi-asserted-by":"crossref","award":["2024YFA1107800"],"award-info":[{"award-number":["2024YFA1107800"]}],"id":[{"id":"10.13039\/501100012166","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Maxillofac Plast Reconstr Surg"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The combination of crus helicis transverse deformity and microtia presents one of the most complex ear deformities. Historically, the surgical correction of this deformity has predominantly utilized rib cartilage for ear reconstruction. This study presents a method for correcting microtia with crus helicis transversal deformity, utilizing the flap technique in conjunction with cartilage transplantation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>From February 2017 to October 2023, a total of 42 patients with crus helicis transversal deformity and microtia were included in this retrospective study. The corrective surgery combines flap technique with cartilage transplantation. We collected the morphological data of ear, Visual Analogue Scale (VAS) satisfaction scores, and Aesthetic Outcomes Scale (AOS) aesthetic ratings of patients both prior to and 12 months following surgery.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The average duration of follow-up was 13.71\u2009\u00b1\u20092.97 months. Following the operation, there has been a significant improvement in the length, width, and circumference of the ear, as well as in the differences in these measurements between the two ears compared to prior to the procedure. The average AOS score prior to surgery was 17.90\u2009\u00b1\u20091.41, while the average AOS score following surgery increased to 29.57\u2009\u00b1\u20091.51. The preoperative VAS satisfaction score was recorded at 1.95\u2009\u00b1\u20091.12, while the postoperative VAS score showed a significant increase to 8.23\u2009\u00b1\u20090.87.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The flap technique, combined with cartilage grafting, effectively corrects the crus helicis transversal deformity with microtia. The approach maximizes the use of deformity ear tissue while minimizing damage. Additionally, it creates a natural and aesthetically pleasing ear shape, resulting in high patient satisfaction.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of evidence statement<\/jats:title>\n                    <jats:p>IV.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s40902-026-00510-2","type":"journal-article","created":{"date-parts":[[2026,4,11]],"date-time":"2026-04-11T07:47:05Z","timestamp":1775893625000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Reconstruction of microtia with crus helicis transversal deformity using flap technique combined with ear cartilage transplantation: a retrospective study"],"prefix":"10.1186","volume":"48","author":[{"given":"Yiwen","family":"Deng","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hongli","family":"Zhao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jianguo","family":"Chen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zexin","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peixu","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Senmao","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wenkang","family":"Luan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaobo","family":"Yu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lin","family":"Lin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bo","family":"Pan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Haiyue","family":"Jiang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,4,11]]},"reference":[{"key":"510_CR1","doi-asserted-by":"publisher","unstructured":"Zhou X, Fang J, Wang X et al (2024) Epidemiology of congenital malformations of the external ear in Hunan Province, China, from 2016 to 2020. Medicine (Baltimore). Apr 12. ;103(15):e37691. https:\/\/doi.org\/10.1097\/md.0000000000037691","DOI":"10.1097\/md.0000000000037691"},{"issue":"9","key":"510_CR2","doi-asserted-by":"publisher","first-page":"1090","DOI":"10.1177\/10556656221091699","volume":"60","author":"AL Johns","year":"2023","unstructured":"Johns AL, Stock NM, Costa B, Billaud Feragen K, Crerand CE (2023) Psychosocial and Health-Related Experiences of Individuals With Microtia and Craniofacial Microsomia and Their Families: Narrative Review Over 2 Decades. Cleft Palate Craniofac J Sep 60(9):1090\u20131112. https:\/\/doi.org\/10.1177\/10556656221091699","journal-title":"Cleft Palate Craniofac J Sep"},{"key":"510_CR3","doi-asserted-by":"publisher","first-page":"145","DOI":"10.1016\/j.bjps.2024.02.073","volume":"92","author":"Y Deng","year":"2024","unstructured":"Deng Y, Yang Y, Wang T et al (2024) Prograde transposition for anteriorly low-set earlobe in lobule-type microtia reconstruction. J Plast Reconstr Aesthet Surg May 92:145\u2013150. https:\/\/doi.org\/10.1016\/j.bjps.2024.02.073","journal-title":"J Plast Reconstr Aesthet Surg May"},{"issue":"10","key":"510_CR4","doi-asserted-by":"publisher","first-page":"1436","DOI":"10.1016\/j.bjps.2016.06.011","volume":"69","author":"J Zhou","year":"2016","unstructured":"Zhou J, Pan B, Yang Q et al (2016) Three-dimensional autologous cartilage framework fabrication assisted by new additive manufactured ear-shaped templates for microtia reconstruction. J Plast Reconstr Aesthet Surg Oct 69(10):1436\u20131444. https:\/\/doi.org\/10.1016\/j.bjps.2016.06.011","journal-title":"J Plast Reconstr Aesthet Surg Oct"},{"key":"510_CR5","doi-asserted-by":"publisher","first-page":"109801","DOI":"10.1016\/j.ijporl.2019.109801","volume":"130","author":"F Guo","year":"2020","unstructured":"Guo F, Lin L, Yu X et al (2020) Classification of the concha-type microtia and their new suitable treatment strategies without autogenous costal cartilage grafting. Int J Pediatr Otorhinolaryngol Mar 130:109801. https:\/\/doi.org\/10.1016\/j.ijporl.2019.109801","journal-title":"Int J Pediatr Otorhinolaryngol Mar"},{"issue":"5","key":"510_CR6","doi-asserted-by":"publisher","first-page":"1447","DOI":"10.1097\/01.prs.0000258572.57161.d8","volume":"15","author":"G Osorno","year":"2007","unstructured":"Osorno G (2007) A 20-year experience with the Brent technique of auricular reconstruction: pearls and pitfalls. Plast Reconstr Surg Apr 15(5):1447\u20131463. https:\/\/doi.org\/10.1097\/01.prs.0000258572.57161.d8","journal-title":"Plast Reconstr Surg Apr"},{"issue":"2","key":"510_CR7","doi-asserted-by":"publisher","first-page":"221","DOI":"10.1097\/00006534-199402000-00001","volume":"93","author":"S Nagata","year":"1994","unstructured":"Nagata S (1994) Modification of the stages in total reconstruction of the auricle: Part I. Grafting the three-dimensional costal cartilage framework for lobule-type microtia. Plast Reconstr Surg Feb 93(2):221\u2013230 discussion 267-8","journal-title":"Plast Reconstr Surg Feb"},{"key":"510_CR8","doi-asserted-by":"publisher","first-page":"462","DOI":"10.1016\/j.bjps.2023.06.015","volume":"84","author":"L Gu","year":"2023","unstructured":"Gu L, Sun P, Pan B, Jiang H (2023) Subtractive thinking: A novel combined application of antihelix reconstruction and outer helix reconstruction to treat mild cases of type I to II conchal microtia. J Plast Reconstr Aesthet Surg Sep 84:462\u2013468. https:\/\/doi.org\/10.1016\/j.bjps.2023.06.015","journal-title":"J Plast Reconstr Aesthet Surg Sep"},{"issue":"1","key":"510_CR9","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1097\/00006534-198007000-00001","volume":"66","author":"B Brent","year":"1980","unstructured":"Brent B (1980) The correction of mi-rotia with autogenous cartilage grafts: I. The classic deformity? Plast Reconstr Surg Jul 66(1):1\u201312. https:\/\/doi.org\/10.1097\/00006534-198007000-00001","journal-title":"Plast Reconstr Surg Jul"},{"issue":"1","key":"510_CR10","doi-asserted-by":"publisher","first-page":"13","DOI":"10.1097\/00006534-198007000-00002","volume":"66","author":"B Brent","year":"1980","unstructured":"Brent B (1980) The correction of microtia with autogenous cartilage grafts: II. Atypical and complex deformities. Plast Reconstr Surg Jul 66(1):13\u201321. https:\/\/doi.org\/10.1097\/00006534-198007000-00002","journal-title":"Plast Reconstr Surg Jul"},{"issue":"5","key":"510_CR11","doi-asserted-by":"publisher","first-page":"890","DOI":"10.1097\/00006534-199111000-00027","volume":"88","author":"K Matsuo","year":"1991","unstructured":"Matsuo K, Hirose T (1991) Reconstruction of the crus helicis in mild microtia using a preauricular tag. Plast Reconstr Surg Nov 88(5):890\u2013894. https:\/\/doi.org\/10.1097\/00006534-199111000-00027","journal-title":"Plast Reconstr Surg Nov"},{"issue":"4","key":"510_CR12","doi-asserted-by":"publisher","first-page":"1111","DOI":"10.1097\/scs.0000000000008163","volume":"1","author":"Q Wang","year":"2022","unstructured":"Wang Q, Wang Y, Zhou X, Zhang Q (2022) Three-Dimensional Auricular Subunit Models for Cartilage Framework Fabrication: Our Preliminary Experience. J Craniofac Surg Jun 1(4):1111\u20131115. https:\/\/doi.org\/10.1097\/scs.0000000000008163","journal-title":"J Craniofac Surg Jun"},{"key":"510_CR13","doi-asserted-by":"publisher","first-page":"237","DOI":"10.1016\/j.bjps.2024.03.008","volume":"92","author":"Y Deng","year":"2024","unstructured":"Deng Y, Jiang H, Pan B, Yu X (2024) Retrospective study on unilateral polyotia combined with microtia utilizing the technique of preserving residual ear tissue. J Plast Reconstr Aesthet Surg May 92:237\u2013243. https:\/\/doi.org\/10.1016\/j.bjps.2024.03.008","journal-title":"J Plast Reconstr Aesthet Surg May"},{"key":"510_CR14","doi-asserted-by":"publisher","first-page":"59","DOI":"10.1016\/j.bjps.2024.07.070","volume":"97","author":"Y Deng","year":"2024","unstructured":"Deng Y, Wang B, Jiang H, Pan B, Yu X (2024) A new corrective method for the Tanzer\u2019s group IIB constricted ear: Helical expansion using V-Y advancement flap combined with concha cartilage graft. J Plast Reconstr Aesthet Surg Oct 97:59\u201364. https:\/\/doi.org\/10.1016\/j.bjps.2024.07.070","journal-title":"J Plast Reconstr Aesthet Surg Oct"},{"issue":"7","key":"510_CR15","doi-asserted-by":"publisher","first-page":"2044","DOI":"10.1097\/01.prs.0000192569.69116.76","volume":"116","author":"Y Demir","year":"2005","unstructured":"Demir Y (2005) Correction of constricted ear deformity with combined V-Y advancement of the crus helicis and perichondrioplasty technique. Plast Reconstr Surg Dec 116(7):2044\u20132046. https:\/\/doi.org\/10.1097\/01.prs.0000192569.69116.76","journal-title":"Plast Reconstr Surg Dec"},{"issue":"8","key":"510_CR16","doi-asserted-by":"publisher","first-page":"1251","DOI":"10.1016\/j.ijporl.2008.05.006","volume":"72","author":"H Jiang","year":"2008","unstructured":"Jiang H, Pan B, Lin L, Cai Z, Zhuang H (2008) Ten-year experience in microtia reconstruction using tissue expander and autogenous cartilage. Int J Pediatr Otorhinolaryngol Aug 72(8):1251\u20131259. https:\/\/doi.org\/10.1016\/j.ijporl.2008.05.006","journal-title":"Int J Pediatr Otorhinolaryngol Aug"},{"issue":"2","key":"510_CR17","doi-asserted-by":"publisher","first-page":"141","DOI":"10.1097\/00006534-198308000-00003","volume":"72","author":"B Brent","year":"1983","unstructured":"Brent B, Byrd HS (1983) Secondary ear reconstruction with cartilage grafts covered by axial, random, and free flaps of temporoparietal fascia. Plast Reconstr Surg Aug 72(2):141\u2013152. https:\/\/doi.org\/10.1097\/00006534-198308000-00003","journal-title":"Plast Reconstr Surg Aug"},{"issue":"14","key":"510_CR18","doi-asserted-by":"publisher","first-page":"2618","DOI":"10.1007\/s00266-024-04124-9","volume":"48","author":"Y Deng","year":"2024","unstructured":"Deng Y, Wang B, Yang Y et al (2024) Minimally Invasive Costal Cartilage Harvesting Incision for Chest Deformity in Microtia Reconstruction. Aesthetic Plast Surg Jul 48(14):2618\u20132624. https:\/\/doi.org\/10.1007\/s00266-024-04124-9","journal-title":"Aesthetic Plast Surg Jul"},{"issue":"5","key":"510_CR19","doi-asserted-by":"publisher","first-page":"875","DOI":"10.1016\/S0030-6665(20)31215-9","volume":"23","author":"WE Davis","year":"1990","unstructured":"Davis WE, Boyd JH (1990) Z-plasty. Otolaryngol Clin North Am Oct 23(5):875\u2013887","journal-title":"Otolaryngol Clin North Am Oct"},{"issue":"7","key":"510_CR20","doi-asserted-by":"publisher","first-page":"2092","DOI":"10.1097\/scs.0000000000009427","volume":"1","author":"T Yotsuyanagi","year":"2023","unstructured":"Yotsuyanagi T, Yamashita K, Sugai A et al (2023) Correction of Cryptotia With Double Z-plasty:Modified Large Z-plasty Technique. J Craniofac Surg Oct 1(7):2092\u20132094. https:\/\/doi.org\/10.1097\/scs.0000000000009427","journal-title":"J Craniofac Surg Oct"},{"key":"510_CR21","doi-asserted-by":"publisher","first-page":"80","DOI":"10.1016\/j.bjps.2025.01.056","volume":"103","author":"Y Deng","year":"2025","unstructured":"Deng Y, Shu K, Wang B et al (2025) Lying ear deformity: Personalized fabricated synthetic expanded polytetrafluoroethylene retroauricular prosthesis as an alternative for its correction. J Plast Reconstr Aesthet Surg Apr 103:80\u201388. https:\/\/doi.org\/10.1016\/j.bjps.2025.01.056","journal-title":"J Plast Reconstr Aesthet Surg Apr"},{"key":"510_CR22","doi-asserted-by":"publisher","first-page":"398","DOI":"10.1016\/j.bjps.2024.09.077","volume":"98","author":"J Zhi","year":"2024","unstructured":"Zhi J, Feng J, Zhao L, Yu X, Jiang H (2024) Auricular deformity correction with simultaneous reconstruction of the conchal bowl using autologous ear cartilage for flat ear: A novel surgical technique. J Plast Reconstr Aesthet Surg Nov 98:398\u2013405. https:\/\/doi.org\/10.1016\/j.bjps.2024.09.077","journal-title":"J Plast Reconstr Aesthet Surg Nov"},{"key":"510_CR23","doi-asserted-by":"publisher","first-page":"71","DOI":"10.1016\/j.bjps.2024.07.073","volume":"97","author":"J Zhi","year":"2024","unstructured":"Zhi J, Wang T, Jiang H, Yu X (2024) Auricular growth potential of patients with concha-type microtia after auricular cartilage stretching surgery: A prospective study. J Plast Reconstr Aesthet Surg Oct 97:71\u201379. https:\/\/doi.org\/10.1016\/j.bjps.2024.07.073","journal-title":"J Plast Reconstr Aesthet Surg Oct"},{"issue":"12","key":"510_CR24","doi-asserted-by":"publisher","first-page":"1982","DOI":"10.1016\/j.bjps.2010.01.034","volume":"63","author":"SY Lim","year":"2010","unstructured":"Lim SY, Lee D, Oh KS et al (2010) Concealment, depression and poor quality of life in patients with congenital facial anomalies. J Plast Reconstr Aesthet Surg Dec 63(12):1982\u20131989. https:\/\/doi.org\/10.1016\/j.bjps.2010.01.034","journal-title":"J Plast Reconstr Aesthet Surg Dec"}],"container-title":["Maxillofacial Plastic and Reconstructive Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s40902-026-00510-2","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s40902-026-00510-2.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s40902-026-00510-2.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,16]],"date-time":"2026-06-16T21:49:40Z","timestamp":1781646580000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1186\/s40902-026-00510-2"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,4,11]]},"references-count":24,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026,12]]}},"alternative-id":["510"],"URL":"https:\/\/doi.org\/10.1186\/s40902-026-00510-2","relation":{},"ISSN":["2288-8586"],"issn-type":[{"value":"2288-8586","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,4,11]]},"assertion":[{"value":"31 January 2026","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"8 April 2026","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"11 April 2026","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The study was conducted in accordance with the principles outlined in the Declaration of Helsinki and obtained approval from the Institutional Research Ethics Board of Plastic Surgery Hospital of Peking Union Medical College (Approval No. 2024-381).","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to particpate"}},{"value":"All participants and their guardians have received informed consent and signed informed consent consent forms. The patient or the patient\u2019s guardian has provided consent for the publication of their own face or a photo featuring a distinctive physical characteristic.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"9"}}