CORRESPONDENCE AND COMMUNICATION The anatomy of the split ear lobe The split ear lobe is a common cosmetic surgery problem especially in countries where ear adornment by heavy jewellery is a custom and tradition. The split ear lobe is a result of gradual splitting of the earlobe by earrings leading to an even complete tear of the lobe. This is more frequent when heavy jewellery is worn over a period of time or sometimes it is due to acute pull on the pendant earring by small children. Much has been written about the methods of repair of split ear lobe but the pathological anatomy of the split of the ear lobe has not received much attention. In a study of over 150 patients with split ear lobe over the last 9 years, interesting observations have been made regarding the axis of the split ear lobe. It has been observed that the axis of the splitting of the ear lobe does not correspond to the anatomical craniocaudal axis of the ear but is directed in a down and out position starting from the original centrally located earhole. This particular axis of tear was found to be present in both incomplete and complete splitting of the ear lobes caused by constant pulling of the earrings (Figure 1). On analysis using clinical goniometry and computer aided designing (CAD) measurements of these cases, it was observed that the axis of splitting is a function of the relative position in which that individual holds the head while awake and performing various tasks. The vertical axis of the ear in normal head-holding position is inclined at an angle of approximately 25 5 and this fact determines the axis of the splitting of the ear (Figure 2). It is clear that gravity com- bined with weight of the earring contributes to the oblique axis of the split. This fact should be taken into consideration when designing ﬂaps for repair of the split ear lobe. Rajiv Agarwal Ramesh Chandra Department of Plastic Surgery, C.S.M Medical University, Lucknow, India E-mail address: [email protected] Figure 1 Near complete split right ear lobe in a 42-year-old female showing the unique axis of splitting of the ear lobe. Figure 2 Diagrammatic depiction of the split ear lobe along with CAD measurement of the axis of splitting. The axis of splitting was 29 from the craniocaudal axis of the ear. 1748-6815/$ - see front matter ª 2008 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved. doi:10.1016/j.bjps.2007.12.067 Journal of Plastic, Reconstructive & Aesthetic Surgery (2008) 61, S114

The anatomy of the split ear lobe

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Page 1: The anatomy of the split ear lobe

Journal of Plastic, Reconstructive & Aesthetic Surgery (2008) 61, S114

CORRESPONDENCE AND COMMUNICATION

The anatomy of the split ear lobe

The split ear lobe is a common cosmetic surgery problemespecially in countries where ear adornment by heavy jewel-lery is a custom and tradition. The split ear lobe is a result ofgradual splitting of the earlobe by earrings leading to an evencomplete tear of the lobe. This is more frequent when heavyjewellery is worn over a period of time or sometimes it is dueto acute pull on the pendant earring by small children.

Much has been written about the methods of repair of splitear lobe but the pathological anatomy of the split of the earlobe has not received much attention. In a study of over 150patients with split ear lobe over the last 9 years, interestingobservations have been made regarding the axis of the splitear lobe. It has been observed that the axis of the splitting ofthe ear lobe does not correspond to the anatomical cranio-caudal axis of the ear but is directed in a down and outposition starting from the original centrally located earhole.This particular axis of tear was found to be present in both

Figure 1 Near complete split right ear lobe in a 42-year-oldfemale showing the unique axis of splitting of the ear lobe.

Figure 2 Diagrammatic depiction of the split ear lobe alongwith CAD measurement of the axis of splitting. The axis of split-ting was 29� from the craniocaudal axis of the ear.

1748-6815/$-seefrontmatterª2008BritishAssociationofPlastic,Reconstrucdoi:10.1016/j.bjps.2007.12.067

incomplete and complete splitting of the ear lobes causedby constant pulling of the earrings (Figure 1).

On analysis using clinical goniometry and computer aideddesigning (CAD) measurements of these cases, it was ob-served that the axis of splitting is a function of the relativeposition in which that individual holds the head while awakeand performing various tasks. The vertical axis of the ear innormal head-holding position is inclined at an angle ofapproximately 25� 5� and this fact determines the axis ofthe splitting of the ear (Figure 2). It is clear that gravity com-bined with weight of the earring contributes to the obliqueaxis of the split. This fact should be taken into considerationwhen designing flaps for repair of the split ear lobe.

Rajiv AgarwalRamesh Chandra

Department of Plastic Surgery, C.S.M Medical University,Lucknow, India

E-mail address: [email protected]

tiveandAestheticSurgeons.PublishedbyElsevierLtd.All rightsreserved.

mailto:[email protected]