Surgical repair of the cleft earlobe.

Piercing of the earlobes has been performed in both sexes for thousands of years for social, religious, and cosmetic purposes in the most primitive as well as the most affluent cultures. Ancient Indian writings’ describe the need for repair of the cleft earlobe. During the past decade, there has been a resurgence of body piercing by in both men and women. Body art in the form of multiple piercing is a hallmark of the so-called generation X. Acquired clefts or splitting of the earlobes commonly occur from prolonged traction of heavy earrings. In rare cases, it can also occur from pressure necrosis from the clip-on earring,2 as well as from intentional and unintentional trauma.’ Children pulling on an adult’s earring, inadvertent snagging of an earring with a hairbrush, and altercations are common causes of traumatic earlobe clefts. These clefts are most commonly incomplete (Fig 1) and bilateral; however, complete clefts are also common (Fig 2). Ear clefts usually involve a linear tear in the case of protracted traction and may be angular in the direction of traumatic vectors in traumatically induced clefts. In either case, the fleshy portion of the earlobe is torn and the cartilaginous portion of the auricle is rarely involved. Bleeding is minimal, and the defect edges heal with little scar formation2 except when keloids occur. A congenital anomaly, Coloboma lob&, a clefting of the earlobe at birth, is treated in the same manner. Most women desire expedient repair so they can once again wear earrings. Because they are reluctant to go for an extended period without an earring, procedures that favor immediate or quick repiercing are perceived as desirable by the patient. The literature describes repair techniques that do not provide for repiercing as well as procedures that leave an opening for the reinsertion of an earring. Boo-Chai’ in 1961 described excision of the cleft and placement of a portion of a sterile toothpick to preserve an opening for an earring post repair. Pardue’ in 1972 pre-