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The conchal churches can be found mainly in the monasteries and are not so exquisite.
The latter feature of conchal shape, while not the sole cause of lobular prominence, appears to play a key role.
More anteriorly is an oblique ridge, the conchal crest, for articulation with the inferior nasal concha.
(b) Conchal excision.
Moreover, to avoid producing a noticeable surgical scar in the concha, the surgeon meticulously closes the conchal defect with sutures.
The vertical walls of the conchal cup translate to a semi-horizontal plane as the concha merges with the folded crest of the antihelix.
Brent, B.: "Auricular Repair with a Conchal Cartilage Graft."
The surgeon applies a corrective technique that combines the pertinent technical aspects of the Furnas suture technique and of the conchal excision techniques.
Self-adhering foam - Meant to prevent the splints from damaging the infantile skin; the foam is applied at the bottom of the auricular fold, and in the conchal fossa proper.
The defect of an alar dome, which retains adequate anatomic support-tripod configuration, can be corrected with an onlay graft harvested either from the nasal septum or from the conchal cartilage of an ear.
Absent alar cartilages can be replaced using all of the conchal cartilage from both ears; two strips, each 10 mm wide, are harvested from the antihelical fold, and then are applied as replacement alar wings.
The respiratory segment has a very vascularized lamina propria allowing the venous plexuses of the conchal mucosa to engorge with blood, restricting airflow and causing air to be directed to the other side of the nose.
The anterior border is thin and irregular; opposite the conchal crest is a pointed, projecting lamina, the maxillary process, which is directed forward, and closes in the lower and back part of the opening of the maxillary sinus.
Yet, when done without an incision, the procedure is deemed an incisionless otoplasty, wherein the surgeon places a needle through the skin, to model the cartilage and to emplace the retention sutures that will affix the antihelix and conchal bowl areas.
The nasal skeleton is replaced with a rib-graft nasal dorsum and lateral nasal wall; septal cartilage grafts and conchal cartilage grafts are applied to correct defects of the nasal tip and of the alar lobules.
If the roll of the antihelix and its crest are effaced and flat, rather than rolled or folded, the steep pitch of the conchal wall continues into the un-formed antihelix and scapha and ends at the helix, with little interruption.
Darwinian ear - A defect wherein the rim cartilage of the conchal bowl of the ear is flat, rather than folded inwards; it is an evolutionary remnant from when the human head muscles permitted the person to voluntarily prick up the ears in a given direction.
Conchal or septal bullae (bony, air-filled sacs in either the turbinates or septum) have also been implicated in the development of rhinogenic migraines, and their resection or unroofing at the time of surgery has eliminated symptoms in patients who manifest this pathology .
The otoplastic technique most effective for lobular repositioning is the Gosain technique (or a variant), wherein the surgeon cuts the skin on the medial surface of the earlobe, and, in suturing it closed, takes a bite of the conchal undersurface to pull the earlobe towards the head.
The design of the cartilage-crescent excision means to produce a closing incision will lay at the junction of the conchal floor and the posterior conchal wall - where it is least noticeable, and causes minimal distortion of the normal contours of the ear.