Lidding is among the most common referrals for EarWell™ treatment. Most often, successful treatment entails the straightforward application of the EarWell™ Cradle and Retractor System as outlined in the Training Video.
There are three occurrences where special techniques in the EarWell application should be considered: 1) Lidding that spans the superior crus helix and does not expand with normal Retractor placement, 2) Lidding that exists along the rim medial to the inferior crus, and 3) Lidding that is part of a Tanzer I malformation with absent skin between the scapha and helical rim.
The technical variations that deal with refractory lidding spanning the superior crus are best shown in the video that features correction of the High Transverse Crus in the Stahl’s deformity. Lidding that persists medial to the inferior crus can be corrected by applying the Large Cradle so as to give more room along the inner perimeter of the Cradle and adding a Mini Retractor to the area of concern. On occasion, I have cut the Large Retractor in half (after removing the metal strip) to enable a better fit. Small strips of tape that span from the helical rim out to the base of the Cradle, or rolled tape placed on the inner aspect of the rim, are useful tricks. (See videos below)
Lidding that is secondary to a true absence of tissue (Tanzer I malformation) can be improved in the final application using the retractor with retention taping. In this technique we are allowing the retractor to be positioned where it would normally be creating pressure against the posterior former of the posterior cradle. When the retractor is used in conjunction with taping, it is mandatory to affix the retractor to a bottom tape (see video below) to protect the skin from ulceration from downward pressure or abrasion from movement.