Appropriate Timing of Otoplasty for Prominent Ears

Abstract

Plastic Surgery| January 01 2005 Appropriate Timing of Otoplasty for Prominent Ears AAP Grand Rounds (2005) 13 (1): 10–11. https://doi.org/10.1542/gr.13-1-10 Views Icon Views Article contents Figures & tables Video Audio Supplementary Data Peer Review Share Icon Share Facebook Twitter LinkedIn MailTo Tools Icon Tools Get Permissions Cite Icon Cite Search Site Citation Appropriate Timing of Otoplasty for Prominent Ears. AAP Grand Rounds January 2005; 13 (1): 10–11. https://doi.org/10.1542/gr.13-1-10 Download citation file: Ris (Zotero) Reference Manager EasyBib Bookends Mendeley Papers EndNote RefWorks BibTex toolbar search toolbar search search input Search input auto suggest filter your search All PublicationsAll JournalsAAP Grand RoundsPediatricsHospital PediatricsPediatrics In ReviewNeoReviewsAAP NewsAll AAP Sites Search Advanced Search Topics: ear, prominent, otoplasty Source: Gosain AK, Kumar A, Huang G. Prominent ears in children younger than 4 years of age: what is the appropriate timing for otoplasty? Plast Reconstr Surg. 2004;114:1042–1054. This study from the Medical College of Wisconsin was performed to determine whether reconstructive otoplasty for prominent ears performed before 4 years of age results in an acceptable long-term outcome. The study consisted of 2 parts: 1) a survey mailed to 481 plastic surgeons asking their opinion on the timing of otoplasty; and 2) a consecutive prospective series of 12 patients who had otoplasty performed before 4 years of age. One hundred seventy-four plastic surgeons responded to the questionnaire (37%). The majority of respondents (57%) routinely delayed otoplasty until their patients were 5 years of age or older. Respondents cited a number of reasons for delaying otoplasty until at least 5 years of age, including decreased anesthetic risk, increased patient cooperation, near adult size of the auricle, and increased awareness of self-image and peer ridicule. Respondents estimated an 8% recurrence rate of the deformity in patients operated on at 5 years of age or older. The second part of the study examined the lead author’s experience with 12 patients operated on before 4 years of age (mean 23 months, range 9 months to 3 years). Bilateral procedures were performed in 9 patients and unilateral in 3 patients. Length of follow-up ranged from 21 months to 7.5 years. No patient demonstrated disturbance in growth of the ear following otoplasty. At follow-up, none of the 3 children with unilateral otoplasty showed any difference in growth between the ear operated on and the uncorrected ear. Notable recurrence occurred in only 1 of the 12 patients (8%) or 1 of 21 ears operated upon (4.8%). A follow-up questionnaire was sent to parents 1 year or more post-operatively. All 10 of the families returning the questionnaire responded that if asked again, they would choose to have the procedure performed at the same age, rather than waiting until their child was older. The authors conclude that otoplasty can be performed safely and without growth disturbance of the surgically corrected ear in patients younger than 5 years of age. They suggest that patients undergoing early surgical correction of prominent ears might benefit from enhanced development of self-esteem. Financial Disclosure: Dr. Burstein has disclosed that he has no relationships relevant to this commentary. This paper raises several issues of concern to plastic surgeons and parents. For example, will a child’s self-image suffer if a prominent ear deformity is not corrected before 4 or even 3 years of age? Since a child of 3 or 4 years of age is not capable of understanding or desiring surgical correction, are we treating the child or the parents when we perform this operation on young children? While a case series of 12 patients is not an adequate evidence base for a recommendation, it is sufficient to spur further exploration of the benefits and risks of early otoplasty.... You do not currently have access to this content.