Combined Technique in Otoplasty

Abstract

The otoplasty techniques are classically classified as cartilage-cutting techniques (from full thickness cutting to cartilage scoring) and cartilage-sparing techniques (basically suturing). Current trends in otoplasty combine elements of various techniques, especially the historically reliable ones, in a graduated approach that is based on the anatomical demands. The author’s experience is a combined technique that blends “closed” anterior cartilage scoring using the Stenstrom otoabrader with Mustarde horizontal mattress sutures to the posterior cartilage through a posterior approach. Some surgical principles make this combined procedure different from the previous techniques: the postauricular skin incision is linear without any skin excision, the cartilage scoring is performed by rasping of the anterior surface the antihelix and scapha with thorough scoring the of the tail of the antihelix and the anterior concha to define the antihelical fold and to turn the ear lobe toward the mastoid. Then, the Mustarde’s mattress sutures and external transfixed stitches are used to stabilize the result. The procedure presents few minor complications that may be decreased by an impeccable technique. The aesthetic results are very good or good in the majority of the cases. It makes this combined technique a versatile and reliable one with a high success rate and low morbidity.