Correction Of Prominent Ears Research Articles

Natural-looking ears after otoplasty with a modified anterior scoring technique.

The correction of prominent ears is a rewarding operation. When choosing a surgical technique, we prefer a cartilage-sparing technique to a cartilage-splitting technique in order to achieve natural-looking long-term results. In this article, we present our preferred technique of an anterior scoring technique combined with concha-mastoid sutures step by step.

Correction of Prominent Ears with Novel Otoplasty Grid.

Correction of Prominent Ears with Novel Otoplasty Grid.

A Different Approach for Protruding Earlobe Correction—Modified Fish-tail Technique

BackgroundProtruding ears are the most common auricular abnormalities seen in children (1). Protruding ears are a condition that has social and psychological consequences due to its physical appearance and one of the main causes of peer bullying at young ages (2). While various surgical methods exist to address prominent ears, the options for correcting the lobule are relatively scarce. In this study, we are aimed to present the modified fish-tail technique that we have developed and to compare it with other techniques in the literature.MethodsThe patients were selected from the cases that underwent otoplasty for prominent ear correction in our clinic between 2020 and 2022. A total of 21 cases that required protruded lobule correction during otoplasty were included in our study. Keloid and hypertrophic scar formation, wound dehiscence, hematoma, infection and recurrence in the lobule were evaluated. The patients were followed up for at least 1 year for early and late complications.ResultsEach patient in the study underwent bilateral prominent ear correction, including bilateral modified fish-tail technique. All cases were followed for at least 12 months. There was no wound dehiscence, infection, recurrence in lobule prominence or hematoma during the follow-up period. No hypertrophic scar or keloid was observed in any case.ConclusionsOur method stands out for its ability to achieve both adjustable vertical height and effective lobule correction with a reduced need for skin excision. We recommend the modified fish-tail technique as an alternative technique for prominent lobule surgery.Level of Evidence IVThis journal requires that authors assign a level of evidence to each article. For a full description of these evidence-based medicine ratings, please refer to the Table of contents or the online Instructions to Authors www.springer.com/00266.

Cartilage excision for antihelix creation in prominent ear correction: A prospective study

Cartilage excision for antihelix creation in prominent ear correction: A prospective study

Prominent ear correction: Three flap technique combined with conventional otoplasty

Prominent ear correction: Three flap technique combined with conventional otoplasty

Modified bilateral fasciaperichondrial flap for prominent ear correction

ObjectiveVarious techniques have been described in the literature for prominent ear correction. These cartilage-preserving or cartilage-shaping techniques have their own advantages and disadvantages. We aim to achieve aesthetic and stable results with low complication rates using combinations of these methods. Herein, we present our results of prominent ear surgery with a modified bilateral fasciaperichondrial flap in combination with concha-mastoid and concha-scaphal sutures. MethodsPatients whose surgeries included a modified bilateral fasciaperichondrial flap for prominent ear deformities were included in the study. Patients’ demographic data, pre- and postoperative Concha-Mastoid Angle (CMA) and upper-middle Helix-Mastoid Distances (HMD), follow-up time, complications, secondary operations, and postoperative Visual Analogue Scale (VAS) results were evaluated. With a postauricular fish-mouth incision, the bilateral fasciaperichondrial flap was planned into two: proximal- and distal-based. They were then elevated from the cartilage subperichondrially on the proximal side and supraperichondrially on the distal side. Concha-scaphal sutures were used to form an antihelical rim along with concha-mastoid sutures to reduce the concha-mastoid angle. Conchal cartilage resection was done if needed. Then, the bilateral fasciaperichondrial flaps were sutured together to cover the concha-mastoid and concha-scaphal sutures. ResultsBetween May 2017 and May 2021, 32 ears of 17 patients were operated on due to prominent ear deformity. No hematoma or infection was observed in any patient, and there were no instances of recurrence, suture exposure, hypertrophic scars, or keloids. The satisfaction level of all patients was 8.2 ± 0.9 points on average according to the VAS. In the anthropometric measurements, a statistically significant difference was found between preoperative and postoperative sixth month CMA and HMD values. ConclusionA combination of suture techniques and a modified bilateral fasciaperichondrial flap may be used in prominent ear cases, with low recurrence rates and high patient satisfaction. Level of evidenceIII.

Long-term outcomes of otoplasty for correction of prominent ear

Long-term outcomes of otoplasty for correction of prominent ear

Our Experience With the Correction of Prominent Ear Deformity.

The ear has a unique architecture of cartilage and skin. The incidence of the prominent ear is about 5%. Surgical correction of the prominent or protruding ear can be carried out either by anterior or posterior approach. We created antihelical fold of cartilage by utilizing a posterior incision to score the anterior cartilage of the lateral scapha with a knife. Sutures were often used to uphold the produced fold. The additional procedure of conchal reduction and concho-mastoid suture was done when required. The objective of our research is to evaluate the patient’s and surgeon’s satisfaction with our technique of prominent ear correction and identify any complication if it occurs post-operatively.This is a retrospective study over a period of eight years (2011-2018) which includes all patients presented to Liaquat National Hospital with prominent ear. A total of 47 patients were included. Patients with a previous history of otoplasty were excluded. Patients were followed up for at least six months postoperatively. The outcome was assessed via Visual Analogue Score by a patient, surgeon, and a third observer (assessor). The average score by the surgeon was 7.9, by the patient it was 8.4 and by the assessor it was 8.1. The average pre-operative concho-mastoid distance was 2.2 cm which decreases to 1.4 cm post-operatively. Correction of the prominent ear by this technique is safe and easy. We did not experience any major complication, giving reproducible and good aesthetic results.

Efficacy of Using Perichondrioadipodermal Flap With Combined Techniques in Prominent Ear Correction.

Prominent ear is 1 of the most common congenital deformities of the ear. Incidence is reported as approximately 5%. This deformity can classically be the result of antihelix insufficiency, overprojection of concha or combination of both. Less frequently, folded or overprojectile ear lobule can aggravate the deformity. Surgical techniques can be aimed at concha, antihelix formation, lobule positioning. In our study, postoperative results for the combination of suture otoplasty and perichondrioadipodermal flap techniques in prominent ear surgery is discussed in light of the recent literature. Forty-nine patients that were operated for prominent ear deformity in our clinic between 2010 and 2015 were evaluated. Anatomic structures that cause the anomaly was analyzed by photographing concha-scaphoid angle, antithetical fold absence or presence, position of the ear lobule, conchal depth, size of the auricula, and positioning Frankfort Plane parallel to the ground. The patients were photographed preoperatively, at postoperative first week and postoperative sixth month, respectively. Comparison of age, surgical technique, surgical complications, necessity for revision surgery, additional procedures, follow up time, preoperative, and postoperative helix-mastoid bone distance were evaluated. Forty-nine patients have been evaluated. Thirty-one of these patients were female, whereas 18 were male. Age of these patients ranged between 6 and 37. Operations were performed in 47 right side ears, and 44 left side ears (97% bilateral and 7% unilateral otoplasty). Preoperative helix-mastoid bone distance ranged between 21 and 33 mm (mean 26.77), whereas postoperative helix-mastoid bone distance was measured between 12 and 22 mm (mean 16.26). Compared to the preoperative values, helix-mastoid distance difference was statistically significant (P < 0.05). Asymmetry and recurrence are the most common late complications of prominent ear surgeries. Perichondrioadipodermal flap can be safely added to the combined surgical techniques protecting the cartilage support, therefore, reducing complication rates, with satisfying results.

Comparative study between Mustarde and Stenström techniques in treatment of prominent ear

Background Numerous methods have been developed for the correction of protruding ears. However, the best technique should be the one that is simple, reliable, and reproducible. Our research aimed to compare Mustarde technique and Stenström technique used in the correction of prominent ears. We included 20 patients who were randomly assigned to Mustarde or Stenström technique. All participants underwent full history collection, general and local examinations, and full investigations. We analyzed the age, sex, surgical technique, follow-up, complications, and results. Aim The aim of this study is to compare between Mustarde and Stenström techniques in the correction of prominent ear. Patients and methods This study included 20 patients with prominent ear, comprising 15 males and five females, attending Al-Azhar University hospitals. The patients were divided into two groups, with each group including 10 patients: creation of antihelix was done in all cases, and conchomastoid sutures were used if needed in some cases. Results According to our results, comparison of these two groups showed that patient satisfaction was high in both groups. In our study, hemorrhage, hematomas, keloid formations, suture extrusion, skin and cartilage infection, skin necrosis, and relapse have not occurred in any of the patients of the two groups. Irregularity in the antihelix was not observed in any patients from group A (Mustarde technique) and observed in one (5%) patient from group B (Stenström technique). Conclusion Minimizing the gap between the ear and the mastoid is the most significant outcome for patients in considering the operation as a success. Mustarde technique was our favorite technique for correction of protruding ear in children with soft or thin cartilage. We also agree that the technique of Stenström was effective in adults with hard or thick cartilage.

Correction of Prominent Ears: Postauricular Muscle Relocation and Fibrofatty Tissue Excision.

In this study, we modified the combined Mustarde and Furnas type otoplasty technique and evaluated the postoperative results of the patients for symmetry and complications. Eighty prominent ears in 42 patients who underwent otoplasty between January 2017 and April 2019 were included in this study. The authors determined the amount of postauricular subcutaneous tissue to be removed according to the shape of skin incision and relocated the postauricular muscle as an adjunct to the Mustarde and Furnas otoplasty technique. All patients were followed-up at least 12 months postoperatively. The patients were also evaluated for early postoperative complications (bleeding, hematoma, perichondritis, wound infection, and skin necrosis), late postoperative complications (asymmetry, hypertrophic scars, suture extrusion, and recurrence), and patient satisfaction using objective and subjective methods.Considering all the patients, early complications consisted of minimal low-flow bleeding (n = 4 ears/4 patients), hematoma (n = 1), and perichondritis (n = 1). Late complications consisted of suture extrusion (n = 2 ears/2 patients), hypertrophic scars (n = 2 ears/2 patients), and asymmetry (n = 1). None of the patients presented with wound infection or skin necrosis. Revision otoplasty was unilaterally performed in only 1 patient with the complaint of asymmetry. A natural-looking, adequate correction, and symmetric ear shape were achieved in all patients except 1. In terms of patient satisfaction, 38 of 42 patients evaluated the outcome as "very good," 3 as "good," and only 1 as "poor." Our modified technique produced very satisfactory results and reduced the postoperative complication and asymmetry rates, as well as eliminating recurrence. The authors recommend this simple and safe procedure with excellent outcomes.

The Earfold implant system for the correction of prominent ears: lessons learnt from the combined experience of two UK aesthetic surgeons

The Earfold implant system, made from a nickel-titanium alloy, is deployed and bends auricular cartilage to address an underdeveloped antehelical fold. The purpose of this study is to report the early results and technical tips from two UK plastic surgeons implementing the Earfold system into their aesthetic practice for the first time. A retrospective review of all patients who received Earfold implants between February 2017 and August 2018 was undertaken. This was a consecutive series in two separate UK clinics. Demographics, clinical outcomes and complications were collected from electronic patient records. A total of 79 implants were used in 36 patients, with 82% (n = 31) placed bilaterally. Mean age was 35 years (56% female). Overall complication rate leading to implant removal was 22% (n = 8). Indication for implant removal included skin erosion (n = 3); implant visibility (n = 2); chronic pain (n = 2) and undercorrection (n = 1). Three patients who had implants removed had previously had an otoplasty procedure. Seven complications (88%) occurred in the first half of Earfold cases performed. Mean follow-up time from surgery was 19 weeks (range 4–58). The Earfold implant system gives reproducible results that can be visualized by patients prior to surgery, and is becoming increasingly popular. Our results highlight a learning curve with the device, leading to revision of seven cases in the first eighteen performed by both surgeons. Therefore, we advise careful patient selection, in particular a history of previous otoplasty procedures, when starting to use the device. Level of evidence: Level IV, therapeutic study.

Importance and necessity of surgical combinations in the correction of prominent ears for natural and long-lasting results

Importance and necessity of surgical combinations in the correction of prominent ears for natural and long-lasting results

Comparison of surgical techniques for prominent ear correction: Mustardé versus Converse

A Revista Brasileira de Cirurgia Plástica é o órgão oficial de divulgação da Sociedade Brasileira de Cirurgia Plástica (SBCP), tem como objetivo registrar a produção científica em Cirurgia Plástica, fomentar o estudo, aperfeiçoamento e atualização dos profissionais da especialidade.

Postcode lottery? Do clinical commissioning groups differ in their funding of prominent ear correction surgery

SummaryIn 2013 Clinical Commissioning Groups (CCGs) were created and became responsible for the planning and commissioning of health care services in their area. The Royal College of Surgeons and the British Association of Plastic, Reconstructive and Aesthetic Surgeons created guideline for the CCGs in 2013 for the surgical treatment of prominent ears. By looking at each of the CCGs’ websites, we aim to review their equity and how well they adhere to standards to determine whether there is a regional variation for funding of this procedure.We found that 47% of the CCGs will fund this procedure only on an exceptionality basis, compared to 26% who had set criteria and would allow funding if these criteria were met. There was significant variation in the age at which funding would be considered with some CCGs allowing funding from 5 years of age and others not providing it until as old as 11 years. Only 11 policies made any reference to cartilage moulding and only 3 mentioned funding to allow correct fitting of hearing aids.Unfortunately, despite recommendations from the Royal College of Surgeons and the British Association of Plastic and Reconstructive Surgery, there is still variation in funding criteria between CCGs for correction of prominent ear surgery. This may result in patients being treated differently depending on their postcode. We would urge commissioners to apply more consistent and uniform guidelines for the funding of surgical correction of prominent ears.

Chirurgie secondaire du pavillon de l’oreille

Secondary surgeries of the external ear can be divided into two categories: secondary otoplasties and secondary ear reconstructions. The most frequent causes of secondary otoplasties are a recurrence, an over-corrected ear, an off-center ear, a prominent lobule, and finally chronic ear pain. Recurrence of the prominence can be treated by a new posterior stitch otoplasty, an Earfold clip, or a frame stitch. The over-corrected ear can be projected either by costal cartilage grafts or by hyaluronic acids. Patients who are unsatisfied of the aesthetic result of their prominent ear correction usually complain about an off-centered ear, because the ideal ear axis is parallel to the cheek. A prominent lobule can be corrected with a posterior stitch and a VY flap. Chronic ear pain can be significantly reduced by a protocol of physiotherapy with positive sensory feedback. In ear reconstruction, it is important preserve the retroauricular skin and the superficial temporal fascia, which are the workhorses of ear reconstruction. Secondary ear reconstructions are usually very complex procedures, which should be performed by specialists.

Earfold Implant System for the Correction of Prominent Ears: Early Experience From 2 UK Esthetic Surgeons

Earfold Implant System for the Correction of Prominent Ears: Early Experience From 2 UK Esthetic Surgeons

Correction of prominent ear by the two parallel incision technique with definition and folding of the antihelix by vertical mattress sutures

BackgroundMultiple techniques have been advocated over the years for correction of the prominent ear. The basic techniques used to correct prominent ears with a missing antihelix depends on incision, scoring, bending and reposition of the auricular cartilages. This study was undertaken to correct prominent ears using cartilage incision and vertical mattress sutures to define antihelix.Patients and MethodsThis study was carried out on 13 patients (25 ears) in the period between February 2014 and June 2017, twelve patients of them were presented with bilateral prominent ears and one patient was presented with unilateral prominent (bat) ear. This series comprised 8 males and 5 females. Their ages ranged between 7 to 33 years. In this technique 2 parallel incision in auricular cartilage, definition of antihelix with vertical mattress sutures and ellipse of skin was removed.ResultsSatisfactory results were obtained in all patients. Complications occurred in 2 patients only: one of them had mild protrusion of upper third of auricle and the other had keloid.ConclusionOur technique produces natural-looking of the operated ears with low complication rates.

Helix free otoplasty for correction of prominent ear

Prominent or bat ear is not uncommon deformity as it affecting 5% of population. Plenty of procedures were reported for its correction. Being plenty means it is still a subject of research. The current procedures could be summarized as cartilage sparing and cartilage splitting ones. During a period of 35 months a total of 31 patients were presented with bilateral prominent ears so the included a total of 62 ears. Their average age was 8 years (ranging from five to 18 years). All deformities were corrected using helix free otoplasty technique which included skin paddle excision, separation of helical cartilage (hence the name helix free), anterior scoring, backward folding, mattress and simple suturing of the folded cartilage, proper definition of antitragus and earlobe and concha-mastoid sutures. Outcomes including patient's and/or guardians' satisfaction were determined. The postoperative period was uneventful except two cases that developed early postoperative hematomas, one case shows late postoperative antihelical fold irregularity in one ear and other case developed ill defined superior helix in one ear. The average follow up period of two years shows no recurrences. Almost all patients (96.85%) and their guardians were satisfied with the aesthetic results while only one (3.2%) was dissatisfied. Helical free otoplasty technique addresses the deformity through a posterior approach with under vision correction. It has very low incidence of complications, high patient's satisfactions, no visible scars and no recurrences. It is a simple, short duration procedure, reliable and good option for correction of prominent ear.

Early experiences with the use of Earfold? for correction of prominent ears

Early experiences with the use of Earfold? for correction of prominent ears