Download PDF
Facial Plast Surg 2015; 31(03): 308-314
DOI: 10.1055/s-0035-1555629
Rapid Communication
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Safety Approach to Otoplasty: A Surgical Algorithm

Diogo Nunes
1   Department of Otolaryngology - Head and Neck Surgery, Klinikum Bremen-Mitte, Bremen, Germany
,
Frank Haubner
2   Division of Facial Plastic and Reconstructive Surgery, Department of Otolaryngology - Head and Neck Surgery, Regensburg University Hospital, Regensburg, Germany
,
Thomas Kuehnel
2   Division of Facial Plastic and Reconstructive Surgery, Department of Otolaryngology - Head and Neck Surgery, Regensburg University Hospital, Regensburg, Germany
,
Holger G. Gassner
2   Division of Facial Plastic and Reconstructive Surgery, Department of Otolaryngology - Head and Neck Surgery, Regensburg University Hospital, Regensburg, Germany
› Author Affiliations
Further Information

Publication History

Publication Date:
30 June 2015 (online)

    Permissions and Reprints

Abstract

An algorithm was developed through an evolution of refinements in surgical technique with the goal to minimize risk and morbidity in otoplasty. Key principles were avoidance of cartilage incisions and transections and the use of multiple surgical techniques to distribute the “surgical load” evenly among these techniques. The present retrospective study was designed to test safety and efficacy of the concept in 100 consecutive patients and to discuss the results in light of the literature. Data detailing the surgery, preoperative, and postoperative period were extracted from the record and during patient interviews. Patients were contacted to complete a questionnaire to rate the postoperative pain and their satisfaction with the final outcome on a 6-point visual analog scale (VAS). An expert and a lay panel assessed preoperative and postoperative frontal-view photographs, using the same VAS. Pain in the postoperative was rated as minor (pain level VAS average score, 2.33) and patients' satisfaction was excellent (satisfaction level VAS average score, 1.82). The assessment by the panels of expert and lay evaluators paralleled these outcomes with a postoperative average VAS score of 1.69 and 1.87, respectively. Cartilage incision and transection can be effectively avoided in otoplasty. Even distribution of the surgical load among multiple techniques avoids the problems associated with “overload” of a single technique. The innovative technique of cortical mastoid drill-out is described. High satisfaction with the results, excellent patient comfort, and a favorable safety profile are associated with the present algorithm.

Keywords

otoplasty - prominent ears - external ear
 

  • References

  • 1 Hao W, Chorney JM, Bezuhly M, Wilson K, Hong P. Analysis of health-related quality-of-life outcomes and their predictive factors in pediatric patients who undergo otoplasty. Plast Reconstr Surg 2013; 132 (5) 811e-817e
    CrossrefPubMedGoogle Scholar
  • 2 Toplu Y, Sapmaz E, Firat C, Toplu SA. Clinical results and health-related quality of life in otoplasty patients using cartilage resection and suturing methods. Eur Arch Otorhinolaryngol 2014; 271 (12) 3147-3153
    CrossrefPubMedGoogle Scholar
  • 3 Janis JE, Rohrich RJ, Gutowski KA. Otoplasty. Plast Reconstr Surg 2005; 115 (4) 60e-72e
    CrossrefPubMedGoogle Scholar
  • 4 Romo T, Baratelli R, Raunig H. Avoiding complications of microtia and otoplasty. Facial Plast Surg 2012; 28 (3) 333-339
    Google Scholar
  • 5 Toplu Y, Sapmaz E, Toplu SA, Deliktas H. Otoplasty: results of suturing and scoring techniques. Eur Arch Otorhinolaryngol 2014; 271 (7) 1885-1889
    CrossrefPubMedGoogle Scholar
  • 6 Limandjaja GC, Breugem CC, Mink van der Molen AB, Kon M. Complications of otoplasty: a literature review. J Plast Reconstr Aesthet Surg 2009; 62 (1) 19-27
    Google Scholar
  • 7 Lentz AK, Plikaitis CM, Bauer BS. Understanding the unfavorable result after otoplasty: an integrated approach to correction. Plast Reconstr Surg 2011; 128 (2) 536-544
    CrossrefPubMedGoogle Scholar
  • 8 Converse JM, Nigro A, Wilson FA, Johnson N. A technique for surgical correction of lop ears. Plast Reconstr Surg (1946) 1955; 15 (5) 411-418
    CrossrefPubMedGoogle Scholar
  • 9 Converse JM, Wood-Smith D. Technical details in the surgical correction of the lop ear deformity. Plast Reconstr Surg 1963; 31: 118-128
    CrossrefPubMedGoogle Scholar
  • 10 Mustarde JC. The correction of prominent ears using simple mattress sutures. Br J Plast Surg 1963; 16: 170-178
    CrossrefPubMedGoogle Scholar
  • 11 Furnas DW. Correction of prominent ears by conchamastoid sutures. Plast Reconstr Surg 1968; 42 (3) 189-193
    CrossrefPubMedGoogle Scholar
  • 12 Obadia D, Quilichini J, Hunsinger V, Leyder P. Cartilage splitting without stitches: technique and outcomes. JAMA Facial Plast Surg 2013; 15 (6) 428-433
    CrossrefPubMedGoogle Scholar
  • 13 Fritsch MH. Incisionless otoplasty. Facial Plast Surg 2004; 20 (4) 267-270
    Article in Thieme ConnectPubMedGoogle Scholar
  • 14 Sadick H, Artinger VM, Haubner F, Gassner HG. Correcting the lobule in otoplasty using the fillet technique. JAMA Facial Plast Surg 2014; 16 (1) 49-54
    CrossrefPubMedGoogle Scholar
  • 15 Mandal A, Bahia H, Ahmad T, Stewart KJ. Comparison of cartilage scoring and cartilage sparing otoplasty—A study of 203 cases. J Plast Reconstr Aesthet Surg 2006; 59 (11) 1170-1176
    CrossrefPubMedGoogle Scholar
  • 16 Naumann A. Otoplasty—techniques, characteristics and risks. GMS Curr Top Otorhinolaryngol Head Neck Surg 2007; 6: Doc04
    PubMedGoogle Scholar
  • 17 Hoehn JG, Ashruf S. Otoplasty: sequencing the operation for improved results. Plast Reconstr Surg 2005; 115 (1) 5e-16e
    PubMedGoogle Scholar
  • 18 Eryilmaz T, Ozmen S, Cukurluoglu O, Sezgin B. External Mustarde suture technique in otoplasty revisited: a report of 82 cases. J Plast Surg Hand Surg 2013; 47 (4) 324-327
    CrossrefPubMedGoogle Scholar