Results of otoplasty by scoring anterior surface of auricular cartilage (original) (raw)
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Our Experience With the Correction of Prominent Ear Deformity
Cureus, 2021
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.
Comparison of cartilage scoring and cartilage sparing otoplasty – A study of 203 cases
Journal of Plastic, Reconstructive & Aesthetic Surgery, 2006
The Edinburgh experience of different methods of otoplasty techniques in 203 patients (406 ears) over a five-year period is reviewed. Materials and methods: The patients were divided into three groups e Group A (anterior cartilage scoring), Group B (cartilage sparing in the fashion of posterior suturing) and Group C (posterior suturing refined with posterior fascial flap). Demographic details, operation technique, operation time, grade of the surgeon, suture materials, early and late complications, recurrence and revision rates, patients' and physicians' comments at the follow-up clinic were retrieved from the case notes. The pre-and the post-operative photographs were assessed by a blinded lay observer and a physician and scored on a visual analogue scale. Median follow-up was 11 months. Results: The recurrence rate was 11.0%, 8.0% and 4.8% in Groups A, B and C, respectively (p ¼ 0.0214). Complications were more common in Group A (8.8%) and Group B (7.9%) compared to Group C (1.2%) (p ¼ 0.0208). The cosmetic result was judged best in Group C.
Prominent Ears: Impact of Combination of Techniques
Annals of Otolaryngology and Rhinology
Purpose: Estimate the effect of combination of different otoplasty techniques and its effects of patients' psychological condition. Methods: From January 2015 to July 2019, otoplasty for 30 patients complaining of bilateral prominent ears were done. Suture techniques were combined with scoring with no cartilage excision have been used to ensure symmetrical and adequate repair with no relapse from the surgery. Results: 30 patients were operated. 28 patients were satisfied. 2 early complications occurred in the form of hematoma, which were evacuated and treated conservatively. Also, 2 late hypertrophic scaring of the post auricular sulci were treated with silicone gel and intra lesional injection of corticosteroids. Patient satisfaction was the utmost, with great impact on psychological status and lifestyle changes. Conclusion: Combination of suture techniques and cartilage scoring with no cartilage excision in surgical management of protruding ears has a great role in restoring normal and symmetrical shape and greatly prevents relapse of the condition. Minimal of no complications could be guaranteed if combination is adequate. Postoperative psychological improvement and change in life style is well established.
Assessment of the degree of correction of prominent ears using a standardized treatment algorithm
2014
Background: The goal of aesthetic otoplasty is the correction of ear deformities by creating harmonious and symmetrical external ears, without visible scars. Otoplasty techniques based on the excision of postauricular skin are associated with high recurrence rates. Modern otoplasty is based on cartilage-cutting and cartilage-sparing techniques, alone or in combination, which lead to lower recurrence rates. Objective: We evaluated the efficacy of otoplasty combined with other techniques in the correction of ear deformities, based on a modified version of the "algorithm for otoplasty at the Craniofacial Center at Texas Children's Hospital". Methods: Forty patients, who underwent otoplasty for prominent ears in our institution between March and September of 2009, were prospectively assessed. The mastoid-helix distance was measured preoperatively (baseline) and at 1, 3, and 6 months postoperatively. Results: The most common deformities were scaphoconchal angle greater than...
Anterior Scoring of the Upper Helical Cartilage as a Refinement in Aesthetic Otoplasty
Aesthetic Plastic Surgery, 2005
Background: Anterior scoring with the use of simple or dedicated instruments, toothed forceps, endoscopic carpal tunnel release instruments, and needles has been described previously. The upper third of the ear easily maintains the original shape because memory and elasticity are stronger than in the middle or the lower part of the ear. This report describes a further refinement to the Chong-Chet anterior scoring technique, consisting of anterior scoring of the upper helical cartilage to correct the helical radix upper prominence. Methods: A retrospective study analyzed 20 surgeries for prominent ears. All the subjects had undergone otoplasty softening the helix. Results: There were no residual ear prominence/upper third prominence or cartilage irregularities at the 1-year followup evaluation. Anterior auricular cartilage scoring is an effective technique for controlling the degree and position of the antihelical fold. Furthermore, the upper third of the pinna seems to have a stronger memory than the middle third. To prevent this late complication the authors routinely perform anterior scoring up to the helix, weakening that cartilage usually untouched with other procedures. Conclusion: This refinement, in combination with other procedures is safe, easy, and fast, giving reproducible and good aesthetic results.
Otoplasty Using a Modified Anterior Scoring Technique
Archives of Facial Plastic Surgery, 2010
To evaluate long-term results of otoplasty using standardized measurements. Methods: We performed a retrospective study of patients who underwent otoplasty using a modified anterior scoring technique combined with postauricular fixation sutures. Two hundred twenty-two consecutive patients (421 primary otoplasties) were included. Each auricle was examined before surgery, after surgery, and at a long-term follow-up visit, and the distance between the lateral helical rim and the mastoid surface was measured at 3 points. In addition, patient satisfaction was evaluated using a questionnaire. Results: Seventy-two percent of 222 patients were examined at a long-term follow-up visit. Follow-up of 301 auricles was on average 6.25 years (range, 44-106 months). The mean preoperative measurements among all auricles were 23.3 mm at the uppermost point of the helix, 28.6 mm at the middle, and 25.9 mm at the lobule; these values were 14.2, 14.0, and 16.1 mm, respectively, at the end of the operation and 16.0, 17.5, and 17.4 METHODS PREOPERATIVE EVALUATION This study included all patients who underwent primary otoplasty in the
Otoplasty for prominent ears deformity
Prominent ears are a common congenital deformity of the external ear, derived from a combination of defects in the antihelix and concha. The majority of cases are treated surgically, but one of major difficulties associated with otoplasty regards the achievement of lasting aesthetic results. With the present study we propose an effective combination of four surgical techniques of cartilage reshaping with the ultimate goal of creating a new stable antihelical fold. Forty-one patients with prominent ears were involved prospectively. The subjects (16 male and 25 female) ranged in age from 6 to 43 years, with a mean age of 12 years. All patients underwent to the same surgical procedure and we performed softening and reshaping of the antihelix adopting the consecutive use of four surgical techniques: hemitransfixing microincisions, scoring, squeezing and posterior mattress suture fixation. Total number of ears that underwent surgery was 71. The mean postoperative follow-up period was 2 y...
Development and implementation of an anthropometric protocol to evaluate results of otoplasty
Revista Brasileira de Cirurgia Plástica (RBCP) – Brazilian Journal of Plastic Sugery, 2016
Desenvolvimento e aplicação de um protocolo antropométrico para a avaliação de resultados de otoplastia Introduction: Prominence is the most common deformity of the ear, affecting about 5% of the population. Most reports on otoplasty describe subjective evaluations, and do not provide accurate postoperative assessment or a comparison between techniques. We propose the development and implementation of a specific protocol to evaluate results. Method: A prospective evaluation for a period of one year in patients who underwent bilateral otoplasty was performed, using a technique based on modeling of the cartilage with sutures, and helix-to-mastoid distance measurements at standardized points. Results: A total of 23 patients with an average age of 17.8 years underwent surgery. Reoperation was performed in 21.7% of the patients or 10.7% of the ears. Nearly 45% of the correction obtained at the upper point and 35% at the middle and lower points were lost in patients who did not undergo reoperation. Conclusions: The protocol was easily used and allowed objective evaluation of the preoperative deformity and surgical results. This technique produced results considered adequate and comparable to the literature.
Modern Plastic Surgery, 2013
Background: Auricular deformities, specifically prominent ears are relatively frequent. Although the physiologic consequences are negligible, the aesthetic and psychological impact on a child's self-image can be substantial. The purpose of our study was to examine the post-operative morbidity of otoplasty, analyse the revision rate and identify, if possible, a gold standard procedure. Methods: Retrospective analysis of the results of 104 operations for correction of prominent ears in 24 months that were performed in one NHS Hospital in London, UK. Complications were recorded and analysed. Cases requiring revision were reviewed further, according to technique, seniority of Surgeon and whether a trainee was supervised or not. Results: Of 104 patients, 57 were male and 47 were female. Age ranged from 4 to 60 years. Peak incidence for the primary operation was identified in the early adolescence for both sexes. Total skeletonisation of the cartilage was used in 26 patients (25%). The anterior scoring technique was used in 76 patients (73%). Cartilage holding sutures were used in 52 patients (50%). Complications were recorded in 32 patients, while 11 patients had more than one complications. There was no significant difference in the complication rate between the most popular methods. (Anterior scoring with or without holding sutures, not including Mustardé type, versus total cartilage skeletonisation technique). Conclusion: The multitude of different approaches indicates that there is not clearly definitive technique for correcting prominent ears. It is preferable that the surgeon is comfortable with multiple techniques (to tailor the correction to each individual patient and deformity).