Refinements in Otoplasty Surgery: Experience of 200 Consecutive Cases Using Cartilage-Sparing Technique.

BACKGROUND: Many techniques have been described to correct prominent ears, including cartilage-suturing, cartilage-scoring, and cartilage-breaking techniques. Understanding the topography and anatomy of the auricular cartilage is crucial for performing safe otoplasty with consistent results.

METHODS: Two hundred consecutive patients with prominent ears were operated on using a modified Mustardé and Furnas technique with some refinements and without performing any cartilage scoring or excision. Adequate dissection and exposure of cartilage and precise repositioning of the tail of helix (cauda helicis) are keys to correction of lobule prominence without the need for any adjunctive procedures such as skin excision from the back of the lobule or suture fixation of the lobular tissues to the concha, mastoid, or scalp. Detailed description of the technique and review of the complications are presented.

RESULTS: This suturing-only technique had a low complication rate. Hematoma occurred in two patients only. Skin necrosis and wound dehiscence were not reported in any patient. Suture extrusion was the most common complication and was easily managed, mostly in the clinic. Relapse of deformity needing surgical correction occurred in eight cases.

CONCLUSIONS: The series demonstrates that most of the potential complications of otoplasty can be avoided and favorable results can be obtained by paying attention to the anatomical details of the deformity and the auricular cartilage anatomy. The described cartilage-sparing otoplasty procedure with the refinements outlined resulted in a reproducible natural correction, with a low risk profile, that can be applied to almost all prominent ears.

CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, IV.