Ear Reduction/ Otoplasty
WHAT CAUSES PROMINENT EARS?
Prominent ears can affect just one ear, or more commonly both. The developmental problems that cause the prominence are varied, and the underlying problem determines exactly what surgery is required to create a more pleasing looking ear. Typically, there are two main causes:
• A prominent conchal bowl, otherwise known as cup of the ear.
• A poorly developed or unfolding of the antihelical fold can create a significant prominence.
Some patients have a combination of these two problems.
WHAT AGE SHOULD SURGERY BE PERFORMED?
Otoplasty is best performed when the child is old enough to understand the procedure and why it’s being done. Additionally, if a child is too young their ear cartilage is too soft and thin to surgically manage. An ideal age is not until they are at least 8 years old. Otoplasty surgery does not interfere with the growth of the ear. Adult patients have less pliable cartilage than children but they can still obtain an excellent result.
The operation is usually performed under general anaesthetic as a day case procedure.
The ear is incised from behind and the cartilage is displayed and it’s shape altered by scoring and suturing.
The surgery required to correct prominent ears is determined by the underlying cause and frequently involves correcting one or more components of the ear. The main and often only incision is hidden behind the ear. Through the incision behind the ear, the ear can be moved closer to the head by suturing down the conchal bowl. Additionally, the cartilage is displayed and shape altered by scoring and often suturing to create an antihelical fold.
All wounds are sutured using dissolving sutures the other ear is then performed to match. A head bandage is applied following the procedure.
The head bandage stays in place for 1 week and is then taken down in the office. The ears will still be swollen and discoloured at this stage and typically the ear pinning appears a little “too corrected”. However, this will settle and it will be at least 4-6 weeks before they completely settle.
Adverse events are few. Bleeding can be a problem in the early postoperative period.
An unsatisfactory or asymmetrical correction is uncommon and may necessitate revision surgery.