M Benedict1, K-U Pirwitz. 1. Praxisklinik für HNO/Plastische Operationen, Ettlingen. info@ORL.de
Abstract
OBJECTIVE: We have further developed a method, first published in 1967 by Kaye but not widely used later, to correct protruding ears. To our knowledge, clinical experience with a closed otoplasty technique based on a large number of patients has not yet been published. SUBJECTS AND METHODS: Of 442 ears in 4.5 years, 385 (200 patients, 15 one sided) were corrected using the minimally invasive technique. The key part of this technique to such otoplasty is the creation of a naturally appearing antihelix by combining permanent buried sutures and a conservative cartilage-breaking technique, both applied without extensive skin incisions and excisions. RESULTS: A total of 154 of the patients (i.e., with six one sided corrections, 302 ears) could be examined at least 3 months after surgery. Complications were revisions for either a partial recurrence or a still insufficient correction in the opinion of the patient (30/302, 9.9%), reactions to the suture material (26/302, 9.3%), early infections (2/385, 0.7%), prolonged sensitivity (2/302, 0.7%) and one hypertrophic scar in the lobule (1/302, 0.3%). There was no bleeding, hematoma, hypesthesia, sensitivity to temperature or skin reactions in the auricle. CONCLUSIONS: Minimally invasive otoplasty is a surgical technique that allows the correction of most protruding ears. Very strong cartilage or a very high lateral conchal wall set the limits to such an approach. We found the cosmetic results and complication rates to match those of open methods. Since patient comfort seems to be higher, the method is better accepted.
OBJECTIVE: We have further developed a method, first published in 1967 by Kaye but not widely used later, to correct protruding ears. To our knowledge, clinical experience with a closed otoplasty technique based on a large number of patients has not yet been published. SUBJECTS AND METHODS: Of 442 ears in 4.5 years, 385 (200 patients, 15 one sided) were corrected using the minimally invasive technique. The key part of this technique to such otoplasty is the creation of a naturally appearing antihelix by combining permanent buried sutures and a conservative cartilage-breaking technique, both applied without extensive skin incisions and excisions. RESULTS: A total of 154 of the patients (i.e., with six one sided corrections, 302 ears) could be examined at least 3 months after surgery. Complications were revisions for either a partial recurrence or a still insufficient correction in the opinion of the patient (30/302, 9.9%), reactions to the suture material (26/302, 9.3%), early infections (2/385, 0.7%), prolonged sensitivity (2/302, 0.7%) and one hypertrophic scar in the lobule (1/302, 0.3%). There was no bleeding, hematoma, hypesthesia, sensitivity to temperature or skin reactions in the auricle. CONCLUSIONS: Minimally invasive otoplasty is a surgical technique that allows the correction of most protruding ears. Very strong cartilage or a very high lateral conchal wall set the limits to such an approach. We found the cosmetic results and complication rates to match those of open methods. Since patient comfort seems to be higher, the method is better accepted.