Surgery to the external ear (pinna) designed to improve the shape and position of the ear.
Indications
One of the few cosmetic procedures done in children, usually pre-school at around 5-6 years or age, although it can be done in younger children, older children or adults. The ears are typically too prominent, and protrude away from the head. These kids may be teased by their peers and become self conscious about their appearance.
Anatomy
The normal ear has specific and characteristic folds and curves, and is positioned quite close to the head. Of interest in otoplasty, is the degree of development of the anti-helix (curve / fold just inside the outer margin of the ear) and the angle between the concha (bowl of the ear) and the mastoid (bone behind the ear on the skull).
Surgery
Whilst adults and older children will often tolerate
the operation under local anaesthetic, younger kids
require a light general anaesthetic to facilitate the
surgery. Once asleep, cuts are made behind the ear and
a small amount of skin may be removed. The cartilage
deformity is then identified, and corrected using a
combination of permanent sutures and scoring to
achieve the desired contours. Sutures are also usually
placed to bring the entire ear a little closer to the
skull. The skin is then closed and a bulky dressing
and head band is applied for about 5 days. A head band
is then worn at night for a further 2 weeks to protect
the repair. This is always done as a day case
procedure and may take 1-3 hours depending on the
nature and complexity of the deformity.
The results are usually good to excellent and are
generally permanent, although some recurrence of the
deformity is possible. Other potential complications include
bleeding, infection, and asymmetry between the 2
sides.
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