Correction of protruding ears (otoplasty)
Introduction
The first thing we notice when looking at one´s face is its middle part. Just sometimes we notice pinnas (external ears) as first, unless they are protruding. Protruding ears can alter the overall balance of the face. Moreover children with protruding, large ears or with the ears deformed in other way, can suffer from peer derision and low self-confidence. If you or your child is bothered with protruding ears, the correction is indicated.
What is in fact the pinna (external ear) correction?
The correction of pinnas is performed in order to correct the shape, size or the position of pinnas. The most common surgery is the correction of protruding ears. They appear larger than normal. The surgery involves reshaping of the pinna into its natural shape and it especially improves the relationship of the ears to the face. We can also correct the unnatural shape of pinnas (eg. "constricted ear", "hidden ear") or deformation caused by trauma. Even correction of small deformations can have a significant effect on the overall face appearance.
Microtia is the most complicated inborn error of the pinna, when the pinna is deformed, small or missing and the residual rudiment is not bigger than an ear lobe. It is often connected with the undeveloped auditory meatus and hearing disorder. The treatment of such deformity is ear reconstruction – formation of completely new pinna.
For whom is the surgical correction of protruding pinnas advisable?
The surgery of protruding or deformed pinnas can be performed earliest since 5 years of age, mostly in 9 years of age, when the cartilage is sufficiently developed and stable. However it is possible to perform it later too.
Who are the ideal candidates for the surgical correction of pinna?
Children who are healthy, without life-threatening illness or untreated chronic ear infection, positively motivated, cooperating well, able to follow the instructions but able to share their feelings at the same time, who are not afraid of the surgery.
Older patients should be healthy, without life-threatening illness or disorder which can worsen the healing process. They should have positive life attitude, clear picture about the aim of the surgery. Smoking can worsen the healing process and increase the incidence of unwanted complications.
Where are the scars located after the protruding ears surgical correction?
If a regular surgery was performed, scars are usually located on the back side of the pinna, approximately 0,5-1 cm from the edge, so they are discreet and visible only from the back view when moving the auricle outwards. The quality of a scar depends on a healing pattern of every patient.
General anaesthesia or local anaesthesia for the surgery of protruding ears?
Almost all surgical corrections of protruding external ears can be performed under local anaesthesia. General anaesthesia is suitable for small or uncooperative children. Since the age of 9, we can administer local anaesthesia in almost all cases, the decision about anaesthesia in younger children is individual.
How long does the surgical correction of the protruding pinnas take?
The surgery of both pinnas takes mostly 1-1,5 hour.
What is the procedure the surgery itself like?
As a first step a disinfectant solution is applied onto the operating field and the gauze pads are placed around. Both pinnas are operated within one surgery, one at the time. The surgical incision is made on the back side of the pinna. Afterwards the front side of the cartilage is being preserved by separating the skin of the pinna, the cartilage is shaped with the help of shaping incisions or abraded into the requested shape. Pinna can be reduced if necessary. Skin is sutured. By using the shaping sutures and cotton, the pinna is fixed in the requested shape and position. At the end of the surgery both auricles are bandaged.
What is the required treatment after the surgical correction of pinna and the recovery like?
Physical resting is recommended after the surgery. Provided you protect the auricles from an injury, it is possible to resume the common daily activities right away. The bandage is left for 10 days and afterwards the shaping sutures are removed. Then we recommend to wear a headband 24 hours a day for 2-3 weeks and afterwards during the night for following 2-3 weeks. Children should not participate in games and physical activities, during which an injury might occur, until the pinnas are healed completely. During this period it is advisable to protect pinnas from extreme cold or sunlight.
The results of the surgical ear correction:
The post-surgery swelling subsides completely within 2-3 months. We can notice the results of the ear correction right away and they are mostly permanent. Children tend to accept the result relatively quickly and often their self-confidence is improved. The scars mature and shrink gradually. The lowered sensitivity of pinnas, tendency to change colour, freeze or swell in a cold can remain for 1 year.
If you have any question or comment, do not hesitate to contact us.