"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 to perform safe otoplasty with consistent results.

PATIENTS AND METHODS: 200 consecutive patients with prominent ears were operated on using a modified Mustarde and Furnas technique with some refinements and without performing any cartilage scoring or excision. Adequate dissection and exposure of cartilage as well as 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 nor 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 2 patients only. Skin necrosis and wound dehiscence were not reported in any patient. Suture extrusion was the most common complications and were easily managed, mostly in the clinic. Relapse of deformity needing surgical correction occurred in 8 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.