Correction of Ear Deformities

Correction of Ear Deformities

OTOPLASTY (EAR SHAPING)

The correction of prominent ears needs a surgical procedure called “otoplasty”, which the goal is to reshape the ears, The surgery is usually performed on the two auricles but could be done unilaterally. An otoplasty corrects the auricle’s cartilaginous abnormalities which are the cause of the prominent aspect. Schematically, we can distinguish three types of abnormalities which are often, more or less, associated:

• Too open angle between the auricle and the skull, carrying out the so called prominence. Too large size of the conchal cartilage projecting forward the ear which improves the prominent aspect (concha hypertrophy).
• Failure of the ear cartilage to fold naturally.

Surgery, definitively, corrects these abnormalities, by reshaping the ear cartilage, in order to obtain well-positioned, symmetrical ears also natural in size and aspect .An otoplasty can be performed in an adult, in a teenager or, most of the time in a 6-7 years old child, as soon as the child starts suffering of his/her ear aspect.

Type of anesthesia Three possible proceedings:

• simple local anesthetic.
• local anesthesia completed by tranquillizing drugs, injected in veins
• classical general anesthesia, which puts you asleep

The choice between these different techniques must come after you have discussed it with the surgeon and the anesthesiologist.  Hospital stay The surgery can be done in the “day care” department; it means you can leave hospital the same day of the surgery just after a few hours of resting and medical supervision. On the other hand, you may be asked to stay in hospital over the night; it means, you enter the hospital early morning, the day of surgery (or sometimes the day before in the afternoon) and leave i t the day after surgery.

THE  SURGICAL PROCEDURE

The usual surgical steps include :-

• Skin incisions: Usually, there are inside the natural retro-auricular fold. But sometimes, some small complementary incisions may take place at the anterior side of the auricles, hidden inside natural folds. Notice that hair will never be cut during surgery.
• Cartilage reshaping : The principle of this surgery is to create or improve the natural reliefs of the auricles by thinning and/or bending the cartilage framework, which may necessitate deep fine stitches. Sometimes, cartilage cutting or partial removing is indicated. Finally, the auricles are put back in a good position, in relation to the skull, and anchored by deep stitches.
• Dressing : It is done with elastic bandages around the head to keep the ears in a good position.
• The surgery usually takes an hour and half for correcting both ears.

COMPLICATIONS

Even if it is done for aesthetical purpose, an otoplasty remains a true surgical procedure, what means, it can induce the same risks as any surgery as little it is. We must distinguish the complications from anesthesia and the one from surgery.

• Concerning anesthesia, anesthesia may induce inside the body unpredictable reactions, more or less easy to control: dealing with a competent anesthesiologist, working in a real surgical environment, pushes down statistically the risks up to an almost insignificant level. The today techniques offer the patient an optimal security, especially since the patient is in good health.

• Concerning the complications, we can quote:

• The post-operative bleeding: if it is more than just a blood fleck on the dressing (what should not make you anxious) a secondary surgery may be necessary to stop the bleeding. But the blood, sometimes, can stay inside, giving an hematoma which could indicate its evacuation to protect the quality of the aesthetic result
• An infection is fortunately rare thanks to the rigorous pre-operative asepsis rules. But if an infection occurs, it needs a quick treatment to avoid reaching the cartilage which can have severe consequence.
• Skin necrosis can exceptionally be seen. It is usually limited and localized at the anterior side of ear relief where the skin is very thin and the blood supply disturbed. The scarring just needs local dressings and a small discreet scar may remain.

Abnormal scars: in spite of all the care of the suturing, an ear scar, of any kind, can always occur.

Earlobe Surgery (torn or enlarged earlobes)

• The procedures for torn or enlarged earlobes both take about 30-60 minutes.
• Earlobe repair is performed under a local anaesthetic.
• Following earlobe surgery minimal discomfort can easily be controlled with painkillers of your choice.
• Sleeping upright and applying ice may be of benefit to help reduce bruising/swelling.
• Sutures are removed (if not dissolving) in 5-7 days.
• If the earlobe was torn, it may be possible to have it re-pierced at a later date.