Ear Reshaping (Otoplasty)
Otoplasty, or a repair of protruding ears can be performed in children above 6 years of age, but is routinely performed in older individuals as well. An incision is made in the crease behind the ear. The skin of the back of the ear is raised to provide access to the placement of tiny sutures that naturally re-create the normal folds and contours of the ear. Shaving, scoring and rasping of the cartilage permits the sutures to generate a permanent result.
Aesthetically un-appealing protruding ears is a common problem in children and adults. Typically, reconstruction or otoplasty is performed after age 6 in children. Many adults who did not have the opportunity to have the procedure as a child request the procedure to be performed as an adult. Otoplasty itself is a simple procedure, but one that is only successful when great attention is given to both diagnostic and surgical detail.
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Ears can be protruding for a number of physical or anatomic reasons. Most common is the absence of a fold in the outer ear, called the anti-helical fold. Absence of this fold causes the outer rim of the ear to protrude. This is essentially repaired by recreating this fold in the proper location, with care not to over- or under-fold the crease, and to create symmetry. This is accomplished via an incision in the crease behind the ear, and using suture and cartilage shaping techniques.
The second most common reason for protrusion is prominence of the “bowl” of the outer ear that is adjacent to the ear canal, known as the conchal bowl. This cartilage is excessively large and causes the ear to protrude from the skull. Techniques to weaken the cartilage, or to suture it toward the nearby skull can help alleviate this problem. Again, care to avoid excessive reduction, and extreme attention to symmetry is critical.
Recovering from Otoplasty
After otoplasty, patients are given an antibiotic, pain medicine, and are wrapped with a bandage that both protects the ears and holds the ears in the desired position. This is eventually replaced with a tennis-type headband for additional time.