Otoplasty (ear pinning)
How common are prominent ears?
Prominent ears are the most frequent congenital abnormality of the head and neck. They affect both genders equally and occur in approximately 5% of the population. While most prominent ears problems are congenital some do result from previous trauma or injury.
What age should prominent ears be corrected?
Prominent ears are corrected by an otoplasty procedure which can be performed at any age. The ideal age is between 4 years and 14 years. During this period the cartilage of the ear is still reasonable “soft” and be more easily moulded into a normal appearance.
How are ears corrected?
Due to the individual nature of ears there is no single universally accepted technique for performing an otoplasty. There are three common problems that need correction in otoplasty. The first is anti-helix (the fold inside the ear) that has not been properly folded. The second is an ear that sits forward too far and needs to be set back. The third is an overly large conchal bowl (the shell-like hollow of the external ear) that needs to be reduced in size.
In recent years surgeons have evolved minimally invasive techniques to create a natural shape without the removal of cartilage in most cases.
Mustarde sutures are stitches that are placed behind the ear within the cartilage framework in order to create a more defined antihelix. The antihelix is the natural ridge that runs in a vertical direction along the outside of the ear. The antihelix acts to flatten the ear and position it close to the head, therefore, a lack of a defined antihelix allows the ears to angle away from the head and stick out.
An incision is made along the back of the ear and several permanent stiches are administered to fold the outer cartilage in the desired fashion.
This suture technique has been widely used since the 1960s and is ideal for children and younger patients as up until the age of 10 the ear cartilage tends to be softer and only a gentle suturing technique is needed to produce a cosmetically pleasing look as well as a lasting result.
The main advantage of using this technique is that an antihelix is able to be created without the removal or cutting of cartilage which can create an unnatural look.
Furnas sutures are used to charge the angle of orientation of the ear in relation to the head. An ear which simply sits forward too far can be angled back into a more natural position. These sutures need to be placed carefully so that the ear canal (for hearing) is not narrowed. They are also very useful when there is excessive conchal cartilage in bringing some of the cartilage back beside the head. This technique is best used in conjunction with Mustrade’s sutures to create a natural shape and curve to the ear.
Sometimes other minor adjustments need to be made to the ear including changing the angle of the lobe (if it points too forward) or reducing the size of one ear (if they are very different in size). There are also a range of more complicated ear abnormalities that may require a more extensive staged reconstructive process.
Technique selection when performing an otoplasty should be done only after a thorough analysis of all factors contributing to the presenting deformity. Cartilage sparing techniques can be safely combined with other cartilage weakening manoeuvres which leading to better long-term results.
You can read more about otoplasty here.
If you would like further information about an otoplasty procedure please contact Dr Roth rooms on 02 9982 3439 or email [email protected]