Otoplasty

If the angle between a patient’s ear and his/her head is 30 degrees or more, the patient has what is known clinically as first-degree dysplasia, or a noticeable deformation of the ears. This can be corrected surgically. Children that have protruding ears may be teased at school and can suffer emotional distress as a result. If you have a child that has protruding ears, you may wish him/her to undergo an otoplasty procedure before he/she starts school. The ideal age for this procedure is between the ages of 6 and 7, since the ear is as good as fully grown, but the cartilage is still soft and can be easily moulded. Health insurance companies cover the cost of otoplasties for children. Careful consideration must be given to any cosmetic correction of the ears. Any procedure must not be carried out on the basis of a spur-of-moment whim. When it comes to a child, we make every effort to ensure that is not just the parents that want us to carry out this procedure, but that it is also something that the child wants too. It is also possible, of course, to carry out cosmetic ear surgery on adults.

PROCEDURE/FOLLOW-UP TREATMENT

Over the years, three techniques have proven to be effective in ear correction surgery.

The scoring technique:
After the cartilage has been exposed, the cartilage is carved from the front and then becomes mouldable. Thanks to modern suturing techniques, there is virtually no visible scarring.

Incision-suture technique:
The procedure is performed on the posterior auricular muscle. Again, the cartilage is superficially smoothed and made malleable. A suture made of high-tech material is then drawn through the cartilage to keep the ear permanently in its new position.

Suture technique:
This technique does not involve the cartilage being scored. After the back of the auricular muscle has been exposed and the ear has been positioned closer to the head, the site is sutured to ensure the necessary fixation.

In the case of the last two suture techniques, an extremely thin, white suture is used, which is not visible following the otoplasty procedure.

Patients may experience slight pain and swelling after the operation. A dressing soaked in ointment must be worn around the ears for about two weeks and then an elastic head band. The sutures are removed after about a week. Patients should refrain from sporting activity and saunas for two months following the procedure. Patients should not expose their ears to intensive sunlight for 3 to 6 months, as the procedure may affect their sensory capacities and they may not therefore be aware of possible sunburn during this period. The patient's need to take sick leave is assessed on a case-by-case basis. Some patients may need to take a week off work.

RISKS/SIDE EFFECTS

For young children, the operation is carried out under general anaesthetic. For older children and adults, the procedure is carried out under local anaesthetic. Anaesthesia also entails some risks (cardiovascular problems, intolerance to medication, breathing problems, nausea, vomiting and post-surgical hoarseness). A follow-up procedure may be necessary as cartilage has the ability to bend back into its original position. The same applies if the suture tears, which may still happen even months after the procedure has taken place. If the patient feels that the outcome of the operation is unsatisfactory, the surgeon will have a detailed discussion with the patient. The surgeon may encourage the patient to take an objective view, as a slight protrusion of the ears is generally felt to be desirable and is the intended outcome on the grounds that it is natural.

In rare instances, there may be wound infections and poor healing with some scarring. In very rare instances, the sensitivity of the earlobes can be permanently affected.

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