Two-Flap Otoplasty: A New Technique for Protruding Ear Correction

Abstract

Prominent ear deformity is a common congenital deformity of the external ear affecting 5% of the general population. Although this is a harmless deformity, several publications demonstrate the psychological distress, emotional trauma, and behavioral problems that this deformity can inflict on children. As a result of these concerns, corrective prominent ear surgery is now widely performed as a prophylactic surgery.A laterally based perichondrioadipodermal flap and a medially based adipoperichondrial flap were elevated. A subdermal pocket was prepared over mastoid bone. Medially based adipoperichondrial flap was fixed to the posterior helical skin; laterally based perichondrioadipodermal flap was fixed to the mastoid bone periosteum. The helix-mastoid distances and concha-mastoid angles of the patients were measured preoperatively and at the sixth month of the surgery as the late postoperative assessment. Patients were also evaluated for suture extrusion, granuloma formation, deformity recurrence, and postauricular area sensitivity.Twenty-two patients with bilateral prominent ear deformities were treated between January 2017 and January 2018. None of the patients suffered from skin necrosis, suture extrusion, hematoma, or wound infection at the early or late postoperative period. Unilateral recurrence was noted in 1 patient, and revision was performed.Preparation of a medially based adipoperichondrial flap and a laterally based perichondrioadipodermal flap and the reposition of these flaps with opposite vectors not only decrease postoperative complication rates but also provide a primary otoplasty technique. The posterior fascia flap is already a well-documented and reliable protruding ear correction method.