Minimally Invasive Auricoloplasty With an Anterior Approach: A 15-Year Experience

Abstract

Background: The otoplasty technique, independently conceived by Kaye and Lewis, is a simple and effective method for correcting prominent ears with an underdeveloped antihelical fold, but it is inappropriate for correcting ears with conchal hypertrophy.

Objectives: To describe an anterior approach to otoplasty that can correct prominent ears, even for those with conchal hypertrophy.

Methods: The 100 most recent otoplasty interventions to correct prominent ears were analyzed retrospectively. Indications, aesthetic results, complications and corrections were evaluated.

Results: The 100 patients who underwent otoplasty included 40 males and 60 females with a mean age of 18 years (range, 8-62 years). Sixty-five patients underwent correction of an underdeveloped antihelical fold, 30 underwent correction of conchal hypertrophy and 5 required resection of a conchal cartilage crescent. Intervention was bilateral in 96 patients and monolateral in 4 patients. Two patients required secondary corrections, including 1 requiring monolateral correction for a trauma after 10 days. No patient experienced hematomas or infections, despite the absence of antibiotic coverage.

Conclusions: This minimally invasive otoplasty technique is a simple, quick, and effective method, even in patients with conchal hypertrophy.

Figure 1.

A 17-year-old man with underdeveloped antihelical fold (A) before and (B) after 12 months.

Figure 2.

An 18-year-old woman with conchal excess and almost absent antihelical fold (A) before, (B) with preoperative markings, and (C) after 12 months.

Figure 3.

A 55-year-old woman with conchal hypertrophy with correct conchoscafal angle fold (A) before, (B) with preoperative markings, and (C) after 10 months.

Figure 4.

(A) Photograph showing the 1 cm incision in the lower part of the drawing, (B) the dissection of the skin from the cartilage in the anterior part of the marked new anthelix, and (C) the anterior scoring of the cartilage with the cartilage rasp in a 21-year-old woman.

Figure 5.

(A-G) The figures show how the stitches are put to fold the cartilage without incision in the way described by Kaye. The knot is buried in a stab incision in the skin on the posterior side of the ear that is not sutured.

Figure 6.

A 23-year-old woman with conchal excess and almost absent antihelical fold (A, C) before and (B, D) after 12 months.

Figure 7.

A 9-year-old male patient with conchal excess and underdeveloped antihelical fold (A, C) before and (B, D) after 12 months.