Cartilage-sparing otoplasty - 288 ears in 3 years

Abstract

Background: Standard methods of otoplasty may risk anatomical distortion. Previous work showcased a novel, cartilage-sparing technique. This study aimed to confirm the safety and effectiveness of the method in a larger cohort.

Methods: This retrospective study included patients undergoing otoplasty by a single surgeon using a single technique between January 2021 and December 2023. Eligible patients were aged >5 years and had prominent or constricted or cup ears, forming a 2 cm distance from the mastoid. Surgical techniques included novel key-point sutures. Minimum follow-up was 6 months. Data on demographics, risk factors, perioperative management, and complications were collected from patient records.

Results: A total of 288 operated ears (147 patients) were included. The mean age was 17 years, and 91 (61.9%) were female. The mean duration of follow-up was 24.3 months. Postoperative complications were generally minor and included Polydioxanone (PDS) suture exposure (n = 16, 5.5%), manageable postoperative pain (n = 8, 2.7%), self-resolving swelling (n = 8, 2.7%), minor bleeding (n = 7, 2.4%), and superficial skin complications (n = 4, 1.3%). Infections occurred in 4 ears (1.3%) and were treated effectively with topical/oral antibiotics. Cases of partial release of the ear resolved without intervention (n = 4, 1.3%). Only 4 (1.3%) ears experienced loss of correction, with options for reoperation available as needed. Analysis showed no significant age differences in postoperative complications and a nonsignificant trend towards higher postoperative swelling in males than in females (10.7% vs 2.2%; P = 0.054).

Conclusions: The data confirms that this technique offers safe and rapid cartilage-sparing otoplasty with minimal complications and low recurrence rates. It ensures long-lasting and aesthetically pleasing results for prominent ear deformities.

Level of evidence: Level III.

Keywords: Cartilage-sparing otoplasty; Cup-constricted Ear; Lop-lidding ear; Otoplasty; Prominent ear; Protruding ear.