Prominent
Ear Correction (otoplasty, pinnaplasty)
Indications
Correction of prominent ears is essentially a cosmetic operation.
Young children may be brought to a surgeon by parents wishing
to avoid later teasing. It is probably better to wait until
the child is aware of the difference and wants an operation
to correct it. With this approach children are generally
co-operative and happier with the outcome.
Most surgeons avoid operating on prominent ears before the
age of 6 or 7 because of concerns about affecting subsequent
growth of the ear cartilage.
Anaesthetic
Local or general anaesthesia; in children general anaesthesia
is usually required.
Technique
Surgical techniques aim to reshape and/or reposition the
ear cartilage to recreate missing folds and/or cause the
ear to lie closer to the head. Surgery is performed via
an incision, about 5cm long, on the back of the ear. Stitches
to close this incision can be absorbable (dissolving) or
need removing. After surgery a well padded head bandage
is applied to protect the reshaped ears; this is left on
for 7 - 14 days.
Length
of operation
One hour to one and a half hours.
Time
in hospital
Day-case or one-night stay.
Postoperative
discomfort/limitations
Significant pain following this operation is unusual; some
discomfort does occur, but this is helped by long acting
local anaesthetics (even if carried out under general anaesthesia)
and simple pain killers, such as paracetamol.
Children under going this kind of surgery seem to be prone
to postoperative vomiting. This can be controlled with anti-sickness
medications.
Itching and feeling hot whilst wearing the head-bandage
are common complaints. The bandage should be kept dry and
if it becomes dislodged should be replaced by someone with
appropriate experience.
After the bandage is removed a head band should be worn
at night for a further month to prevent the ear from being
pulled forward during sleep. Stitches are removed at 10
- 14 days. Contact sports should be avoided for 6-8 weeks.
Time
off work
It is possible to return to work or school one to two days
following surgery. Most individuals prefer to stay at home
until the head bandage is removed.
Risks
and complications
General anaesthesia is very safe; but in a tiny proportion
of patients caries a very small risk.
Complications include: bleeding; perhaps the commonest -
may require a return to the operating theatre to stop; infection,
potentially very serious, but usually responds to antibiotics;
residual/recurrent deformity; asymmetry; unsatisfactory
scarring (keloid or hypertrophic); small areas of skin on
the front of the ears may ulcerate and take a long time
to heal.
The ears are often bruised when dressings are removed; numbness
is common - improves with time. Cold sensitivity (pain in
cold weather) is not uncommon.
Outcome
The vast majority of patients are satisfied with the outcome
of surgery.
