Percutaneous adjustable closed otoplasty for prominent ear deformity

J Craniofac Surg. 2013 Mar;24(2):398-404. doi: 10.1097/SCS.0b013e31827ff103.

Abstract

Objective: The aim of this study is to follow longitudinally the prominent ears treated by percutaneous adjustable closed otoplasty (PACO) and evaluate this procedure in terms of technical efficiency, recurrence, complications, and patient satisfaction.

Materials and methods: Percutaneous adjustable closed otoplasty was used to treat 28 ears in 15 patients presenting with prominent ear deformities. To determine the success of each operation, distances between the helical rim and scalp were measured at 4 levels preoperatively, at the end of the surgery and again postoperatively at the first week and the first, third, and sixth months. Patient satisfaction was evaluated using a visual analog scale and Glasgow Benefit Inventories.

Results: Favorable outcomes were observed in scales and health-related quality-of-life surveys of patient satisfaction. Mean operating time was a mere 19.4 ± 5.7 minutes. Complication rates were low. Auriculocephalic distances increased by 7.3%, 11%, 15.3%, and 20%, respectively, compared with the preoperative measurements during the follow-up.

Conclusions: Percutaneous adjustable closed otoplasty is an efficient surgical procedure with positive outcome, low recurrence, and high patient satisfaction. In prominent ear deformities with soft cartilage, PACO should be the preferred surgical choice because of its advantages of shorter time in surgery, lack of need for prolonged postoperative compressive dressing, and allowing patients to view the results immediately after surgery. In contrast to the previously described techniques, auriculocephalic distances are adjustable while tightening the mattress sutures. Besides, it is a reversible technique, if the surgeon not satisfied with the result of the surgery can either redo the procedure or revert to CST. Percutaneous adjustable closed otoplasty does not cause serious complications, contour deformities, hematoma, or incision scars. For ear deformities presenting with stiff helical cartilage and conchal hyperthrophy, surgical indications can be extended by scoring and conchal resection, respectively.

MeSH terms

  • Adolescent
  • Child
  • Ear, External / abnormalities*
  • Ear, External / surgery*
  • Female
  • Humans
  • Longitudinal Studies
  • Male
  • Patient Satisfaction*
  • Plastic Surgery Procedures / methods*
  • Quality of Life
  • Suture Techniques
  • Treatment Outcome