A new validated otoplasty dressing technique

The goal of otoplasty surgery for prominent ears is to normalize the shape and position of both ears with maximal symmetry. The operation is often performed on children; thus, the importance of dressing design has been emphasized in the literature as a factor determining successful outcome. We present an audited method for otoplasty dressing accompanied by an intraoperative photographic sequence. Proflavin-soaked wool is molded into the anatomical sulci anteriorly and a combination of Vaseline gauze and dressing gauze are held in position posteriorly by tying the continuous skin suture over them. Gauze is then placed over the pinna with a thick soft piece of cotton wool covering the whole area bilaterally. Finally, a length of stockinet is used to secure the dressings in place for 10 days, ensuring support, yet without undue pressure. An audit of the cases we have done so far demonstrated no complications relating to the dressing and satisfaction from patients and staff. We have found this otoplasty dressing technique to be simple, economical, and unobtrusive to the patients, while reproducible by junior staff if examination is required prematurely. Compromise of forehead or anterior pinna skin has not been encountered.     

Aesthetic otoplasty: A new technique

Our technique for the correction of the protruding ear deformity has been successfully used in 275 patients. It gives a natural look of the auricle, symmetrical results, and a decreased number of secondary surgical procedures. This technique is based on a careful planning of the operation and measurement of the auricle, a large posterior skin excision proportional to the protrusion, breaking of the keystone of the auricular cartilage (horizontal cut of the cartilage between the antitragus and antihelix for 10–12 mm), superficial scratching of the periochondrium of the antihelix, and deep scratching of the cartilage laterally and medially to the antihelix. The dressing remains on for only 24 hours.Presented at the Seventh International Congress of Plastic and Reconstructive Surgery, Rio de Janeiro, Brazil, May 20–25, 1979     

A technique for otoplasty

Numerous otoplasty procedures for correcting the protruding ear are described in the literature. What makes one technique superior to another lies in its reproducibility of natural-appearing results. One must avoid the operated-on postoperative look of sharp cartilaginous margins and the straight-line antihelical appearance.     

A technique for otoplasty

Numerous otoplasty procedures for correcting the protruding ear are described in the literature. What makes one technique superior to another lies in its reproducibility of natural-appearing results. One must avoid the "operated-on" postoperative look of sharp cartilaginous margins and the straight-line antihelical appearance.     

Incisionless otoplasty

Otoplasty surgery for correction of the "lop" protuberant ear deformity continues to evolve. A noninvasive method for achieving normal appearance and physiology for the protuberant ear pinna is presented. Incisionless Otoplasty surgery, involving a combined cartilage scoring procedure and a percutaneously placed retention suture procedure, creates a predictable and permanent correction of the missing antihelical fold. In addition, treatment of the protruding conchal bowl by endoscopic techniques further enhances the cosmetic appearance. A long-term follow-up period of over 10 years gives perspective on the efficacy of the operation.     

Braces for postoperative bandage after otoplasty

Postoperative bandaging following otoplasty is commonly used. It is also frequently perceived as cumbersome and often lost by patients. Simple splinting potentially offers a less obtrusive postoperative ear fixation. Braces consisting of silicone-coated steel wire have been designed for simpler and lighter postoperative fixation. The braces replaced conventional bandaging. The initial favorable experience with the ear braces is described following the otoplasty of 17 ears. It is suggested that the use of splints may improve the immediate postoperative appearance, and subsequently compliance for patients. However, the long-term effect of postoperative bandaging remains unknown.     

A new operative strategy for refractory microcystic lymphangioma

The optimal management of microcystic lymphatic malformations (LMs) in children has not been established. We describe how we used the Ligasure? Vessel Sealing System (LVSS) to achieve partial resection of refractory microcystic LMs in a 1-year-old boy. The child was admitted in respiratory distress caused by infection and swelling of cervical LMs. The LMs had been diagnosed prenatally, but had not decreased in size despite three treatments with OK-432 sclerotherapy. We performed direct dissection of the microcystic LMs using the LVSS with minimal intraoperative blood loss or lymphatic leakage. The LMs were resected as completely as possible without damage to the jugular vein or major nerves. His postoperative course was uneventful. Histological examination revealed complete sealing of the lymphovascular channels with obliterated lumens. Resection using the LVSS is effective and easy to perform for partial resection of microcystic LMs. We recommend the combination of initial OK-432 injection therapy and subsequent partial resection using the LVSS for refractory microcystic LMs.     

Small incision otoplasty for prominent ears

A 5-cm incision and an elliptical skin excision are part of almost all surgical techniques designed to correct prominent ears. It is proposed that two 0.5-cm incisions be used that give access to the lateral surface of the auricular cartilage, which is thinned with a rasp along the antihelix and concha. The skin is not removed at all. Results obtained with this technique are presented.Presented at the Sociedad Argentina de Cirugia Plastica, XVII Congress, Buenos Aires, Argentina, September 4, 1987.     

Minimally invasive otoplasty

Over the past five years we have successfully performed what we call a minimally invasive technique. The objectives of this technique are minimal incisions, limited dissection, and absence of internal permanent sutures for antihelix definition. In this article, we describe the surgical technique and analyze its advantages. There has been a reduction in complications and other problems associated with the conventional techniques. Received: 20 January 1997 / Accepted: 18 August 1997     

Analysis in otoplasty

The normal auricle has a well-recognized shape, and significant deviation from "normal" is immediately evident. In particular, prominent ears are readily apparent and are a relatively frequent cause of patient concern. Correction of the outstanding ear requires a careful understanding of the discrete elements that compose the normal ear. Careful anatomic analysis to determine the precise cause allows appropriate preoperative planning for the correction of a protruding ear.     

Retrospective analysis of the Farrior technique for otoplasty

OBJECTIVE: To evaluate clinical outcomes and patient satisfaction following otoplasty for surgical correction of protruding or prominent ears using the Farrior technique. METHODS: This was a retrospective study of patients undergoing cosmetic otoplasty with the Farrior method at a private facial plastic surgery practice in Tampa, Fla. The study population comprised 75 subjects desiring operative correction of auricular deformities by one of the authors (E.H.F.) over the past 15 years. The subjects (40 male and 35 female) ranged in age from 5 to 68 years, with a mean age of 23.9 years. Clinical follow-up ranged from 1 day to 7 years 2 months, with a mean duration of 1 year 5 days. The Farrior otoplasty is a graduated technique that combines elements of cartilage sculpting, suturing, and conchal setback procedures, and stresses a patient-specific, anatomy-directed approach. This method was first introduced in the literature in 1959 by the senior author (R.T.F.) and is continued to the present day by his son (E.H.F.). Main outcome measures included satisfactory correction of auricular deformity, incidence of postoperative complications, and degree of patient satisfaction with the procedure. These outcomes were compared with that of other otoplasty techniques and long-term studies in the literature. RESULTS: Of the 75 patients who underwent otoplasty via the Farrior technique over the last 15 years, bilateral otoplasties were performed in 69 (92%). Of the cases, 69 (92%) were primary procedures, with revision otoplasties constituting 6 (8%) of the total. A combination of conchal cartilage reduction, cartilage scoring, and mattress suturing was the most frequently used maneuver (47 cases [63%]). Most cases were performed using local anesthesia (n = 62 [83%]), with 18 (24%) of all cases having adjunctive procedures at the time of the otoplasty. No major complications (large hematoma, tissue necrosis, gross deformity, or significant wound infection) were documented. A total of 40 minor complications was observed in 29 patients, with suture extrusion and persistent auricular protrusion being the most common (occurring in 14 [19%] and 17 [23%] cases, respectively). Overall, 11 patients required revision surgery (9 for protrusion, 1 for hypertrophic scar, and 1 for cartilaginous callus). A majority of positive responses on an anonymous patient survey reflects a high degree of patient satisfaction with the procedure and results. CONCLUSIONS: The Farrior otoplasty is a graduated technique that has met with clinical success over the years. It combines elements of cartilage shaping and suturing procedures and as such is susceptible to complications such as suture extrusion and auricular protrusion that are ascribed to similar otoplasty methods described in the literature. It allows for a directed approach to correct the causative anatomic defects, while maintaining a natural appearance. While further research and long-term analyses are encouraged, this technique remains a valuable component of a facial plastic surgeon's armamentarium.