Otoplasty (Ear Pinning)

WHAT CAUSES PROMINENT EARS?

The ears are one of the first part of the body to reach adult size and they are therefore often more prominent in children as they are relatively out of proportion. As many as 2% of the population feel that their ears stick out too far, and this might be on one side only. It is often an inherited problem involving the development and lack of the usual cartilage folds in the ear.

WHEN CAN PROMINENT EARS BE TREATED?

The cartilage in a baby’s ear is very soft and pliable and can be molded with the use of splints if prominent ears are obvious from birth. Most cases of prominent ears become a problem in early childhood particularly because of teasing and bullying at school. Some children may become very self conscious while others may not be bothered by their ears. Most surgeons advise that surgery for prominent ears is not undertaken until the child is old enough to understand what the surgery involves. In most cases it is best that the child feels that their ears are a problem and is able to express a desire for surgery themselves. At this stage the child is more likely to be cooperative and happy with the outcome. For this reason, and the fact that the cartilage is too soft in the early years, the operation is rarely performed under the age of five years.

WHY IS OTOPLASTY PERFORMED?

Otoplasty is designed to correct deformed or protruding ears. In adults of all ages, protruding ears are frequently unsightly and can even lead to unhappiness with appearance and the inability to select hairstyles. The result of this surgery is immediate, often dramatic, and very rewarding to both the patient and surgeon.

WHAT IS INVOLVED IN THE OPERATION?

The surgery involves a general anesthetic but may be performed under local anesthetic in adults. The surgery usually takes 1-2 hours without the need for an overnight stay in hospital. A cut is made behind the ear close to the groove between the ear and the side of the head. The multiple elements of this surgery include external ear (pinna), which is remolded by placing small incisions behind the ear then reshaping or trimming the cartilage to define how and where the ear bends. Placing the ear in the proper aesthetic position achieves natural balance between the various elements of the ear. A consent form must be signed before surgery. This must be signed by an adult (parent or legal guardian) on behalf of any child under the age of 18.

ARE THERE ANY COMPLICATIONS?

There are risks associated with a general anesthetic such as aspiration of stomach content into the lungs which can cause serious illness or death. Therefore, to help prevent this it is mandatory that you do not eat or drink anything (usually 8 hours) preceding your surgery. Other risks include DVTs, (clots in the veins of the legs) which can break off and travel to the lungs, this is known as an embolus and although very rare, can be life threatening; especially in smokers. You will be encouraged to get up and walk around as soon as possible to reduce these risks. In some patients problems with red, raised and lumpy scars can develop. There can also be prolonged discomfort or numbness associated with the scars. In very rare cases, problems with wound healing might lead to the need for a small skin graft behind the ear. Wound healing can also be delayed if the wounds become infected. Bleeding under the skin (hematoma) occasionally requires a return to the operating theatre for the clot to be removed. Most patients are happy with the outcome but some may feel that there is some asymmetry (the ears don’t match) which might involve further surgery for minor adjustments.

WHAT HAPPENS AFTER THE OPERATION?

You will need someone to drive you home and stay with you the first 24 hours after surgery. After the operation the ears will be strapped with a heavy bandage like a large sweat band to provide protection which should only be removed by your surgeon. You may experience some discomfort which should be alleviated by the pain medications. Any non-dissolvable stitches can usually be removed in about 10 days.

WHEN CAN NORMAL ACTIVITES BE RESUMED?

Care must be taken when washing hair initially and it is advised to avoid swimming for at least 2 weeks and contact sports for eight weeks.

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