Protruding ears are a burden for many people. Already in childhood there is teasing and ridicule. These experiences are imprinted in our memory and influence our entire future and development. Ear correction (synonyms: earplasty; otoplasty) is a surgical procedure performed for both aesthetic reasons and functional necessity. Otoplasty treats protruding ears, which are a burden for many people, as teasing and ridicule occur even in childhood. Such stigmatization leads to severe psychological stress, especially in children and adolescents, and can lead to the development of complexes. The correction of protruding ears is therefore nowadays usually carried out before children start school, in order to protect them from bad experiences. However, adults who suffer from their ears throughout their lives can also be successfully treated. We speak of protruding ears when the distance between the edge of the ear (helix) and the skull is greater than about 18 mm. In addition to the correction of protruding ears, various deformities, so-called auricular dysplasias, are also treated. In addition, ears disfigured by an accident can be surgically corrected by surgery. The absence of the auricle is called anotia, and auricular deformities are classified into grades I-III:
- Grade I – In the lesser malformations, almost the entire auricle is completely present and requires only minor surgical correction. Apostasis otum or protruding ear belongs to this category.
- Grade II – Grade II malformations have more severe changes. These include pronounced cup ears and the so-called mini-ears. In some cases, the ear canal is also affected by the malformation. In case of surgery, cartilage and skin from the patient’s body is used for reconstruction.
- Grade III – This grade refers to the complete absence of the auricle (anotia). Again, the ear canal is affected and reconstruction relies on additional tissue.
Indications (areas of application)
- Protruding ears (sail ears)
- Ear asymmetry
- Ear dysplasia
Before surgery
In the case of minor children, both parents must sign a consent form for surgery.Before surgery, an intensive medical history discussion should be conducted that includes the medical history and motivation for the procedure. The procedure, any side effects, and the consequences of the surgery should be discussed in detail. Note: The requirements of the explanation are stricter than usual, since courts in the field of aesthetic surgery demand a “relentless” explanation. Furthermore, you should not take acetylsalicylic acid (ASA), sleeping pills or alcohol for a period of seven to ten days before the operation. Both acetylsalicylic acid and other painkillers delay blood clotting and can lead to unwanted bleeding.Smokers should severely limit their nicotine consumption as early as four weeks before the procedure so as not to jeopardize wound healing.
The surgical procedure
In the following, primarily the surgery for the correction of protruding ears is described in more detail. Unlike the creation of the auricle, plastic surgeries for complicated reconstruction of malformed or destroyed ears are extremely complicated. Usually, transplantation of autologous tissue such as rib cartilage or foreign material is performed. Ear correction is usually performed under local anesthesia (local anesthesia) so that the patient can be discharged immediately. If desired, the procedure can also be performed under general anesthesia if very young patients tend to be uncooperative. There are now more than 170 different techniques of ear pinning. The basic principle is to remove excess cartilage. First, the surgeon will make an incision in the skin fold behind the ear and carefully separate the skin and cartilage. Once the cartilage is exposed, the doctor can reshape it using special instruments. The cartilage is sometimes ground or a piece is detached and removed. Tissue adhesive is used to reattach the skin to the cartilage and the edges of the wound are sutured. The ears are then held in place and fixed in place by a head wrap dressing.The wound dressing should be checked regularly to prevent swelling and bleeding and to control the blood supply to the tissue. Meanwhile, the trend is toward gentler, less invasive methods such as purely percutaneous (“through-the-skin”) stitched suture methods that do not require an incision (surgical cut; “incisionless”) at all.
After surgery
Antibiotics are given to prevent complications such as inflammation. For children, note that a 14-day ban from school and a 4-week ban from sports should be observed. Young patients should wear a headband for about three months, which is also a sensible measure at night to avoid kinking of the auricle. About a week to ten days after the procedure, the stitches can already be removed and the head bandage removed. The scars behind the ears fade after some time and after about two to three months the final result is visible. A check-up should be done after three or six weeks, after three months and after one year.
Possible complications
- Infection
- Asymmetric result
- Later rejection of the suture material used on the cartilage.
- Incisions and resections on the auricle can occasionally result in disfiguring kinks and edges that may require follow-up correction.
Further notes
- In addition to surgical procedures, there are conservative, non-invasive alternatives (“non-surgical”). These take advantage of the malleability of the early ear cartilage in the first weeks of life. Long-term stable auricular correction is to be achieved by special shaping splinting, taping and adhesive systems. According to a study, a comparatively shortened treatment protocol of only two weeks duration (instead of the usual 6-8 weeks) is thereby possible, if within the first days postnatal (” after birth “) with the treatment is started (< 14 days).
Benefit
Young children can be spared a great deal of suffering by having their ears corrected, as they will never have to face ridicule and teasing that is common among children. Adults who have suffered from their protruding ears for years or even decades will find that the surgery will give them a whole new outlook on life and a stronger sense of self-confidence.
