Prominent Ear Aesthetics (Surgery) Otoplasty
Prominent ear deformity is defined as the fact that the ears protrude from the head more perpendicularly than they should be and are particularly prominent when viewed from the front or from the back. This condition, which is seen at a rate of about 5% in different degrees and in different types in society, can be observed in one or both ears, and although it does not cause any health problems, it can cause significant psychological problems.
Operations performed with the aim of correcting prominent ear deformity, which requires surgical treatment, except for the early newborn period, are called “otoplasty”.
What is the Normal Ear Structure?
The auricle, which grows rapidly from birth, reaches 70-90% adult size in the first year and completes its development at the age of about 10 years. The auricle consists of the “auricular cartilage” with various folds on it and the skin covering this cartilage. There is no cartilage in the earlobe at the lower end of the auricle, this part consists of the skin and subcutaneous adipose tissue. The task of the auricle is to collect the sound waves in the environment and direct them to the outer ear canal.
In adult sizes, the normal auricle is 5.5-6.5 cm in length and 3.5-4 cm in width. When viewed from the side, the upper end of the auricle is turned backward at an angle of 15-30 degrees with respect to the lower end, while there is an angulation of 20-25 degrees between the auricle and the skull bones when viewed from above. As a result of this angulation, a distance of 10-12 mm in the upper part of the ear, 16-18 mm in the middle part, and 20-22 mm in the lower part is formed between the outer fold of the auricle called the helix and the region called the mastoid behind the ear. These anatomical dimensions are especially helpful in performing the surgery in a way that provides a natural appearance, especially in patients with deformities in both ears.
What Causes Prominent Ear Appearance?
There are two different problems that cause prominent ear deformities to occur. These are the incomplete formation of the fold called “antihelix” in the auricle and the overdevelopment of the “concha cartilage” that forms the cavum concha section in the inner part of the auricle. These two conditions, alone or together, can cause prominent ears.
In order to obtain successful results in prominent ear surgery, it is necessary to make a detailed evaluation before the operation, to fully understand the cause of the problem, and to apply the surgical procedures in a way to correct all the existing problems.
Before and After Prominent Ear Surgery
- General anesthesia is always preferred in young children for single or bilateral otoplasty operations, and in older children and adults, the operation can be performed using local anesthesia or sedative drugs (sedation).
- There are many different techniques and approaches defined for otoplasty surgery. Some of these are applied to shape the cartilages by using sutures, some of them are applied to make weakening on the cartilages to facilitate them to take shape, and some are to partially remove the cartilages.
- While it is more preferred to shape the auricle with stitches, especially in early ages when the cartilages are softer, other techniques may need to be used in later ages. In cases where the problem is caused by the advanced development of the conchal cartilage, some cartilage is usually required to be removed.
- At the end of the operation, the bandage applied on the treated ears is changed several times during the first week, according to the need, and then removed. If the stitches that need to be removed during the surgery are used, they are also removed during the first week’s control. It is recommended that patients use a bandage or headband to keep the ears in the proper position while lying down for the first two weeks, followed by the first month.
Although the development of the auricle is 10 years old, it is largely completed at the age of 4-5 years. There is no harm in performing prominent ear surgery in any period of life, but since this problem can cause psychological problems, especially in children at school age, due to environmental factors, otoplasty operations are also frequently performed on school-age children.
The auricle can be shaped with bandages or molds during the first six weeks of the neonatal period. For this reason, taping is recommended when some other visual problems such as a prominent ear or folding of the auricle are detected at birth. This method, which has a chance of success in the early period, has a very low chance of success after six weeks.
Otoplasty surgery is generally in the low-risk surgery group. The most common problems that can be seen in the short term after the operation are blood collection (hematoma formation) and infection in the operation area. Both problems can be solved without additional problems with appropriate treatments.
The problems that can be seen in the medium-long term are the formation of asymmetry in the ears or the reoccurrence of the prominent ear appearance over time. In order to solve this problem, which is relatively rarely encountered with detailed pre-operative evaluation and appropriate surgical techniques, re-operation is usually required.