A Modified Closed Cartilage-Preserving Otoplasty Technique for Prominent Ear Correction

Choi, Tae Joon; Burm, Jin Sik; Lee, Yung Ki

Abstract

BACKGROUND
In the surgical correction of prominent ear, a technique known as percutaneous adjustable closed otoplasty (PACO), which does not involve skin incision, undermining, or cartilage manipulation, has been developed to resolve problems including hematoma, infection, contour deformities, prolonged use of a compressive dressing, and hospitalization. We modified this procedure to make it more practical and accessible and to achieve better results. In this article, we introduce our modifications and demonstrate the clinical applicability of the modified procedure to patients with hardened auricular cartilage.
METHODS
Two adult patients with prominent upper ears underwent closed otoplasty in an outpatient setting. Based on the anatomical features of the patients, three lines for traction sutures were designed on the scapha and counter scapha. Tab incisions were made at all predetermined puncture sites. Three antihelix-forming sutures (4-0 nylon) were put in place via percutaneous punctures. The sutures were performed from the counter scapha to the postauricular sulcus subcutaneously, using an 18-mm empty curved needle. The sutures were scraped over the mastoid bone such that they were anchored to the mastoid periosteum. After determining an adequate auriculocephalic distance, the sutures were tied at the postauricular sulcus. A slight overcorrection was made to compensate for post-surgical relapse.
RESULTS
We observed no complications such as hematoma, infection, contour deformities, epithelial inclusion cyst formation, suture extrusion, or dimples on the scapha. At a long-term follow-up examination, the patients had well-defined antihelical folds and were satisfied with the aesthetic results of the procedure.
CONCLUSIONS
We propose our technique as a reliable treatment option for the correction of prominent ear.