Reshaping external ears involves that the patient’s ears will be molded to a naturalistic shape, and/or position. Other than pinning prominent ears, Otoplasty is performed on patients who have any structural distortion due to accidental damages or any kind of blow, or have a stretched ear lobe for wearing heavy earpieces.
Surgical plans of Otoplasty vary as per the requirement of the correction. It does not always need to involve incisions or to cut the cartilage; sometimes non-surgical otoplasty suffices the requirement. The types of ear correction include—
- Ear augmentation/pinnaplasty— poor development of the ear pinna (microtia) or the absence of pinna (anotia) is reconstructed with autologous cartilage grafting, using the patient’s own costal cartilage, or some cartilage of the ear itself, if it is available.
- Ear Pinning/Otopexty — is the actuall surgery for pinning protuberant ears to lay proportionately flat with the head. The surgery involves incisions made to the back of the ears, following the natural crease of the pinna, to bring the conchal bowl close to the head and sutures are used to secure the newly positioned concha, as well reshape the antihelix.
- Ear reduction— excessively large ears are reduced to a proportionate alignment with the face, by removing or molding ear cartilage.
Prosthesis implants, and splints may be used to remold the cartilage. This is ideal for adults with a minor protrusion of the auricle. The implant or splints are inserted inside the pinna with two tiny incisions under local anaesthesia.
Otoplasty surgery for adults is performed under local anaesthesia, sometimes with sedation. Incisions take place in the back of the ear and the along the natural creases. There are three major surgical plans that address the varying deformities of the external ears.
- 1. Manipulating the Anihelix
The surgeon fold, suture or score the cartilage of the antihelix to achieve a proportionate definition. In case of suturing the antihelical fold, there may not be any excision of cartilage involved.
- 2. Reconstruction the Concha
While altering the concha, sutures, or conchal excision or both may be involved. An incision is made along the natural crease at the back of the ear, and repositioning ear with sutures attached to the mastoid fascia. Another method is medialisation, in which the conchal part of the antihelix, or the upper crust of helix is readjusted by changing its direction towards the ear canal by using fingers and without excisiong the cartilage.
- 3. Ear Lobe Correction
Lobular correction is sometimes the most challenging parto fothe otoplasty surgery, wherein the earlobe becomes disproportionate to the newly reconstructed concha and pinna. Usulay the surgeon removes some skin from the mid region of the earlobe, and takes a bite of the conchal undersurgace in suturing it closed, thus pulling the earlobe upwards.
Health Related Quality Of Life
Usually the surgery is opted as early as possible by parents and children alike. However sometimes, either the parents or the child is not ready for surgery due to a number of reasons. Expense might be a factor, or as child the adult does not luckily go through any bullying neither did their parents see the protruding ears as an inferior characteristic that correction does not happen.
As a person grows up to adulthood, he/she faces adult form of bullying, in office and other social gatherings and finally tends to seek ear correction surgery. Prominence of ears can be enhanced with short-cropped hair (kept either willingly or unwillingly) especially with male pattern baldness.