Otoplasty is a plastic surgery for correcting ears and elimination of droopy ears. Otoplasty is performed in cases when the anatomical structure of the pinna is violated (droopy ears, etc.) and it requires surgical intervention affecting the cartilage and soft tissue of the ear. The operation is often recommended in childhood and adolescence (6 years), as droopy ears and other congenital problems can cause psychological disorders in the child.
The otoplasty is subdivided into:
- Aesthetic (changing the shape of ears)
- Reconstructive (creating of a fully or partially missing pinna)
Currently otoplasty includes over 170 techniques of droopy ears correction, deformations and defects of the ear.
Droopy ears (protruding ears) are supposed to be corrected by otoplasty. Droopy ears are severe congenital deformity of the ear causing protruding ears. Shape and dimensions of the ears, when such a deformation occurs, tend to be in the normal range but are not placed parallel to the temporal bone, and they are at nearly a right angle. Signs of droopy ears are: increased angle of the ear to the back of the head as well as a smooth contour of the ear and antihelix.
The outer ear of a fetus begins to form and grow at the end of the first trimester, and the inner folds and relief of the ear develop in the sixth month. Droopy ears are clearly visible at birth, and just in this period you can change the shape of the ears of the newborn even without surgery. If you fix the child's ears, requiring a change of shape, they can take other shape or position. If deformable ear was not corrected before the age of six months, it is impossible to make corrections without surgery in the future due to the further stabilization of cartilage.
It is believed that the normal angle between the shell of the ear and the head should be equal to 30 °, and the pinna should be parallel to the cheek, and the distance between the skull and the edge of the ear should be about 2 cm. Outlines of shell ear and its configuration are individual and unique like the pattern on the fingertips.
Deformation can affect one or both ears. The type and degree of deformation ears at droopy ears are very diverse; therefore, there is no unified medical tactics to fix it.
The indications for the otoplasty:
- irregular shape of the ears
- droopy ears
- smooth front surface of the pinna and antihelix
- increase in the angle between the occipital part and the pinna
- partial or complete absence of the pinna (congenital and acquired nature)
While planning the correction it's important to determine the correct position of the protruding ear.Features of intrauterine growth of the ear can cause droopy ears.Most often droopy ears is a consequence of underdevelopment, smoothness of antihelix (it is a protrusion on the inner part of the ear, which is parallel to the helix). Flattening of antihelix may be wholly or partially missing, while only the upper part of pinna protrudes.
The cause of excessive protrusion of the ear can be the hypertrophy of a cartilaginous structure of the ear. It is believed that smoother cartilaginous patterns of antihelix and helix usually settle on a solid cartilage of the outer ear, and its increase leads to the protrusion of the pinna as a whole. In the ear, which is located within the normal range, sometimes there is only a protrusion of the earlobe; the reason is the exaggerated size of pinna or a special shape of the helix tail.
Protruding ears can occur at a uniform increase of the ear as a whole. Droopy ears of this kind are called "macrotia". Sizes of the normal ear are highly variable, but sometimes they are not proportional to the facial skeleton. Droopy ears in this variant occur in case of the isolated congenital and excessively rapid growth of a ear or rapid growth of one-half of the face. The above-mentioned macrotia may occur in neurofibromatosis, Recklinghausen's disease or vascular anomalies.
Contraindication for surgical intervention are cancer and problems with blood clotting.
It is necessary to undergo medical tests before the operation. If there are no contraindications specialist appoint the date for operation. Typically, local anesthesia is used for adults and general anesthesia is used for children.
Technique of correction depends on the individual structure of the ear and the surgeon's preference. In case of eliminating the droopy ears incision is performed on the rear wall of the ear and it is not noticeable. Cartilage is dissected and its excesses are exsected, and a new form of the pinna is shaped.
Surgeon defines a new shape and location of the cartilage beforehand taking into consideration the anthropometric data of the patient. The patient is exposed to local or general anesthesia, after that the incision is made in the fold of the ear. The cartilage is formed so that it ensures a close fit of the ear to the head. Sometimes together with otoplasty the plasty of the earlobe is performed. This operation takes about half an hour - an hour and is tolerated by patients quite easily. To maintain the new position of cartilage, special rollers are imposed on the ears, and on top - fixing bandage or brace to be worn for two weeks.
Classical otoplasty using a surgical scalpel may be replaced with the laser otoplasty.
The rehabilitation period
In the first days after otoplasty swelling can be observed in the area of the surgical intervention.The ligations are made once every two days within 2 weeks after the correction. After 10-12 days, sutures are removed.