The presence of protruding ears is usually evident
in early childhood and almost always is congenital in nature. Acquired
development of protruding ear is unusual and is almost invariably related
to some type of major trauma. Correction of protruding ears by Otoplasty
depends upon the type of deformity present. Two major type exist, one in
which the whole ear is rotated outward and one in which the outer rim of
the ear failure to achieve the normal curvature. Various combination of
these two types of deformities may be found.
Children can be unkind to each other and frequently
taunts of "Dumbo" or other disparaging remarks may be directed
at children with protruding ears. For this reason correction is recommended
prior to starting school where exposure to such ego-diminishing remarks
is great.
In the usual type Otoplasty, a wedge of skin is
removed from behind the ear, the ear is mobilized and the excess soft tissue
removed from the overlying skull. The ear is then rotated back into normal
Position and held in place by Suture passed through the covering of the
ear cartilage and the covering of the bone (perichondrium and periosteum).
The skin is closed with a permanent suture to be removed in about a week.
A small drain is inserted and attached to a vacuum tube. A bulky protective
dressing is applied and the patient is seen on the first post-operative
day. The drain is removed in 24 hours. Protective head gear is worn for
about 2 weeks (and stitches are removed at one week).
Results are apparent immediately and undergo little
change with time. Possible complications include post-operative hemorrhage,
infection, abnormal scaring and failure to achieve desired results or symmetry.
Figures 1.1 and 1.2 illustrate pre and post operative
condition in an adult.
