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An unusually projecting human ear is known as a prominent ear, otapostasis, or bat ear. It might be both bilateral and unilateral. The scapha and antihelix of the big concha are not well formed. It is the outcome of cartilage deformity that occurred during early ear development in utero. After the child reaches five years old, the abnormality can be corrected at any time. In order to prevent psychological suffering, the procedure should ideally be performed as soon as possible. Otoplasty correction is reshaping the ear cartilage to bring the ear closer to the side of the head. The cartilage is reshaped, but the skin is left in place. Hearing remains unaffected by the operation. It is mainly done for aesthetic reasons. Although they are uncommon, the post-operative consequences from the operation include hematoma development, keloid formation, infection, and asymmetry in the ears. Otoplasty is a cosmetic operation that involves permanent sutures to alter the size, shape, or location of the ear. The main purpose of otoplasty is to treat promin auris, or bulging ears. Promin auris, the principal indication for otoplasty, is the subject of this review. The indications, contraindications, and method utilized in otoplasty are reviewed in this exercise, which also emphasizes the need of pre- and post-operative care for patients having this surgery. Otoplasty results are generally lifelong and will improve the self-confidence. The goals of otoplasties are to make the ears appear more natural in comparison to the head and help with the overall contour of the ears. Final ear surgery results will be visible after a two week recovery period, with small improvements appearing for up to 12 months post-procedure. A proper understanding of the diagnosis, indications, and surgical techniques will lead to positive outcomes in otoplasty. [ABSTRACT FROM AUTHOR]

The complexity of a constricted ear shape renders the aim of establishing a uniform surgical method unattainable, thus posing an ongoing challenge in its correction. The Tanzer's group IIB constricted ear is characterized by a prominent downward folding, an underdeveloped antihelix, and the absence of sacpha. The present study used a V-Y advancement flap combined with concha cartilage for the repair of Tanzer's group IIB constricted ear. A total of 16 patients diagnosed with type IIB ear constriction from September 2016 to September 2022 were enrolled in this retrospective study. The correction procedure for the constricted ear involved the utilization of a V-Y advancement flap combined with concha cartilage graft. The auricle shape data of the patients, their visual analog scale (VAS) satisfaction scores, and aesthetic outcomes scale (AOS) aesthetic scores were examined preoperatively and 12 months post-operatively. The mean duration of follow-up in this study was 18 months. The post-operative measurements of ear length, ear width, bilateral differences in ear length, and bilateral differences in ear width exhibited significant improvement compared to the preoperative values. The mean preoperative AOS score was 1.12 ± 0.34, and the mean post-operative AOS score increased to 3.81 ± 0.40. The preoperative VAS satisfaction score was 2.31 ± 0.70, whereas the post-operative VAS score significantly increased to 8.00 ± 0.89. The follow-up period did not present any cases of flap necrosis, hematoma, infection, or wound dehiscence. The combination of V-Y advancement flap and concha cartilage transplantation for the correction of Tanzer's group IIB constricted ear can achieve a natural and aesthetically pleasing auricle shape, resulting in high patient satisfaction. [Display omitted] [ABSTRACT FROM AUTHOR]

Background: Protruding ears are the most common auricular abnormalities seen in children (1). Protruding ears are a condition that has social and psychological consequences due to its physical appearance and one of the main causes of peer bullying at young ages (2). While various surgical methods exist to address prominent ears, the options for correcting the lobule are relatively scarce. In this study, we are aimed to present the modified fish-tail technique that we have developed and to compare it with other techniques in the literature. Methods: The patients were selected from the cases that underwent otoplasty for prominent ear correction in our clinic between 2020 and 2022. A total of 21 cases that required protruded lobule correction during otoplasty were included in our study. Keloid and hypertrophic scar formation, wound dehiscence, hematoma, infection and recurrence in the lobule were evaluated. The patients were followed up for at least 1 year for early and late complications. Results: Each patient in the study underwent bilateral prominent ear correction, including bilateral modified fish-tail technique. All cases were followed for at least 12 months. There was no wound dehiscence, infection, recurrence in lobule prominence or hematoma during the follow-up period. No hypertrophic scar or keloid was observed in any case. Conclusions: Our method stands out for its ability to achieve both adjustable vertical height and effective lobule correction with a reduced need for skin excision. We recommend the modified fish-tail technique as an alternative technique for prominent lobule surgery. Level of Evidence IV: This journal requires that authors assign a level of evidence to each article. For a full description of these evidence-based medicine ratings, please refer to the Table of contents or the online Instructions to Authors www.springer.com/00266. [ABSTRACT FROM AUTHOR]

Prominent ears (PEs) are the most frequent congenital external ear deformity, occurring in ∼5% of the population. Although the deformity does not usually cause functional difficulties, it can significantly affect the patient's psychological and social health. The authors aim to present the Welsh experience of pinnaplasty, reviewing our outcomes and complications. A retrospective cross-sectional study was performed of all patients undergoing pinnaplasty in Morriston Hospital, Swansea, Wales. We represent the tertiary plastic surgery referral unit across Wales. We included all patients undergoing pinnaplasty between 2015 and 2022 inclusive. We excluded patients undergoing revision procedures or those who had no follow-up. Over the 7-year period, 236 pinnaplasties were performed and 203 were included in the analysis. Ninety-six percent of cases were performed using a cartilage-sparing approach, which represents the mainstay in our unit. The mean follow-up length for our cases was 12 months. Revision procedures were required in 4% of cases. Three hematomas (1.5%) and one (0.5%) wound dehiscence due to infection were recorded and required a return to the operating room. Suture extrusion was noted in 5% of cases (10 patients); 4.5% (9) cases were affected by either hypertrophic or keloid scarring. Across the United Kingdom, cosmetic procedures have come under scrutiny, namely, because of a difficult economic climate. In the era of tight fiscal control in health care, it is pertinent to analyze the outcomes and performance metrics of our operations regularly, thus aiding in the development of an established evidence base to advocate for our respective patients. [ABSTRACT FROM AUTHOR]

Objective To investigate the surgical method and clinical effect of autogenous concha cartilage graft for correction of “lying ear”. Methods From June 2021 to January 2023, Department of Plastic Surgery, The Affiliated Friendship Plastic Surgery Hospital of Nanjing Medical University performed autogenous concha cartilage graft on 12 patients with“lying ear”to correct the lying ear deformity. In all cases, open incisions were used to fully free and loosen the subcutaneous tissue and muscle on the dorsal side of the antihelix. A scratch on the dorsal cartilage of the antihelix was made to release cartilage stress, and autogenous concha cartilage was grafted to the dorsal side of the antihelix to increase the cephaloauricular angle and the angle between the ear concha and the ear navicular angle. The external ear was fixed with a thermoplastic plate after the operation. The changes of cephaloauricular angle and visual analogue scale of ear shape before and after the operation were scored, and postoperative complications were recorded. Results The incision healed in 12 patients. All patients were followed up for 6 months. The "lying ear" was corrected and the cephaloauricular angle angle was increased. All patients were satisfied with postoperative results and no complications occurred. The cephaloauricular angle was (26.25°±6.72°) before surgery and (40.08°±4.52°) after surgery, the difference was statistically significant (P<0.01). Patient evaluation the VAS score of ear contour was (2.17±1.11) before surgery and (7.75±1.29) after surgery, the difference was statistically significant (P<0.01). Physician evaluation the VAS score of ear contour was (2.82±1.25) before surgery and (7.83±0.94) after surgery, the difference was statistically significant (P<0.01). Conclusion Autogenous concha cartilage graft for correction of "lying ear" deformity, with wear external stent after operation is a safe and effective plastic surgery method to correct the "lying ear". [ABSTRACT FROM AUTHOR]

Psychological distress, emotional trauma, and behavioral problems related to prominent ears can cause complicated situations in children and adults. This study aimed to investigate the changes in the psychological impact on quality of life after Otoplasty. The study used several measures, including the Glasgow Benefit Inventory, Social Appearance Anxiety Scale (SAAS), Body Image Scale (BIS), Rosenberg Self-Esteem Scale (RSES), and Visual Analogue Score (VAS), which were completed before and six months after the surgery. The GBI questionnaire was used to detect the health-related quality of life changes after Otoplasty, as it is a reliable, valid, and responsive measure. Six months after the surgery, BIS total scores, VAS scores, and SAAS scores decreased significantly, while RSES scores were not significantly different. These results suggest that Otoplasty can significantly impact adult patients' psychological well-being and quality of life and that the surgery should be considered regardless of age. [ABSTRACT FROM AUTHOR]

Objective: We aimed to evaluate the complication rate and satisfaction status of patients who underwent otoplasty with the combined Mustardé and Furnas sutures with minimal medial conchal cartilage excision. Materials and Methods: Forty-four ears of 22 patients, operated for prominent ear deformity were retrospectively included in the study. Patients were called for follow-up at various time intervals. At the sixth month, the patient and parents were asked to rate their satisfaction with the operation on a scale of 1-10 and noted. Results: The mean age of the patients was 8.09±2.72 years. The antihelix was created with Mustardé technique, minimal medial conchal excisions were performed, two conchamastoid sutures were placed with Furnas technique. The mean follow-up period was 23.86±11.97 months. Complications developed in 4 of 44 ears (9%). Major complication rate was 4.5%. Two patients (4.5%) had suture extrusion in one ear. None of the patients scored lower than 7 in the satisfaction questionnaire. Conclusion: Otoplasty with a combination of cartilage-sparing techniques has low complication, revision, and high satisfaction rates. Minimal medial conchal cartilage excision in addition to this technique is beneficial in reducing the conchamastoid tension and does not increase the risk of complications. [ABSTRACT FROM AUTHOR]

Abstract Background Importance of helix valgus lies in the psychological and social effect it could have on the patient. Our objective was to assess the impact of otoplasty on the quality of life of children with prominent ears and to establish possible predictors of post-surgical outcomes. Material and methods A retrospective review of children with prominent ears who underwent otoplasty between 2016 and 2018 was conducted. Demographical information, medical history, characteristics of helix valgus, motivations for surgery, complications, and post-surgical satisfaction were collected. To assess changes in parent-reported quality of life and patient satisfaction following surgery, the validated Glasgow Children’s Benefit Inventory (GCBI) and Patient Outcomes of Surgery-Head/Neck (POS-Head/Neck) surveys were used, respectively. Results Fifty-three patients responded to the survey (64.6%). From those, 90.6% of parents reported an improvement in health-related quality of life after otoplasty, with a 24.6 ± 20.6 average score on the global GCBI scale. The post-surgical score on the POS-Head/Neck surveys was significantly higher than the pre-surgical score (p

Objectives: Prominent ear abnormalities affect 5% of the population. A prospective, double-blind study of patients who underwent otoplasty procedures to correct these abnormalities was conducted to compare two surgical techniques. They diverge by the preservation or not of conchal cartilage. Methods: The two techniques were compared by measuring the cephalo-auricular and scapho-conchal angles. Measurements were performed in pre and 6-months post-operative periods using alginate molding. Twenty patients were randomly assigned to two groups (with and without cartilage preservation) with 10 participants each. Student’s t-test, Covariance Analysis Model (ANCOVA), and non-parametric Mann–Whitney were used in the statistical analyses. Results: A significant reduction in the average of the cephalo-auricular and scapho-conchal angles was observed in both surgical procedures (p

Background: Ear keloids form after ear piercing in genetically predisposed young adults, causing cosmetic disfigurement and negative psycho-social impact, and reducing quality of life. Total excision of ear keloids leads to loss of ear tissue distorting ear framework and reconstruction to restore esthetically pleasant ear causes scarring and more aggressive keloids. Rate of recurrence is higher than 80% when surgical excision alone is done. Aims and Objectives: The study was conducted to compare the efficacy of intralesional triamcinolone acetonide (TAC) or 5-fluorouracil (5 FU) as monotherapy, combined TAC+5 FU and multi-modal therapy (TAC+5 FU+surgical excision) for keloids of the ear. Materials and Methods: The prospective comparative study included 30 patients who presented to the out-patient clinic of plastic surgery department of Government Mohan Kumaramangalam Medical College Hospital, Salem for a duration of 2 years from January 2021 to December 2022. Patients were categorized into three groups based on size of ear keloids, Group I (10) – Injection TAC (A) or 5- FU (B), Group II (10): Injection TAC+5-FU, and Group III (10): Injection TAC+5- FU+Surgical excision (A – neoadjuvant+adjuvant; B – only adjuvant). Results: Of a total of 30 patients, Group IIIA showed significant reduction of keloid with least side effects, most pleasing cosmetically (Patient and observer scar assessment scale 1/10). No recurrence in follow up. Conclusion: Multi-modal therapy consisting of neoadjuvant TAC+5-FU, surgical excision, and adjuvant TAC+5 FU offers the best long-term results for large ear keloids.

Prominent ears were the most common auricular deformity. Different surgical techniques, such as cartilage-cutting techniques and suturing techniques, are available for treatment. The horizontal mattress suture technique, represented by the Mustard technique, is widely accepted, while the vertical mattress suture technique is rarely discussed in otoplasty. A total of 104 cases of prominent ear deformities were treated from January 2017 to December 2020. Several hypothetical "tension bands" perpendicular to the natural curvature of the antihelix were introduced for the surgical design and determination of the position of the antihelix fixation, and vertical mattress sutures were placed accordingly for the auricular cartilage fixation. Follow-up ranged from 3 months to 2 years. No complications, such as hematoma, infection, or poor wound healing, were observed. Three patients had recurrence within two months post operation, and one complained about the overfolded antihelix. Three cases had suture exposure, but the shape of the auricle was not affected after suture removal. The surgical result was evaluated according to the overall shape of the auricle, including the shape of the antihelix, the improvement of the prominent, the surgical marks, and the bilateral symmetry. A total of 98 patients (94.23%) rated the results as "very satisfactory" or "satisfactory". The vertical mattress suture applied as "tension band fixation" could provide stable cartilage fixation with the natural appearance of the antihelix formation. In addition, the technique could fit a wide range of indications with a low risk of complication and reoccurrence. [ABSTRACT FROM AUTHOR]

Objective: Various techniques have been described in the literature for prominent ear correction. These cartilage-preserving or cartilage-shaping techniques have their own advantages and disadvantages. We aim to achieve aesthetic and stable results with low complication rates using combinations of these methods. Herein, we present our results of prominent ear surgery with a modified bilateral fasciaperichondrial flap in combination with concha-mastoid and concha-scaphal sutures. Methods: Patients whose surgeries included a modified bilateral fasciaperichondrial flap for prominent ear deformities were included in the study. Patients’ demographic data, pre- and postoperative Concha-Mastoid Angle (CMA) and upper-middle Helix-Mastoid Distances (HMD), follow-up time, complications, secondary operations, and postoperative Visual Analogue Scale (VAS) results were evaluated. With a postauricular fish-mouth incision, the bilateral fasciaperichondrial flap was planned into two: proximal- and distal-based. They were then elevated from the cartilage subperichondrially on the proximal side and supraperichondrially on the distal side. Concha-scaphal sutures were used to form an antihelical rim along with concha-mastoid sutures to reduce the concha-mastoid angle. Conchal cartilage resection was done if needed. Then, the bilateral fasciaperichondrial flaps were sutured together to cover the concha-mastoid and concha-scaphal sutures. Results: Between May 2017 and May 2021, 32 ears of 17 patients were operated on due to prominent ear deformity. No hematoma or infection was observed in any patient, and there were no instances of recurrence, suture exposure, hypertrophic scars, or keloids. The satisfaction level of all patients was 8.2 ± 0.9 points on average according to the VAS. In the anthropometric measurements, a statistically significant difference was found between preoperative and postoperative sixth month CMA and HMD values. Conclusion: A combination of suture techniques and a modified bilateral fasciaperichondrial flap may be used in prominent ear cases, with low recurrence rates and high patient satisfaction. Level of evidence: III.

Background: This article aims to present an alternative technique for elevating distal, proximal, and inferior based perichondrioadipodermal (PAD) flaps along with traditional otoplasty to correct ear lobule protrusion, covering the Mustarde and Furnas sutures, and lowering the potential risk and complications. Materials and Methods: This study included undergoing primary otoplasties and had the prominence of ear lobule protrusion and both ears. It included as many as 61 patients (122 ears) who complained of prominent ear deformity with the protruding earlobe and were operated on between February 2015 and December 2020. Thirty-four patients were male and 27 patients were female. The mean age of patients was 26 (9-39). The perpendicular distance from the mastoid to the helical rim's middle part and the antitragus to the mastoid area were measured at the level of Frankfort's horizontal line preoperatively and at 6 months postoperatively. The value of auricular mastoid distance exceeding 20 mm in all situations preoperatively corresponded to a prominent ear. The distance between the antitragus and the mastoid area higher than 22 mm in any situation corresponded to a prominent lobule preoperatively. Results: The average width measured in the frontal view of the ear lowered from 29 ± 4 mm to 17 ± 3 mm postoperatively at 6 months. The average width measured in the lobules' frontal view postoperatively lowered from 27 ± 5 mm to 16 ± 4 mm at 6 months. A round, natural-looking, and durable shape were accomplished in all patients. No complications pertaining to prominent ear deformity or the lobule's correction were observed. No patient was found to experience suture extrusion, skin necrosis, hematoma, or wound infection either early or later at the postoperative period. Conclusion: This study presented a safe and effective three PAD flap technique combined with traditional otoplasty for addressing prominent ear deformity with protruding ear lobule. The advantages of this technique include round, durable, and natural-looking ear shape as well as a consequent natural-looking earlobe. [ABSTRACT FROM AUTHOR]

Background: Otoplasty is mostly performed for cosmetic reasons, and it has been observed that people who have undergone the procedure may experience a minor reduction in their hearing compared to those who have not. The surgeon's goal should be nothing less than perfection in terms of aesthetics. Improving upon one's own efforts necessitates reflective self-analysis. Otoplasty is normally successful, and the surgeon and patient are pleased with the results, but occasionally there are complications. Objective: assessment of aesthetic results and complications in otoplasty. Methods: We scoured medical publications and databases including PubMed, Google Scholar, and Science Direct for information on otoplasty, complications and management between December 1995 and February 2022. However, only the latest or most comprehensive study was considered. The authors also assessed the usefulness of references drawn from similar books. As a result, non-English documents have been overlooked due to a lack of resources to translate them. It was commonly recognized that scientific research did not include things like unpublished publications, oral presentations, conference abstracts, or dissertations. Conclusion: Fortunately, otoplasty problems are infrequent and can usually be avoided with careful planning, execution, and follow-up care on the part of the surgeon and patient. The surgeon needs to be well-versed in potential problems, capable of providing accurate pre-operative risk assessments, and comfortable managing any hazards may develop during surgery. [ABSTRACT FROM AUTHOR]

Background: Ear keloids form after ear piercing in genetically predisposed young adults, causing cosmetic disfigurement and negative psycho-social impact, and reducing quality of life. Total excision of ear keloids leads to loss of ear tissue distorting ear framework and reconstruction to restore esthetically pleasant ear causes scarring and more aggressive keloids. Rate of recurrence is higher than 80% when surgical excision alone is done. Aims and Objectives: The study was conducted to compare the efficacy of intralesional triamcinolone acetonide (TAC) or 5-fluorouracil (5 FU) as monotherapy, combined TAC+5 FU and multi-modal therapy (TAC+5 FU+surgical excision) for keloids of the ear. Materials and Methods: The prospective comparative study included 30 patients who presented to the out-patient clinic of plastic surgery department of Government Mohan Kumaramangalam Medical College Hospital, Salem for a duration of 2 years from January 2021 to December 2022. Patients were categorized into three groups based on size of ear keloids, Group I (10) - Injection TAC (A) or 5-FU (B), Group II (10): Injection TAC+5-FU, and Group III (10): Injection TAC+5-FU+Surgical excision (A - neoadjuvant+adjuvant; B - only adjuvant). Results: Of a total of 30 patients, Group IIIA showed significant reduction of keloid with least side effects, most pleasing cosmetically (Patient and observer scar assessment scale 1/10). No recurrence in follow up. Conclusion: Multi-modal therapy consisting of neoadjuvant TAC+5-FU, surgical excision, and adjuvant TAC+5 FU offers the best long-term results for large ear keloids. [ABSTRACT FROM AUTHOR]

Background: Cryptotia is a common congenital auricular malformation seen in Asian people. To date, multiple surgical procedures have been described for correcting cryptotia. However, the deformity often recurs, presenting as an unclear auriculotemporal sulcus and a malformed helix. The present study aimed to introduce a novel surgical approach to obtain a stable and aesthetic auricular correction in cryptotia patients and to acquire an understanding toward improved surgical management of cryptotia. Methods: Twenty-four cryptotia patients (28 ears), who were operated between April 2018 and November 2021, were included in this study. All patients underwent surgical correction for cryptotia using a modified V-Y advancement flap with helix rounding technique, performed by a senior surgeon. Results: Patients were followed for an average period of 9.4 months (6 to 18 months). Twenty-one patients (87.5%) were satisfied, three (12.5%) were partially satisfied, and none were unsatisfied. Most patients experienced temporary edema as a postsurgical complication, which resulted in a swollen auricle appearance lasting for three to four weeks postoperatively. One patient experienced skin necrosis in one ear on the anterior portion of the upper helix and this was solved by skin grafting. Conclusions: The method of surgical correction utilizing a modified V-Y advancement flap with helix rounding technique proved to be a reliable option in cryptotia patients. It can provide stable aesthetic results after cryptotia correction in clinical practice. Level of Evidence IV: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266. [ABSTRACT FROM AUTHOR]

The Antia–Buch flap technique is used for the reconstruction of pinna helical defects. We present our modification of this flap to reconstruct large defects (greater than 20 mm) with good outcomes. A retrospective review was conducted on all modified Antia–Buch flaps performed in a single unit from January 2011 to April 2019. All adult patients (greater than 16 years of age) who underwent this method of reconstruction after surgical excision of a pinna lesion were included. Measurements of the excision specimens from the final histological reports were used to determine the defect size. The helical lengths of the defect were used for analysis. Medical records were reviewed to identify postoperative complications from the reconstruction. A total of 103 patients underwent the modified Antia–Buch flap reconstruction. All cases were performed by a single surgeon (senior author SA). Patients were 51–96 years of age (mean 76 years, SD±8.6), including 92 males and 11 females. The helical length of defects closed was between 12 and 42 mm (mean 26.7 mm, SD±6.46), and defect widths were 6–37 mm (average 14.5 mm, SD±5.28). There were 5 complications in our series (4.8% complication rate), with a revision rate of 2.9% (n = 3). Our case series is the largest in the literature. Our modification demonstrates that large pinna defects can be reliably repaired with modification of the Antia–Buch flap that gives patients the option of a single-stage reconstruction without added morbidity and a good cosmetic outcomes. [ABSTRACT FROM AUTHOR]

Background: Prominent ear deformity is an autosomal dominant inherited deformity. Surgery is the most effective treatment method for prominent ear patients. Different prominent ear operations have been described in the literature. In this study, it is aimed to compare the transcutaneous fixation-assisted method that we described in prominent ear repair with the classical needle-assisted method. Methods: Patients who were operated for bilateral prominent ear deformity between January 2017 and January 2020 were included in the study. Two different approaches were used in the operations. In the first group, conventional needles were used to adjust the position of the concha-scaphal sutures. In the second group, transcutaneous suturing was used to adjust the position of the concha-scaphal sutures. The duration of the operation was recorded. Patients were called for controls in 1–3–6 and 12th months; photographs were taken. Measurements were made in the preoperative period, in the intraoperative and at the postoperative 12th month. SPSS program was used for statistical analysis. Results: A total of 52 patients were included in the study. There were 27 patients in Group 1and 25 patients in Group 2. There was no significant difference between the groups in terms of demographic characteristics (p>0.05). While the average operation time was 80.37 minutes in Group 1, the average operation time was 60.40 minutes in Group 2. The operative times between the groups were statistically significant (p<0.05). There was no statistically significant difference between the groups in preoperative, intraoperative and postoperative measurements (p>0.05). Conclusions: As a result, transcutaneous fixation-assisted method is performed faster than the classical needle-assisted method and the results are understood right at the beginning of the operation. Level of evidence III: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266. [ABSTRACT FROM AUTHOR]

Abstract Objectives This study proposes a new surgical alternative for the most common deformity in the ears, the so-called "protruding/prominent ears", which is a condition that affects 5% of the Caucasian population (Goulart et al. in Rev Bras Cir Plast 26:602–607, 2011). This technique comes with the benefits of reduced surgical time, shallow learning curve, and a low revision rate. Methods We studied a total of 213 patients with an indication for otoplasty from January 2020 to January 2021. Women made up 65% of the study population, while men made up 35%, with an average age of 21 years, the youngest being 7 years of age. The technique presented here corrects all the deformities that cause protruding ears and can be performed together with other ear surgeries, such as surgical treatment of macrotia and lobuloplasty. All surgeries were performed in an outpatient setting under local anesthesia and sedation. Results All surgeries followed a performance-optimized protocol, with an average total surgical time of 45 min for a bilateral approach. Revision surgery was needed in 2% of cases, with the most frequent complaint being asymmetry in the upper third of the ears. The complication rate was approximately 7.5%, with 1 case of hematoma, 1 case of mild infection, 2 cases of altered ear sensitivity, 3 cases of keloid scar formation, 6 cases of asymmetry in the upper third of the ears, and 3 cases of irregularities or spikes in the antihelix cartilage. Patient satisfaction was measured using the McDowell/Wright Objectives and Outcome Index (McDowell in Plast Reconstr Surg 41:17–27). Conclusion The proposed performance technique is a viable alternative to optimize the surgical time of otoplasty in an outpatient setting. This technique can be performed together with other corrective ear surgeries, has a shallow learning curve, and has a low revision rate. Level IV: Evidence obtained from multiple time series with or without the intervention, such as case studies.

Objective: In our center (UZ Brussel), a small modification of the “Converse and Wood-Smith technique” is used to correct prominent ears in children. We present our results and complication rate. We also investigated the influence of a temporarily introduced medical fee on the number of operations and satisfaction of the patients/parents. Methods: Out of all children that were operated (otoplasty) on between January 2005 and December 2016, we included all minors with a minimum follow-up period of 6 months. Data about complications were collected retrospectively from their medical files. Data about satisfaction of the patient/parent and surgeon were prospectively collected by questionnaire. Patients were excluded from the study if they were previously operated elsewhere, if the questionnaire was incomplete, if their auricle could not be classified as a grade I dysplasia (Weerda) or as a class V dysplasia (Tanzer’s classification), and if the protrusion was secondary to any genetic disease, trauma, or infection. Results: The parent’s/patient’s satisfaction differed significantly from the surgeons’ satisfaction, with the patient/parent being more satisfied than the surgeon. In 9 out of 105 ears (8.6%), revision surgery under general anesthesia was needed to resolve a complication such as recurrence of protrusion. The introduction of a medical fee did not have a significant influence on the mean number of surgeries performed each year and did not alter patient’s/parent’s satisfaction. Conclusion: The results of our modified Converse and Wood-Smith technique were satisfying for correction of prominent ears. The introduction of a medical fee did not seem to have an influence on satisfaction [ABSTRACT FROM AUTHOR]

Objective: Prominent ear deformity is one of the aesthetic problems that should be treated due to the psychosocial problems it causes. We aimed to present our results in which we used the combination of Mustarde suture to create an antihelix, conchal resection, and concomastoid suture combination to reduce conchal excess in the light of literature. Materials and Methods: A total of 28 cases in which the same otoplasty method was used in 2 separate centers between 2014 and 2020 were included in the study. Elliptic skin excision, antihelix reconstruction with Mustarde suture, and in cases with large conchal cartilage, cartilage excision and reconstruction with concomastoid suture were performed in all of our cases. After the skin was closed, a bandage was applied to the ear. Results: In the early postoperative period, hematoma developed in 4 cases. There was superficial erosion of the skin in 4 cases. In the late period, hypertrophic scar developed in both ears and resolved with medical treatment. There was minimal asymmetry in 4 cases, but intervention was not required in cases with asymmetry. Skin necrosis, infection, and visible cartilage irregularity on the anterior side were not observed in any case. Conclusion: The aim of otoplasty is to create symmetrical ears with smooth contours, so combined techniques should be used instead of a single technique. In otoplasty, we used Mustarde suture to create antihelix, conchal resection, and concomastoid suture combination to reduce cavum. Our results were satisfactory. [ABSTRACT FROM AUTHOR]

Background: Standard methods of otoplasty may risk anatomical distortion. Previous work showcased a novel, cartilage-sparing technique. This study aimed to confirm the safety and effectiveness of the method in a larger cohort., Methods: This retrospective study included patients undergoing otoplasty by a single surgeon using a single technique between January 2021 and December 2023. Eligible patients were aged >5 years and had prominent or constricted or cup ears, forming a 2 cm distance from the mastoid. Surgical techniques included novel key-point sutures. Minimum follow-up was 6 months. Data on demographics, risk factors, perioperative management, and complications were collected from patient records., Results: A total of 288 operated ears (147 patients) were included. The mean age was 17 years, and 91 (61.9%) were female. The mean duration of follow-up was 24.3 months. Postoperative complications were generally minor and included Polydioxanone (PDS) suture exposure (n = 16, 5.5%), manageable postoperative pain (n = 8, 2.7%), self-resolving swelling (n = 8, 2.7%), minor bleeding (n = 7, 2.4%), and superficial skin complications (n = 4, 1.3%). Infections occurred in 4 ears (1.3%) and were treated effectively with topical/oral antibiotics. Cases of partial release of the ear resolved without intervention (n = 4, 1.3%). Only 4 (1.3%) ears experienced loss of correction, with options for reoperation available as needed. Analysis showed no significant age differences in postoperative complications and a nonsignificant trend towards higher postoperative swelling in males than in females (10.7% vs 2.2%; P = 0.054)., Conclusions: The data confirms that this technique offers safe and rapid cartilage-sparing otoplasty with minimal complications and low recurrence rates. It ensures long-lasting and aesthetically pleasing results for prominent ear deformities., Level of Evidence: Level III., (Copyright © 2024 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.)

Congenital ear anomalies are associated with psychological morbidity. Ear deformities can usually be corrected by nonsurgical techniques such as splinting or molding in the neonatal period, initiated before 6 weeks. Without early corrections, many will require otoplasty during childhood. We introduce a novel silicone-based custom mold technique for congenital ear anomalies. The highly malleable silicone was pushed into every part of the auricle, enabling the auricle to remain in the desired shape, with new molds made weekly. Of 31 newborns (18 males, 13 females), 54 ears were treated. Average age at treatment initiation was 26.8 days. The mean treatment duration was 43.2 days, with a median of 28 days. Normal appearance and parent's satisfaction were achieved in 30 patients with 49 deformed ears and also in four newborns older than 6 weeks. Three concha type microtia in two patients achieved great improvements and parents' satisfaction. No complications were reported. Marked aesthetic improvements and normal appearance were achieved for all deformed auricles treated, and improvements in the concha type microtia will partially alleviate future surgical corrections. The results are not inferior to other techniques. The advantages are as follows: cost-effective, time-saving, simple to master, no need for hair shaving, and easy use for parents. Patients older than 6 weeks of age achieved normal auricle appearance, enabling the correction in older newborns. Custom made silicone auricle molding offers a simple nonsurgical technique for correcting congenital ear anomalies, alleviating the need for future surgical corrections. [ABSTRACT FROM AUTHOR]

Objectives: This study proposes a new surgical alternative for the most common deformity in the ears, the so-called "protruding/prominent ears", which is a condition that affects 5% of the Caucasian population (Goulart et al. in Rev Bras Cir Plast 26:602-607, 2011). This technique comes with the benefits of reduced surgical time, shallow learning curve, and a low revision rate.Methods: We studied a total of 213 patients with an indication for otoplasty from January 2020 to January 2021. Women made up 65% of the study population, while men made up 35%, with an average age of 21 years, the youngest being 7 years of age. The technique presented here corrects all the deformities that cause protruding ears and can be performed together with other ear surgeries, such as surgical treatment of macrotia and lobuloplasty. All surgeries were performed in an outpatient setting under local anesthesia and sedation.Results: All surgeries followed a performance-optimized protocol, with an average total surgical time of 45 min for a bilateral approach. Revision surgery was needed in 2% of cases, with the most frequent complaint being asymmetry in the upper third of the ears. The complication rate was approximately 7.5%, with 1 case of hematoma, 1 case of mild infection, 2 cases of altered ear sensitivity, 3 cases of keloid scar formation, 6 cases of asymmetry in the upper third of the ears, and 3 cases of irregularities or spikes in the antihelix cartilage. Patient satisfaction was measured using the McDowell/Wright Objectives and Outcome Index (McDowell in Plast Reconstr Surg 41:17-27).Conclusion: The proposed performance technique is a viable alternative to optimize the surgical time of otoplasty in an outpatient setting. This technique can be performed together with other corrective ear surgeries, has a shallow learning curve, and has a low revision rate.Level Iv: Evidence obtained from multiple time series with or without the intervention, such as case studies. [ABSTRACT FROM AUTHOR]

Introduction: Ear congenital deformities represent an aesthetical concern in adult patients and a social matter in children. An accurate assessment of ear defects should be made preoperatively in order to plan surgery adequately. Materials and Methods: In order to correctly assess the ear preoperatively the authors have considered four different subunits: helical and scaphal region (A), antihelical region (B), conchal region (C) and lobule region (D). Surgical planning should start from sub-unit A evaluation, ending with sub-unit D, in a concentric fashion. When sub-unit A defects have to be corrected, an anterior approach is preferred. Discussion: A correct evaluation of ear defects prior to surgery is of dramatic importance. Sub-unit A ear defects are often disregarded, and surgical techniques for their correction are rarely considered. Correcting helical and scaphal defects requires an anterior approach, influencing the technique employed for the correction of subunits B and C defects. Sub-unit B defects should be evaluated and corrected before sub-unit C defects in order to avoid overcorrection of ear protrusion. Conclusion: Several surgical techniques have been described in the literature for correcting ear defects. After many years of experience, we outlined a schematic flowchart that prevents from leaving areas of the ear untreated, providing the best possible result for the patient. Level of Evidence IV: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266. [ABSTRACT FROM AUTHOR]

Background Numerous methods have been developed for the correction of protruding ears. However, the best technique should be the one that is simple, reliable, and reproducible. Our research aimed to compare Mustarde technique and Stenström technique used in the correction of prominent ears. We included 20 patients who were randomly assigned to Mustarde or Stenström technique. All participants underwent full history collection, general and local examinations, and full investigations. We analyzed the age, sex, surgical technique, follow-up, complications, and results. Aim The aim of this study is to compare between Mustarde and Stenström techniques in the correction of prominent ear. Patients and methods This study included 20 patients with prominent ear, comprising 15 males and five females, attending Al-Azhar University hospitals. The patients were divided into two groups, with each group including 10 patients: creation of antihelix was done in all cases, and conchomastoid sutures were used if needed in some cases. Results According to our results, comparison of these two groups showed that patient satisfaction was high in both groups. In our study, hemorrhage, hematomas, keloid formations, suture extrusion, skin and cartilage infection, skin necrosis, and relapse have not occurred in any of the patients of the two groups. Irregularity in the antihelix was not observed in any patients from group A (Mustarde technique) and observed in one (5%) patient from group B (Stenström technique). Conclusion Minimizing the gap between the ear and the mastoid is the most significant outcome for patients in considering the operation as a success. Mustarde technique was our favorite technique for correction of protruding ear in children with soft or thin cartilage. We also agree that the technique of Stenström was effective in adults with hard or thick cartilage.

Abstract Background Bat ear deformity is a common presentation among the ENT patients (22.5%). Many surgical procedures have been described to manage such a problem. A thorough study of the anatomical anomalies contributing to such deformity is required by any plastic surgeon in handling this anomaly. Results Modified anterior scoring (Chong-Chet) was done on 45 bat ear deformities in 31 patients. Good surgical results were obtained in 97.7% of patients, and the surgical time ranged from 60 t0 90 min. Postoperative pain and infection were minimal and effectively managed. Conclusions The modified Chong-Chet anterior scoring is a reliable and effective surgical tool for managing bat ear deformity done through one postauricular incision. This technique could be used in young as well as adult patients because it renders the auricular cartilage easier to manipulate.

Background: In cosmetic pinnaplasty, an underdeveloped or absent antihelical fold and a hypertrophic concha are the most frequent defects requiring surgical consultation. With this study, the authors intend to describe a technique consisting of an anterior para-helical incision to approach the antihelix, with no posterior approach. Advantages of this surgical approach are described. Methods: All patients consecutively operated in the period 2016–2019 by the senior author (FB) with the anterior incision technique were retrospectively included in the study. Demographic and comorbidities were sought. Postoperative patient's reported pain and satisfaction were determined. Early and late complications were also mentioned. Results: Forty-five Caucasian patients were included, of whom 23 were women and 22 were men. Mean age was 25 years old (range 14 to 52). Follow-up was from a minimum of 12 months to a maximum of 36 months. All complications were managed with an office-based approach. Patient's satisfaction was rated as very good in most cases (25 patients, 56%), excellent in 9 cases (20%), good in 7 (16%) and fair in 4 (9%), and no one expressed poor satisfaction. The most common postoperative pain was mild. The parahelical anterior incision has proven to be a safe and effective technique for antihelical open sculpting. The scar tends to fade nicely and remain well hidden under the helical fold. Conclusions: The proposed technique allows an open approach to the antihelix and a surgical moulding under direct view, in addition to a limited risk of complications and an optimal balance compromising operative efficiency-efficacy and risks, patient's and surgeon's intraoperative comfort, appearance of the scar and duration of the result. Level of evidence: IV, therapeutic study [ABSTRACT FROM AUTHOR]

Background: Many techniques have been introduced to correct cryptotia. The previous methods are releasing the constricted cartilage and changing the mechanical fulcrum partly to the right position. However, some patients are still not satisfied with the treatment results, due to cryptotia recurrence and insufficient superior 1/3 width. This study aimed to develop a new method for completely changing the mechanical direction of constricted cartilage for correcting cryptotia. Methods: From 2007 to 2020, twenty-four cryptotia patients were treated. During surgical reconstruction, the retroauricular skin flap was elevated, the posterior aspect of the upper auricular cartilage was completely exposed, and the abnormal insertion of the auricular intrinsic muscles detached. The sharply curved antihelical cartilage was cut and overturned, and the scalp skin flap was undermined and advanced toward the postauricular sulcus. The edge of the retroauricular scalp flap is fixed on the mastoid periosteum. The incision was closed. Results: Eighteen patients had unilateral cryptotia, and six had bilateral cryptotia. Relatively favorable results were obtained in the follow-up period (range, 6–48 months). There were no cases of skin necrosis, complications, or revision surgery. Conclusions: The main advantages of this technique are the surgically reproducible results, and that it can be applied to most cases. The method described in this paper could potentially increase the width of the upper third of the auricle and reduce recurrence rate, while also leaving an inconspicuous scar and a satisfactory auricular contour. It is suggested that this technique could be an alternative method of cryptotia correction. Level of Evidence IV: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266. [ABSTRACT FROM AUTHOR]

Background: Question mark ear is a rare congenital deformity, mainly characterized the interruption of the natural continuity between the lower border of the helix and the earlobe. In severe cases, the earlobe may be absent. In addition, there may be protrusion and outward expansion of the upper part of the auricle, with partial or complete disappearance of the antihelix. This article aims to introduce a technique that combines autologous costal cartilage carving with auricular cartilage folding to achieve a stable and aesthetic auricle. Method: This study included 26 patients with sporadic question mark ear deformity who were treated at our clinical center from January 2020 to December 2022. Based on the different appearances of the lower part of the auricle, they were divided into 2 categories:11 cases showed a natural continuity interruption between the helix and the earlobe, while 15 cases showed the absence of the earlobe. All patients underwent corrective surgery using costal cartilage transplantation combined with the upper part of the auricular cartilage folding, performed by senior surgeons. Results: Question mark ear was effectively improved and with no significant rebound. The average follow-up period was 8.4 months (ranging from 6 to 12 months). A satisfaction survey showed that 23 patients (88%) were satisfied, 3 patients (12%) were partially satisfied, and no patients were dissatisfied. Most patients experienced temporary swelling after surgery, which resolved within 3 months to half a year. Conclusion: Autologous costal cartilage transplantation combined with folding of the auricular cartilage is an ideal surgical method to correct question mark ear., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Objective: Cauliflower ear, or "hematoma auris," is a permanent condition that is typically viewed as a deformity. Despite this, it has anecdotally been observed that combat sport athletes view cauliflower ear as a respected aesthetic trait. This study characterizes and quantifies the differences in initial impressions of subjects with cauliflower ear between combat sport athletes and the general population., Methods: In a cross-sectional survey, participants were shown frontal and profile views of four subjects with cauliflower ear and five control subjects. Respondents rated the subjects on a scale of 0-100 in perceived success, attraction, approachability, and affect display. Numeric scores were compared between combat sport athletes and the general population. Additionally, first impressions were categorized into positive, neutral, or negative classes via latent class analysis (LCA)., Results: 678 combat sport athletes and 129 general casual observers participated in the survey. Combat sport athletes rated subjects with cauliflower ear significantly more favorably than respondents in the general population in all personal attributes: perceived success (+4.03, 95 % CI:1.8-6.2, p = 0.0003), attractiveness (+4.11, 95 % CI:1.8-6.4, p = 0.0005), approachability (+11.57, 95 % CI: 8.4-14.7, p < 0.0001), and affect display (+4.14, 95 % CI: 1.9-6.3, p = 0.0002). They also had approximately seven times greater odds (95 % CI:4.0-12.6, p < 0.001) of reporting a positive first impression of a person with cauliflower ear than the general population., Conclusion: Confirming anecdotal observation, the combat sports group had a more positive perception of cauliflower ear than the general population. Conditions that are typically viewed as deformities can be looked upon favorably in specific subpopulations., (Copyright © 2024 Elsevier Inc. All rights reserved.)

Objectives/hypothesisTo demonstrate the dosimetry effect of electromechanical reshaping (EMR) on cartilage shape change, structural integrity, cellular viability, and remodeling of grafts in an in vivo long-term animal model.Study designAnimal study.MethodsA subperichondrial cartilaginous defect was created within the base of the pinna of 31 New Zealand white rabbits. Autologous costal cartilage grafts were electromechanically reshaped to resemble the rabbit auricular base framework and mechanically secured into the pinna base defect. Forty-nine costal cartilage specimens (four control and 45 experimental) successfully underwent EMR using a paired set of voltage-time combinations and survived for 6 or 12 weeks. Shape change was measured, and specimens were analyzed using digital imaging, tissue histology, and confocal microscopy with LIVE-DEAD viability assays.ResultsShape change was proportional to charge transfer in all experimental specimens (P

The use of a semilunar cartilage block to elevate a reconstructed ear does not always achieve a well-defined auriculocephalic sulcus. Herein, we modified the conventional crescent cartilage block through sculpting a concavity at its posterior surface, with the aim of improving the retroauricular contour. The study aimed to verify the effectiveness and reliability of this modified cartilage block through a retrospective cohort study. A retrospective review of patients who underwent Nagata microtia reconstruction between October 2017 and November 2018 were conducted. The esthetic outcomes of auricular projection and cranioauricular sulcus in patients who accepted the modified semilunar block were compared with those of patients who underwent the same procedure using the traditional crescent pad. A total of 163 (84 of the modified group and 79 of the traditional group) patients were included. The mean (median) esthetic scores for ear projection in the modification and traditional groups were 3.13 (3) and 3.06 (3), respectively. The rate of favorable ear projection in the modification group (83.3%) was similar with that in the traditional group (78.5%) (p = 0.550). The mean (median) esthetic scores for cranioauricular sulcus in the modification and traditional groups were 2.51 (3) and 2.90 (3), respectively. The rate of favorable retroauricular sulcus in the modification group was 75.9%, whereas that in the traditional group was 51.2%, with the differences reaching statistical significance (p = 0.001). The concave crescent-shaped block can improve the contour of the auriculocephalic sulcus under the premise of ensuring the ear projection. [ABSTRACT FROM AUTHOR]