Otoplasty in children younger than 5 years of age

The prominent ear is the most common congenital deformity of the auricle. It is often recommended that prominent ears be surgically repaired before children start school and most surgeons seem to perform the surgery after 5 years of age. The aim of our study is to summarize the rationale of performing otoplasty procedure in children under the age of 5, to discuss the advantages and disadvantages, and to review the patient (parent) satisfaction.

A retrospective study was performed on 10 children under the age of 5 who underwent otoplasty procedure and was followed for over a year.

Ten patients (3 boys and 7 girls) between the ages of 48 months and 59 months, with a median age of 51.5 months were evaluated. Otoplasty was bilateral in 8 patients and unilateral in 2 patients. Global Aesthetic Improvement Scales of the patients were rated as "improved" or "better" at 52 weeks. The patient (parent) satisfaction was measured by a telephone survey. Parents revealed that 9 out of 10 were "very" or "completely" satisfied with the appearance and symmetry of their children's ears. We did not observe any visible disturbance or growth restriction in our patients, even in the unilateral operated group.

Timing of surgery is an issue of concern with regard to otoplasty in children. There may be significant psychosocial benefit to early intervention, particularly in light of changing norms for interaction with peers at ages considerably earlier than what had previously been thought of as the "school age." Our preference is to plan the otoplasty as young as four years of age, after the child has expressed some concern about the deformity.