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Otoplasty. Clinical protocol and long-term results
1Division of Otolaryngology/Head and Neck Surgery, Lucile Salter Packard Children's Hospital at Stanford, Palo Alto, Calif, USA.
Insights
Otoplasty for prominent ears shows significant loss of correction over time, especially at the upper pole. Despite this, most patients and families report high satisfaction with the surgical outcomes.
Area of Science:
- Plastic Surgery
- Pediatric Otolaryngology
- Aesthetic Surgery Outcomes
Background:
- Prominent ears affect self-esteem in pediatric patients.
- Otoplasty is a common surgical procedure to correct ear protrusion.
- Long-term outcome data for otoplasty is crucial for patient counseling.
Purpose of the Study:
- To evaluate the long-term efficacy and patient satisfaction following otoplasty for prominent ears.
- To assess the degree of correction maintenance and potential relapse over several years post-surgery.
Main Methods:
- Prospective measurement of ear protrusion using the Frankfort horizontal line preoperatively and postoperatively.
- Follow-up measurements at a minimum of 1 year after surgery for 31 of 51 pediatric patients.
- Patient and family satisfaction survey administered at follow-up.
Main Results:
- One-third of ears returned to their original position, one-third maintained immediate postoperative results, and one-third showed partial relapse.
- An average of 58% of correction at the superior rim was lost over time.
- 78% achieved good to excellent ear symmetry, with a 3% revision rate and 9% stitch granuloma rate.
Conclusions:
- A substantial loss of otoplasty correction is common long-term, particularly at the superior aspect of the ear.
- Despite potential relapse, otoplasty generally leads to high patient and family satisfaction.
- Otoplasty remains an effective procedure for improving prominent ears and patient well-being.
Objective:
To evaluate the long-term results after otoplasty on prominent ears.
Design:
Between 1988 and 1993, ear protrusion was measured preoperatively and postoperatively in pediatric patients undergoing otoplasty by means of a standard protocol based on the Frankfort horizontal line. Patients were asked to return for follow-up measurements a minimum of 1 year after surgery. At the time of follow-up, a patient satisfaction survey was completed by the patients and their families.
Setting:
The Hospital for Sick Children, Toronto, Ontario, a tertiary care children's hospital.
Participants:
Thirty-one of 51 patients returned for follow-up an average of 3.7 years after surgery.
Results:
One third of ears returned to their original position, one third of ears stayed in a position equal to the immediate postoperative position, and one third of ears had final positions between the preoperative and post-operative positions. At the superior rim, an average of 58% of the operative medialization was lost. Good to excellent ear-to-ear symmetry was obtained in 78% of patients who returned for follow-up. Retrospective chart review showed a revision surgery rate of 3%; stitch granulomas were removed in 9% of patients. The patient satisfaction survey found that 85% of patients were happy or very happy with their ears.
Conclusions:
With time, a substantial loss of correction can be expected in most (but not all) patients who undergo otoplasty, particularly at the upper pole. Overall, patients and their families are happy with the results of otoplasty surgery.