A variety of surgical procedures to reconstruct or correct inborn or acquired differences of external ear. Most commonly performed to set back the ears that stick out too far or appear to be too large for the head.
Corrective ear surgery refers to an array of procedures that can normalize the appearance of the ears. We performed it to change the size of the ears, reshape the ears, or reset protruding ears. Most often it is used for correction of protruding ears, which can negatively affect the lives of adults and children. Ears that project excessively from the head are often missing their natural folds created by the ear cartilage. There are several other aesthetic operations that can modify distorted or congenitally malformed ears. One is a correction of congenital defect in which the outer ear is pulled together into a cup like shape (cup ear deformity). Another condition that can be corrected is microtia, where the outer ear is greatly underdeveloped or even missing at birth. These are highly specialized and technically demanding procedures requiring a lot of skill and expertise. Correction of microtia is a two stage procedure, during which we create a complex framework of the ear from rib cartilage and cover it with thin skin. Sometimes adults have only the earlobe reshaped or corrected.
Children usually do not notice their protruding ears until they begin to hear hurtful comments about them from other children. Children who find this disturbing often operate their protruding ears prior to starting school. At the age of 5-6, the ear has stopped growing sufficiently for surgery to be done. It is important that the child is not submitting to the operation because the parents desire it. Children are generally more cooperative and happy with the outcome, when they fully understand why the surgery is undertaken. Frequently we perform the correction of protruding ears in teenagers and adults.
During the preoperative consultation, we will evaluate the structure of the ear, to determine which parts have to be corrected. Young children are operated under general anesthesia and can leave the hospital on the day of the surgery. In teenagers and adults operation is carried out under local anesthesia as an outpatient procedure. Skin incision is made behind the ear. The back surface of the cartilage is incised and cartilage loosened from the skin. The cartilage is adjusted the reshaped to create the missing natural folds and to allow the ear to lie closer to the side of the head. Skin incision can be closed with normal or dissolving sutures.
After surgery, we will wrap the head in soft dressing to protect the ears and promote healing in the new position. Bandage and any sutures that do not dissolve on their own are removed within a week. Afterward hair can be washed. Once the dressing has been discarded, a headband should be worn while sleeping for another two weeks preventing the ear from being bent forwards. The ears are often sore and tender for a couple of days and oral painkilling medication may be required. There may be some residual bruising and swelling which will subside in a week. Because the operation is carried out from behind the ears, a small scar is discretely hidden close to the groove between the ear and the side of the head. A week off work is recommended in adults to allow for initial healing. Children should avoid sports and aggressive playing for approximately three weeks.
A few individuals can develop keloid scars that can evolve into hard raised red lines behind the ears. Treatment with injection of steroids may hold down progression, but sometimes corrective surgery is also needed. Careful surgical technique can minimize the risk of ugly scarring after ear surgery. Infection is not common, but if occurs it requires treatment with antibiotics and regular dressing changes. Bleeding is avoided with careful bandaging, and if haematoma (collection of blood) forms it has to be removed.