Otoplasty: Anterior scoring technique and results in 500 cases

Corrective otoplasty is a commonly performed procedure to change the shape of the auricular cartilage. Many techniques use permanent sutures to mainta in the cartilage folding, whereas other techniques rely on cartilage incisi ons (partial thickness or full thickness). At this in stitution, a cartilag e cutting and anterior scoring technique has been used for more than 30 yea rs with pleasing results. The surgical techniques published in the past hav e been reviewed and compared with the procedure used at this institution to point out the advantages, disadvantages, and differences of these various techniques. Also reviewed were 500 consecutive cases operated on under loca l or general anesthesia between January of 1993 and December of 1995 to det ermine the incidence of early and late complications. The patients were con tacted by mail to return for a follow-up examination or answer a questionna ire, at least 2 years after the procedure. Early complications were bleedin g in 13 cases (2.6 percent) and hematoma in 2 cases (0.4 percent). There we re no infections or ear necrosis. A small cutaneous wound was present on th e anterior skin in three patients (0.6 percent), and there was one wound de hiscence (0.2 percent). Late complications were keloids in two cases and in clusion cysts in three cases. Residual deformity was noted in 22 cases and asymmetry in 28 cases. Secondary surgery was performed in six cases. The qu estionnaire was answered by 387 patients (77.4 percent response rate): pain when the ear is touched was present in 22 cases (5.7 percent), hypesthesia in 15 cases (3.9 percent), occasional cutaneous irritation in 38 cases (9. 8 percent), asymmetry in 71 cases (18.4 percent), and abnormal ear shape in 17 cases (4.4 percent). Twenty-nine patients (7.5 percent) also noted that the ear was more sensitive to cold or touch. The satisfaction rate was 94. 8 percent: very satisfied, 74 percent; satisfied, 20.8 percent; dissatisfie d, 4.2 percent; and very dissatisfied, 1 per cent. These results were compa red with other published series of complications and late results after oto plasty; the complication rates are similar or lower in this study. Therefor e, it can be concluded that the cartilage cutting and anterior scoring tech nique otoplasty is a safe procedure with a high patient-parent-surgeon sati sfaction rate.