New modification in otoplasty: Anterior approach

After harvesting the conchal cartilage in a large series of secondary rhino plasties using the anterior approach, there was a marked improvement in the shape of the auricle, with unnoticeable scarring hidden under the convolut ion of the antihelix. In this series of 250 cases, there were no hypertroph ic scars or keloid formations. Based on these favorable results, a new modi fication of otoplasty was developed using only the anterior approach. Betwe en 1992 and 2000, 108 otoplasties were performed on 55 patients to correct the prominent ear using only the anterior approach. All maneuvers used in m odern otoplasty, such as conchal reduction, scaphal cartilage scoring and f olding, placement of horizontal mattress buried sutures, conchal setback, a nd the positioning of the tail and upper pole, can be easily and effectivel y performed using only the anterior approach as described in this article. The use of an anterior approach does not disturb the neurovascular system o f the ear because it is located on the ear's posterior side. Overall, patie nt and physician satisfaction has continued to be very high during the 8 ye ars that this technique has been used. Some patients experienced a few mino r complications, such as postoperative pain (16.3 percent), late suture rea ction (1.8 percent), hidden helix (3.6 percent), and partial relapse (3.6 p ercent), that were easily corrected by the application of a Kaye-type burie d suture and that were not directly related to the technique.