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Clinical Protocol and Long-term Results

Anna H. Messner, MD; William S. Crysdale, MD, FRCSC

Arch Otolaryngol Head Neck Surg. 1996;122(7):773-777.

Abstract
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 postoperative 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.

Arch Otolaryngol Head Neck Surg. 1996;122:773-777

Author Affiliations
From the Division of Otolaryngology/Head and Neck Surgery, Lucile Salter Packard Children's Hospital at Stanford, Palo Alto, Calif (Dr Messner); and Department of Pediatric Otolaryngology, Hospital for Sick Children, Toronto, Ontario (Dr Crysdale).

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