Otoplasty. Clinical protocol and long-term results
A. H. Messner and W. S. Crysdale
Division of Otolaryngology/Head and Neck Surgery, Lucile Salter Packard Children's Hospital at Stanford, Palo Alto, Calif, USA.
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.
