OTOPLASTY

Protruded Ear Surgery

There are many techniques that can be used in otoplasty. Surgeon will determine an appropriate method based on analysis of the ear condition. Patient is recommended to consult with surgeon prior the surgery, as well as inform the surgeon about the correction required. Surgeon will help assess whether the surgery should be done. The technique employed in surgery of left ear and right ear might differs depending on condition of each ear.

Ideal ear shape should be as follows:

1. Curve of the ear and compositions should appear natural and not too visible

2. Viewing from the front, ear should not standout from the face

3. Viewing from the front, helix part of the ear should be clearly visible. Anti helix should not be more pronounce than helix as it will make ear appear unnatural 

Determining the Surgical Technique

The surgical technique is determined during the consultation period, in which surgeon will analyze abnormality of the ear and assess the most appropriate method. The most common cause for protruded ears are

1. Anti Helix is too flat and positioned in an obtuse angle

2. Concha is too large or too deep

Protrusive ear might be caused by issue 1, issue 2 or both issues. The surgical technique is determined based on whether the problem is caused by Anti Helix or Concha. The problem is commonly found on the Anti Helix part, however, in some cases when the problem is from issue 2, patient would still require Anti Helix surgery for a better outcome. Apart from the two main factors, shapes of the upper edge of the ear and the earlobe should also be taken into account, as in some cases these parts would also need to be corrected to prevent telephone ear shape.

The Surgery

1. Before the surgery, surgeon will use anesthetic on patient. This anesthetic contains Adrenalin which helps in blood staunching during surgery

2. Surgeon will draw incision areas and draw the cartilage area

3. Cartillage shape will be corrected by suturing or incising to change the angle of the cartilage. The incision might be made either on the front or the back of the ear

4. In those with a problem on Concha, the cartilage around this area will be sutured or incised

5. In some cases, hatch suture might require to be performed to correct angle of the upper cartillage. Patient will not be able to wear glasses for 2 weeks until the wounds are healed

6. In some cases, earlobe surgery might be required. This can be performed by making an incision behind the earlobe or suture earlobe to the cartilage or scalp

7. Suture with smaller silk

8. There are 2 methods of wound suturing

9. Regular wound suture – use cotton wound and bandage to cover the incision. This method is used if patient does not have any activity the next day

10. In case patient has an activity the next day, surgeon will cover the wound with small bandage at the back of the ear, with clear tape at the front of the ear and cover the wound with hair band. This method might cause bleeding and patient might require to meet the surgeon for follow up sooner than the regular method. 

Treatment After Surgery

Patient is required to be admitted to the hospital if they receive general anesthetic. Local anesthetic does not require admission to the hospital.

1. Leave the wound covered for 2 days. On the 2nd or 3rd day doctor will make an appointment for a follow up and removal of the bandage. Patient is recommended to ensure that the bandage is well attached to the wound until then

2. After the bandage is removed, apply antibiotics on both ears twice a day until the stitches are removed by the doctor

3. If bleeding does not stop or the wound is irregularly swollen, make an appointment with doctor

4. Use hairband while sleeping for 2-3 weeks after bandage is removed 

5. Meet the surgeon 1 week after the surgery

6. Stitches are removed two weeks after the surgery

7. Abstain from alcohol and cigarettes for 1 week after the surgery

8. In general, patient will not experience intense pain after the surgery, except in case that the ear is pressed

9. Patient can wash their hair 2-3 days after the bandage is removed

10. During the first 2 weeks, avoid using hair dryer as this might affect the wounds

11. During the first 4 weeks, refrain from some activities such as wrestling

12. Patient can go to work the next day after the surgery

13. Patient should avoid strenuous sports for 1 week

14. In child, it is recommneded to remain inactive for 7 days and avoid sports and gymnastics for 2 weeks

15. In general, ear surgery does not cause too much bruising or swelling

16. Swelling will improve after 2-4 weeks

17. Use saline solution to clean the wounds. Apply antiseptic around the back of earlobe daily and use bandage and hairband to cover the wound. After 1 week, the bandage can be removed and patient can use hairband directly on the wound

18. During the first 2 weeks, it is recommended to sleep on your back and avoid sleeping on your ear

Possible Problems After the Surgery

* Ear surgery aims to create attractive natural looking ears, but in some cases the ears are folded too far, making them appear unnatural and unattractive 

* Over folded ear will make Anti Helix stick out. This might result from irregular large and deep Concha that was left uncorrected

* Telephone ear – is a result from asymmetrical surgery on cartilage as the upper and lower cartilage are left uncorrected 

 

 

 

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