Surgical Otoplasty Definition and Indications

Surgical otoplasty is a surgical procedure to reshape damaged ears so that they will appear back as normal, without any evidences or indications that they have been medically changed. After performing a surgical otoplasty, a person’s ear should be normal viewed from front perspective (the helical rim should be clearly visible), rear perspective (the helical rim is straight), and side perspective (the contours of the ear should be soft, not sharp). The perfect timing to undergo a surgical otoplasty depends on how is the ear deformity. For example, kids with pointy ears can perform a surgical otoplasty on age 4 or more. General anaesthesia is required before performing surgical otoplasty.

Ear reconstruction

The general procedure of surgical otoplasty is collecting a costal cartilage graft from the rib cage of the patient and sculpting it into the auricular framework placed under the temporary skin on the head of the patient. The skin envelope will then encompass the cartilage framework, or the ear prosthesis. After that, the surgeon will create an outer ear shape called pinna based on natural proportions and appearance of normal ears. It takes some months to perform a follow-up surgery, in which the surgeon starts to create the earlobe and put the now reconstructed pinna off the side of the head. It then reforms into a small round projection placed next to the external entrance of the ear, called a tragus.

Under certain circumstances which do not allow this general procedure to be performed (like when there is not enough cartilage to be collected), a technique called Antia Buch helical advancement may be applied. First, the surgeon creates a design of an incision inside the helical rim and around the shank of the helix, using ink. The skin and the cartilage are then cut without piercing the rear skin behind the ear. Then, let the helical rim suture and remove the graft of skin from behind the ear.

Indications

There are many indications of ear deformity necessary to be treated with surgical otoplasty. The right method of surgical otoplasty depends on which indications of ear deformity appear:

• Cagot ear: Ear without an earlobe, commonly caused by genetic. Mostly found in northern Spain and western France, among Cagot people.
• Cat’s ear: Outer edges of the ears folded away from the head sides towards the face, just like a cat’s ear.
• Cauliflower ear: Ear deformity caused by repetitive injuries to the tissues, making the blood in the ear to have the tendency to be cartilaginous, making the ear looks like a cauliflower. Mostly happens to boxers and wrestlers.
• Cleft earlobe: An indentation or notch on the fleshy part of the ear lobe.
• Constricted ear: An ear deformity where, in the most damaged case, makes the shank of the helix to go out of the concha. Some other case includes the shank to be advanced into the helical rim.
• Cryptotia: The rim of the helix cartilage in ear buried under the skin of the head, making the ear looks a little bit hidden.
• Darwinian ear: An ear deformity in which the conchal bowl of the ear is flat, not folded inwards. It derives from the name of Britis biologist and evolutionary theoretician, Charles Darwin.
• Lop ear: An ear deformity characterized by a too-small cartilage stiffened rim of the ear and a large depression near the ear opening part. This overall characteristic makes the ears look like a cup.
• Macrotia: Ears whose size proportion is significantly bigger than the person’s head.
• Microtia: The opposite of macrotia; ears whose size proportion is significantly smaller than the person’s head. It is because either a mild underdevelopment or an absence of the outer ear.
• Question Mark Ear: This is a rare ear deformity. It is characterized by an indentation between the earlobe and the outer cartilage rim of the external ear.
• Scroll ear: A congenital ear deformity in which the outer part of the ear curled down, up, and back against the head.
• Skin cancer and malignant melanoma: Melanoma appears on the ear. In this case, the Antia-Buch surgical otoplasty technique may be applied.
• Stahl’s ear deformity: Ear looks pointed rather than rounded, and the skin and the cartilage of the ear folded abnormally, making the ear looks like an elf.
• Wildermuth’s ear: Ear with the curved cartilage border face backwards, deformint he ear by protruding the inner ridge of the ear. This indication found by Hermann A. Wildermuth and thus named after him.

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