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Aesthetically, the general expectation from the auricle is that it stands unobtrusively on both sides of the head. In other words, the result after prominent ear surgery should not vary from person to person and from doctor to doctor. The ultimate goal to be achieved after surgery is to construct ears that do not attract attention and do not look abnormal.

Prominent ear is the most common congenital ear anomaly and is observed in approximately 5% of Caucasians. Although the physiological consequences are considered insignificant, the psychological and aesthetic consequences on the patient can be significant.

The most common defects requiring surgery are an underdeveloped or absent antihelical fold, separation of the auricle from the scalp, an abnormally large concha (auricular cartilage), and a prominent earlobe.

The history of otoplasty surgery dates back a century and during this time, more than 200 surgical techniques have found their place in the literature. The most important reason why so many surgical techniques have been published in a period of 100 years is that a perfect technique that can be applied to all prominent ears has not yet been defined.


Patient’s Age at Surgery

It is recommended to perform otoplasty surgery in children before they start school. Herein, the aim is to minimize possible mockery and exclusion by peers. However, the psychological violence that children are exposed to in preschool and kindergarten is often underestimated. Due to the changing socioeconomic conditions, the fact that both parents are working, today’s children are starting to attend kindergarten at an earlier age.

It has been shown that otoplasty surgery performed at a young age has no effect on the growth of the ear. Upon reviewing the literature, Adamson et al. showed that the ear reached 85% of its adult size by age 3. Balogh and Millesi concluded that ear growth did not stop after otoplasty. Gosain et al. reported that otoplasty can be performed safely under the age of 4 without any significant effect on ear growth.

The major disadvantage of surgery performed before the age of five is the difficulties associated with dressing, and it is best performed when the child is old enough to cooperate with postoperative care. It should be kept in mind that correction performed before the age of five may complicate the postoperative process and potentially impair the repair.

Its Impact on Quality of Life

Our study with 67 patients who underwent otoplasty surgery in 2014 was published in the internationally reknowned journal of “European Archives of Oto-Rhino-Laryngology”. In this study, the effects of otoplasty surgery on the quality of life were evaluated two years after the operation, and improvement was observed in all subgroups of the patients’ quality of life (emotion, physical health, learning, and vitality) according to the evaluation scales. As a result, it was concluded that the quality of life of the patients increased thanks to otoplasty surgery.

Psychosocial Effects

Our study with 107 otoplasty surgery patients in 2014 was published in the internationally reknowned “The Journal of Laryngology & Otology”. In this study, the psychosocial effects of otoplasty surgery were evaluated two years after the operation, and it was observed that the scores of patients’ anxiety and depression, social problems, thinking difficulties, attention problems, aggressive behaviors, internalization and externalizing problems decreased according to the evaluation scales. As a result, it was concluded that psychological problems related to prominent ears can be reduced with appropriate corrective surgery.

Postoperative Dressing

Ear dressing is a critical stage of surgery. Vaseline petrolatum gauze is carefully placed to support the newly formed folds of the ear and to emphasize its contours, and the ear is wrapped in medium tightness.

The dressings are opened for ear control the next morning of the surgery. On the first day of the operation, the ears are swollen, edematous and purple in color. During the first week following the surgery, the dressing is renewed every other day. On the seventh day, the entire dressing is removed and the patient can take a bath. After removal of dressings, patients are advised to wear a headband every night for one month to prevent accidental trauma at night. Patients are seen at the 1st month, 3rd month, 6th month and 1st year postoperatively.

Surgery for Big Ears (Macrotia)

Macrotia describes ears larger than normal. They can accompany prominent ear deformity or can be observed by itself. After macrotia surgery, the ear is brought to its normal size and can gain an unobtrusive appearance.

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