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Otoplasty - techniques, characteristics and risks.

Naumann A - GMS Curr Top Otorhinolaryngol Head Neck Surg (2008)

Bottom Line: Apart from reducing the cephaloauricular angle to 15-20°, emphasis on the antihelical fold and a smooth rim of the helix without interruption of the contour are desirable outcomes of this operation.Occasionally, surgical fixation (lobulopexy) may be required to treat protruding lobules or, in rare cases, an additional conchal reduction may become necessary in cases of conchal hyperplasia.Since postoperative complications can often result in severe auricular deformities, as a matter of principle, each ear should be analysed individually regarding its problem areas, and the surgical approach that causes the least injury to the cartilage should be used.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Otorhinolaryngology, Saarland University, Homburg/Saar, Germany.

ABSTRACT
The protruding ear as a minor ear abnormality is found in approx. 5% of the German population and may give rise to serious emotional problems in children and also in adults. In general, the procedure used for the surgical correction of protruding ears (otoplasty) is a combination of incision, scoring and suture techniques. The choice of the surgical procedure is based on the severity of the ear abnormality and the individual characteristics of the auricular cartilage. In children up to the age of ten years, a soft, elastic or easily pliable auricular cartilage is often still present. In this situation, gentle suture techniques, such as a suturing technique described by Mustardé, are frequently enough to achieve a cosmetically good and lasting result. In adults, the auricular cartilage has already become stiff. Therefore, a combination of incision, scoring and suture techniques is usually required. Apart from reducing the cephaloauricular angle to 15-20°, emphasis on the antihelical fold and a smooth rim of the helix without interruption of the contour are desirable outcomes of this operation. Occasionally, surgical fixation (lobulopexy) may be required to treat protruding lobules or, in rare cases, an additional conchal reduction may become necessary in cases of conchal hyperplasia. Since postoperative complications can often result in severe auricular deformities, as a matter of principle, each ear should be analysed individually regarding its problem areas, and the surgical approach that causes the least injury to the cartilage should be used.

No MeSH data available.


Related in: MedlinePlus

Anatomy of the auricle
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Figure 1: Anatomy of the auricle

Mentions: The auricle (pinna) and the external auditory canal are part of the external ear. The fine contour of the ear is determined by the form and shaping of the elastic auricular cartilage, which is covered by a skin with fine pores. The lobule itself does not contain any cartilage, but is mainly composed of adipose and connective tissue. The funnel formed by the auricle extends into the slightly curved external auditory canal, which consist of a lateral cartilaginous portion and a medial bony portion [1]. The complex shape of the auricle is determined by the individual form of the helix, the antihelix, the antihelical scapha, the antihelical crura, the tragus, the antitragus, the cavum conchae, the cymba conchae, and the lobule (Figure 1 (Fig. 1)). As early as in week 4 of gestation, the auricle, the auditory canal and the middle ear form from an ectodermal protuberance of the first two branchial arches. The auricle develops from hillocks of the second branchial arch with the formation of the lobule, the antihelix, and the dorsocaudal portion of the helix. In contrast, the cartilage of the tragus is formed from the first branchial arch [2]. Therefore, in case of an incomplete fusion of the aggregations of the branchial arches, malformations of the external ear and the middle ear can already develop during the embryonic stage.


Otoplasty - techniques, characteristics and risks.

Naumann A - GMS Curr Top Otorhinolaryngol Head Neck Surg (2008)

Anatomy of the auricle
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC3199845&req=5

Figure 1: Anatomy of the auricle
Mentions: The auricle (pinna) and the external auditory canal are part of the external ear. The fine contour of the ear is determined by the form and shaping of the elastic auricular cartilage, which is covered by a skin with fine pores. The lobule itself does not contain any cartilage, but is mainly composed of adipose and connective tissue. The funnel formed by the auricle extends into the slightly curved external auditory canal, which consist of a lateral cartilaginous portion and a medial bony portion [1]. The complex shape of the auricle is determined by the individual form of the helix, the antihelix, the antihelical scapha, the antihelical crura, the tragus, the antitragus, the cavum conchae, the cymba conchae, and the lobule (Figure 1 (Fig. 1)). As early as in week 4 of gestation, the auricle, the auditory canal and the middle ear form from an ectodermal protuberance of the first two branchial arches. The auricle develops from hillocks of the second branchial arch with the formation of the lobule, the antihelix, and the dorsocaudal portion of the helix. In contrast, the cartilage of the tragus is formed from the first branchial arch [2]. Therefore, in case of an incomplete fusion of the aggregations of the branchial arches, malformations of the external ear and the middle ear can already develop during the embryonic stage.

Bottom Line: Apart from reducing the cephaloauricular angle to 15-20°, emphasis on the antihelical fold and a smooth rim of the helix without interruption of the contour are desirable outcomes of this operation.Occasionally, surgical fixation (lobulopexy) may be required to treat protruding lobules or, in rare cases, an additional conchal reduction may become necessary in cases of conchal hyperplasia.Since postoperative complications can often result in severe auricular deformities, as a matter of principle, each ear should be analysed individually regarding its problem areas, and the surgical approach that causes the least injury to the cartilage should be used.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Otorhinolaryngology, Saarland University, Homburg/Saar, Germany.

ABSTRACT
The protruding ear as a minor ear abnormality is found in approx. 5% of the German population and may give rise to serious emotional problems in children and also in adults. In general, the procedure used for the surgical correction of protruding ears (otoplasty) is a combination of incision, scoring and suture techniques. The choice of the surgical procedure is based on the severity of the ear abnormality and the individual characteristics of the auricular cartilage. In children up to the age of ten years, a soft, elastic or easily pliable auricular cartilage is often still present. In this situation, gentle suture techniques, such as a suturing technique described by Mustardé, are frequently enough to achieve a cosmetically good and lasting result. In adults, the auricular cartilage has already become stiff. Therefore, a combination of incision, scoring and suture techniques is usually required. Apart from reducing the cephaloauricular angle to 15-20°, emphasis on the antihelical fold and a smooth rim of the helix without interruption of the contour are desirable outcomes of this operation. Occasionally, surgical fixation (lobulopexy) may be required to treat protruding lobules or, in rare cases, an additional conchal reduction may become necessary in cases of conchal hyperplasia. Since postoperative complications can often result in severe auricular deformities, as a matter of principle, each ear should be analysed individually regarding its problem areas, and the surgical approach that causes the least injury to the cartilage should be used.

No MeSH data available.


Related in: MedlinePlus