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Otoplasty Surgical

Otoplasty denotes the surgical and non-surgical procedures for correcting the deformities and defects of the pinna (external ear), and for reconstructing a defective, or deformed, or absent external ear, consequent to congenital conditions (e.g. microtia, anotia, etc.) and trauma (blunt, penetrating, or blast). The otoplastic surgeon corrects the defect or deformity by creating an external ear that is of natural proportions, contour, and appearance, usually achieved by the reshaping, the moving, and the augmenting of the cartilaginous support framework of the pinna. Moreover, the occurrence of congenital ear deformities occasionally overlaps with other medical conditions (e.g. Treacher Collins syndrome and hemifacial microsomia).

History

Otoplastic surgery was first practiced and established in Asia, by Sushruta, an Indian Ayurvedic physician. (ca. 800 BC)

Otoplasty (surgery of the ear) was developed in ancient India, in the 5th century BC, by the ayurvedic physician Sushruta (ca. 800 BC), which he described in the medical compendium, the Sushruta samhita (Sushruta’s Compendium, ca. AD 500). In his time, the physician Sushruta and his medical students developed otoplastic and other plastic surgical techniques and procedures for correcting (repairing) and reconstructing ears, noses, lips, and genitalia that were amputated as criminal, religious, and military punishments. The ancient Indian medical knowledge and plastic surgery techniques of the Sushruta samhita were practiced throughout Asia until the late 18th century; the October 1794 issue of the contemporary British Gentleman’s Magazine reported the practice of rhinoplasty, as described in the 5th-century medical book, the Sushruta samhita. Moreover, two centuries later, contemporary otoplastic praxis, slightly modified, derives from the techniques and procedures developed and established in antiquity, by the Indian ayurvedic physician Sushruta.

Surgical

The corrective goal of otoplasty is to set back the ears so that they appear naturally proportionate and contoured, because they are harmoniously set back, without evidence or indication of surgical correction. Therefore, when the corrected ears are viewed, they should appear normal, from the:

  • Front perspective. When the ear (pinna) is viewed from the front, the helical rim should be visible, but not set back so far (flattened) that it is hidden behind the antihelical fold.
  • Rear perspective. When the pinna is viewed from behind, the helical rim is straight, not bent, as if a “letter-C” (the middle-third to flat), or crooked, as if a hockey stick” (the earlobe is insufficiently flat). If the helical rim is straight, the setback is harmonious; that is, the upper-, middle-, and lower-thirds of the pinna will be proportionately setback in relation to each other.
  • Side perspective. The contours of the ear should be soft and natural, not sharp and artificial.

Otoplasty Minimun Age

Timing otoplastic correction the ear deformity to be corrected determines the advantageous timing of an otoplasty, for example, in children with extremely prominent ears, 4-years old is a reasonable age. In cases of Macrotia associated with prominent ears, the child’s age might be 2-years, nonetheless, it is advantageous to restrict the further growth of the deformed ear. Moreover, regardless of the patient’s age, the otoplasty procedure requires that the patient be under general anaesthesia.

The ear defect or deformity to be corrected determines the otoplasty techniques and procedures to be applied, thus, a torn earlobe can be repaired solely with sutures; a slight damage to the rim of the pinna (outer ear) might be repaired with an autologous skin graft harvested from the scalp, yet conversely, a proper ear reconstruction might require several surgeries. In the correction of infantile ear defects and deformities, the otoplasty usually is performed when he or she is about six years old, because, at that age, the healthy ear is almost adult-sized, and thus can serve the plastic surgeon as a corrective template for the auricular reconstruction.

For more information go to Wikipedia.

Photo Credit: On Pixabay, CC0 License.

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