Well, otoplasty is basically called ear pinning. It’s fairly common. It depends on the person’s practice, their orientation, and their specialty. It fits more into facial plastic surgery than anything else.
It’s a congenital problem. Children are born with this. We probably do roughly one case a month. We enjoy doing it, and patients appreciate the results.
The ear abnormalities are usually one of three possibilities. It can be the external ear, this part right here, or it can be the actual cartilage of the ear that positions it either further away from the head or closer to the head.
One is a cartilage issue. That’s the ear positional thing. The other is the ear fold issue. So, a person can have one of those problems, or they can have both of those problems.
Motivation for otoplasty is more or less psychological, to be quite honest. People are made fun of when they have big ears. And that’s the bottom line. You do see people in society with big ears who grow old, and they adapt, and they seem to be fine with that.
Many people, especially in the childhood years, developmental years, do get made fun of at school, and that’s probably the biggest motivation for fixing.
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During the consultation of otoplasty. I first ask the patient, why? What’s your motivation? What brought you to this at this point in time?
That’s interesting is sometimes we’ll see people who are much older, in their 30s, sometimes 40s, and now they decide to get their ears fixed. And you’d wonder why not when you were a child, because clearly you probably had concerns way back then. So we ask them that what brings you to this point.
Even though I can look at the ear and say, Okay, here I see these problems, it’s more important to know what the patient is concerned about. They might just be concerned about the fold up here. They might be concerned about the ear being too far away from the head, or both. And so we go through that so that we match their concerns with the procedure.
The surgery can be performed on all age groups. Again, there tends to be a trend towards a younger age, as children become aware of themselves in school, particularly grade school and junior high, and there’s criticism about their prominent ears.
That would that would be the the primary age group, younger, maybe as young as five, but in the range to early teens. And then occasionally, rarely will see people in their 30s or 40s.
There are two primary surgeries on a prominent ear.
There’s what’s called the Davis procedure, and I’ll go through that with you.
The Davis procedure addresses the excess cartilage in the ear that causes the year to come away from the head. The conchal cartilage, located inside the ear, resembles a kidney bean shaped bowl.
The Davis procedure removes excess tissue from the base of this bowl that allows the air to be repositioned, so it lies in a more normal position closer to the head.
So that’s the Davis procedure. That addresses what we call conchal bowl cartledge hypertrophy.
The second issue is what’s called lack of an antihelical fold. All of us should have a little crease or a fold right here, which determines where the tip of the ear sits.
If there’s no fold there, no antihelical fold, the ear will come out and stick out. We’re talking about the top of the ear, not the whole ear that we addressed with the Davis procedure.
So this loss of antihelical fold is recreated by what’s called the Mustarde Procedure.
The Mustarde Procedure constructs a fold where there is none on the external ear. This fold is created by measuring, marking and then stitching into place with permanent sutures to create a more natural looking fold.
And it’s basically done with permanent stitches that fold the top of the ear back in and create that antihelical fold.
The safety aspects of otoplasty are pretty good, actually. We can do these surgeries under straight local anesthesia if the patient desires. Do Patients Need General Anesthesia for Otoplasty? Probably 90% of the procedures we do are under what we call twilight anesthesia, where they’re not awake, but they’re not asleep. And, then we numb up the ear, so there’s no feeling, there’s no sensation. Occasionally we’ll be asked to put somebody under general anesthesia. Safety aspects in part are dictate
A person who’s healthy is going to have a better outcome than somebody who’s unhealthy. Sometimes people ask about age, they’ll say, well, am I too old for the surgery?
The length of time for an otoplasty again, depends on what you have to do. If you have to do the Davis and the Mustarde procedure, then you’re probably going to be about two and a half to three hours. The other two probably cut it in half, so an hour and a half for each if they’re just done separately.
The two procedures in question the Davis and the Mustarde procedures are considered permanent. at is 100% correct for the Davis procedure because we remove the cartilage, and never grows back.
Op. Dr. Okan Parmaksız is here to offer you the highest quality aesthetic and functional solutions in the field of rhinoplasty and otoplasty.
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