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Facial Plast Surg 2025; 41(02): 149-150
DOI: 10.1055/a-2434-6959
Preface

Aesthetic & Reconstructive Otoplasty

Andres M. Gantous 
1   Division of Facial Plastic and Reconstructive Surgery, Department of Otolaryngology-Head and Neck Surgery, University of Toronto Temerty Faculty of Medicine, Toronto, Ontario, Canada
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Andres M. Gantous, MD, FRCSC

It is a great pleasure and honor to have been invited as a guest editor of this volume of Facial Plastic Surgery. The topic of otoplasty and ear reconstruction is fascinating and, like many other procedures in our specialty, subject to change, difference in opinions, and multiple ways of trying to achieve the best results.

Prominent ears are the most common congenital deformity of the head and neck area. Its incidence is 5% in Caucasians as an autosomal dominant trait, but the incidence of auricular deformities has been estimated to be as high as 47% if all births.[1] [2] A common but erroneous belief held by many health practitioners is that the majority ear deformities detected in newborns will correct themselves with time. In truth, only a third of these deformities will self-correct.[3] Another misconception is that these minor cosmetic defects will cause minimal psychological effects or problems of adjustment. In fact, MacGregor has shown that patients with deformities that provoked laughter were objects of ridicule or derogatory nicknames, and the psychological impact was marked.[4]

The term otoplasty refers to any surgical procedure that has as its goal the creation of a normal looking ear and restoration of the normal relationship between the auricle and the head.[1] This type of operation has been performed, in a variety of different ways, for over a thousand years. The earliest descriptions are found in the writings of Shusruta in ancient India in the 7th century and in Bologna in the 16th century. It was Dieffenbach, in 1845, that reported on an otoplasty geared toward the correction of a prominent ear. He described a postauricular skin excision to set the pinna back.[5] Surgeons have modified and attempted a variety of different operations to achieve this goal. During the later part of the 19th century and the early part of the 20th century, the majority of the techniques were based on skin excisions and cartilage incisions in different parts of the ear attempting to correct the prominence of the ear and the recreation of the antihelical fold.[6] [7] [8] [9] [10] [11] [12] In 1958, Gibson and Davis noted that making relaxing incisions in the cartilage resulted in bending of the cartilage to the opposite side.[13] In 1963, Stenstrom described scoring the anterior surface of the cartilage that facilitated the posterior plication and formation of the new antihelix.[14] These techniques certainly improved on the earlier operations, but surgeons began noticing problems such as high recurrence rates, scarring, and sharp antihelical borders.[15] [16] Less invasive techniques were introduced by Mustarde in 1963 and Furnas in 1968 who used suture-based techniques to recreate the antihelical fold and reposition the concha onto the mastoid periosteum respectively.[17] [18] Fritsch was the first to describe the incisionless otoplasty technique in 1992.[19] This procedure has been further modified by him and other authors to simplify it and make it more versatile in treating a wider array of ear deformities.[20] [21] [22] [23] [24]

In this issue, I have tried to compile a variety of otoplasty techniques that are preferred by the different authors, different points of view in microtia reconstruction, a chapter on traumatic ear injuries, one of nonsurgical and early management of ear deformities and one on the management of complications. I trust you will enjoy and find this useful.



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Artikel online veröffentlicht:
24. Oktober 2024

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