Background: Many techniques have been described to correct prominent ears,
including cartilage-suturing, cartilage-scoring, and cartilage-breaking tech-
niques. Understanding the topography and anatomy of the auricular cartilage
is crucial for performing safe otoplasty with consistent results.
Methods: Two hundred consecutive patients with prominent ears were operat-
ed on using a modified Mustardé and Furnas technique with some refinements
and without performing any cartilage scoring or excision. Adequate dissection
and exposure of cartilage and precise repositioning of the tail of helix (cauda
helicis) are keys to correction of lobule prominence without the need for any
adjunctive procedures such as skin excision from the back of the lobule or
suture fixation of the lobular tissues to the concha, mastoid, or scalp. Detailed
description of the technique and review of the complications are presented.
Results: This suturing-only technique had a low complication rate. Hematoma
occurred in two patients only. Skin necrosis and wound dehiscence were not
reported in any patient. Suture extrusion was the most common complication
and was easily managed, mostly in the clinic. Relapse of deformity needing
surgical correction occurred in eight cases.
Conclusions: The series demonstrates that most of the potential complications
of otoplasty can be avoided and favorable results can be obtained by paying
attention to the anatomical details of the deformity and the auricular cartilage
anatomy. The described cartilage-sparing otoplasty procedure with the refine-
ments outlined resulted in a reproducible natural correction, with a low risk
profile, that can be applied to almost all prominent ears.