Otoplasty for prominent ears with combined techniques

Otoplasty for prominent ears with combined techniques Eur J Plast Surg (2003) 26:149 DOI 10.1007/s00238-003-0517-6 INVITED COMMENTAR Y D. Tolhurst Published online: 21 May 2003 © Springer-Verlag 2003 Sooner or later in one’s practice of plastic surgery one I do support the idea of excising an hourglass-shaped tends to adopt a basic technique for the correction of piece of skin posteriorly, an idea I introduced into my common deformities such as prominent ears. Of course, procedure some 20 years ago as this helps to prevent the when something new comes along that is obviously su- dreaded telephone deformity. Although I have corrected perior, it is worthwhile trying it out and perhaps using it more than 1000 cases, I would not say they have all been as a replacement. The contribution by Bogetti et al. does perfect. Sometimes there has been slight asymmetry or not introduce any new ideas but merely presents a col- a small sharp edge visible in the lateral view. However, lection of various techniques or minor modifications I have been fortunate in never having seen more than with which most of us will be familiar. one minor infection despite not using antibiotics, which All the photos of postoperative results show that the I thus consider unnecessary. ears are very flat or a little overcorrected. By this I mean Excision of conchal cartilage is hardly ever needed if that the helix has disappeared behind the antihelix when one “breaks the springs” and scores the cartilage well viewed from the front. Some normal ears do display this into the concha. This is, of course, performed under configuration but most do not. My preference is for direct vision which is far superior to blind scoring as has the latter, although some patients ask for, or are happy been discussed often in the past. with, the flatter look. The results shown are very sym- The 5 cases in 42 extrusions of buried nylon sutures, metrical and no doubt pleasing for the patients, but it whether or not according to Mustardé, do not commend would be useful in judging the results if lateral views the use of buried nylon in the ear, and I am surprised the were included. idea has not been sent to the recycle bin once and for all. Finally, I must say that the dilemma of whether to use two different nylon suture techniques, excision of con- chal cartilage and removal of muscle as well as the man- An invited commentary to this paper is available at: datory scoring and skin excision in each case makes the http://dx.doi.org./10.1007/s00238-003-0516-7 procedure unattractively complicated when every case of grade 1 and 2 prominent ears can be satisfactorily cor- D. Tolhurst ( ) rected by the Chongchet procedure with an hourglass London, UK e-mail: det@onetel.net.uk skin excision. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png European Journal of Plastic Surgery Springer Journals

Otoplasty for prominent ears with combined techniques

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Publisher
Springer Journals
Copyright
Copyright © 2003 by Springer-Verlag
Subject
Medicine
ISSN
0930-343X
eISSN
1435-0130
D.O.I.
10.1007/s00238-003-0517-6
Publisher site
See Article on Publisher Site

Abstract

Eur J Plast Surg (2003) 26:149 DOI 10.1007/s00238-003-0517-6 INVITED COMMENTAR Y D. Tolhurst Published online: 21 May 2003 © Springer-Verlag 2003 Sooner or later in one’s practice of plastic surgery one I do support the idea of excising an hourglass-shaped tends to adopt a basic technique for the correction of piece of skin posteriorly, an idea I introduced into my common deformities such as prominent ears. Of course, procedure some 20 years ago as this helps to prevent the when something new comes along that is obviously su- dreaded telephone deformity. Although I have corrected perior, it is worthwhile trying it out and perhaps using it more than 1000 cases, I would not say they have all been as a replacement. The contribution by Bogetti et al. does perfect. Sometimes there has been slight asymmetry or not introduce any new ideas but merely presents a col- a small sharp edge visible in the lateral view. However, lection of various techniques or minor modifications I have been fortunate in never having seen more than with which most of us will be familiar. one minor infection despite not using antibiotics, which All the photos of postoperative results show that the I thus consider unnecessary. ears are very flat or a little overcorrected. By this I mean Excision of conchal cartilage is hardly ever needed if that the helix has disappeared behind the antihelix when one “breaks the springs” and scores the cartilage well viewed from the front. Some normal ears do display this into the concha. This is, of course, performed under configuration but most do not. My preference is for direct vision which is far superior to blind scoring as has the latter, although some patients ask for, or are happy been discussed often in the past. with, the flatter look. The results shown are very sym- The 5 cases in 42 extrusions of buried nylon sutures, metrical and no doubt pleasing for the patients, but it whether or not according to Mustardé, do not commend would be useful in judging the results if lateral views the use of buried nylon in the ear, and I am surprised the were included. idea has not been sent to the recycle bin once and for all. Finally, I must say that the dilemma of whether to use two different nylon suture techniques, excision of con- chal cartilage and removal of muscle as well as the man- An invited commentary to this paper is available at: datory scoring and skin excision in each case makes the http://dx.doi.org./10.1007/s00238-003-0516-7 procedure unattractively complicated when every case of grade 1 and 2 prominent ears can be satisfactorily cor- D. Tolhurst ( ) rected by the Chongchet procedure with an hourglass London, UK e-mail: det@onetel.net.uk skin excision.

Journal

European Journal of Plastic SurgerySpringer Journals

Published: Jun 1, 2003

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