Prominent ears (ears which stick out) are one of the most common cosmetic defects. Usually this defect affects both ears, although the angle at which they stick out does not have to be the same on both sides. Children with prominent ears can be targets of bullying, which can cause psychological problems. It is important to tailor treatment to the individual patient to ensure optimal timing of surgery.
Usually, a child starts to be aware of the defect after starting school, so we often deal with the problem between the ages of 5 to 7. We never perform the procedure on a child that absolutely rejects the surgery and when the desired treatment is more the parent's wish than the child's. In such cases, we postpone treatment until the child decides it is happy to have the procedure, as surgery can be performed even in later years. Prominent ears are caused by an abnormal curvature of part of the ear cartilage. The ear is then flattened and the angle it sticks out increases to 150 degrees and more.
The surgery needs no special preparation. The patient should not take drugs that influence blood clotting or bleeding for 3 weeks before the procedure, which is usually performed under local anaesthesia. In certain cases, when the treatment is performed under general anaesthesia or analgosedation, it is necessary not to eat, drink or smoke from midnight on the day of the operation. The patient needs to be in a good state of health. We postpone surgery in the case of skin inflammation, acne, eczema, fungal skin infection or poor health.
The aim of surgery is to create a natural looking ear, with all structures in their natural position without visible marks of surgical intervention. One of the methods is navicular excision of part of the skin on the back of the ear. The cartilage is filed down using a small grinder or also with the help of parallel cuts into the cartilage. The most important phase of the surgery is fashioning the cartilage into the right shape and tightening it adequately. After closing the incision behind the ear, external removable sutures are sometimes added to shape the ear. The head is bandaged completely upon completion of surgery. Another method is to make rounded cuts on the front side of the cartilage followed by suturing.
The head will be re-bandaged 1 to 2 days after surgery and left for 10 to 14 days. A hair band is then used at night or when playing sports for another month.
Complications after ear pinning are not frequent. They can be of a surgical nature, e.g., swelling, infection, necrosis, wound diastasis, or specific to the treatment, e.g., prolonged swelling or redness of the ear, reduced sensitivity, sutures falling out and recurrence of prominent ears, deformity and hypertrophic scarring.
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