Discussion
auricular deformities, hematomas, auricular deformity, hypertrophic scars, infections, infection, hematoma, Keloids
HEMATOMAS, RECURRENCE, INFECTIONS, INFECTION, COLLAPSE, HEMATOMA, COMPLICATIONS, COMPLICATIONS
The complications of otoplasty are uncommon. Keloids, hypertrophic scars, infections and hematoma can occur. Converse, in 570 ears studied, reported 1.2% infection rate, 0.8% recent postoperative hematoma, 2.1% keloid formation in Caucasians and 11% in people of African descent.For years, hundreds of techniques have been described to correct auricular deformities.There are two possibilities to correct the conchal hyperdevelopment, mastoid fixation and conchal resection. The conchal degree of development should be analyzed. The conchal-mastoid sutures described by Furnas are effective in mild to moderate deformities, where the conchal height reaches up to 2.5 cm.Excisions with partial conchal removals, addressed by retroauricular access, tend to have a guarantee of non-recurrence, with more predictable results of the distance between the edge of the helix and the retroauricular region.The cartilage preservation technique is more conservative when compared to cartilage resection. They are ideal for patients with flexible cartilage and minimal and/or moderate deformities. Complications, such as post-surgical hematomas, are rare in these cases, in addition to decreasing management and surgical time. A greater example would be the master sutures discussed classically by Mustarde.The resection techniques aim to eliminate the cartilage memory to modify the shape of the ears. Therefore, it is described as a technique to avoid recurrence. They are more suitable for patients who have rigid cartilage structure with increased thickness. However, they may lead to important asymmetries.The combination of procedures could be one of the reasons that contribute to the maintenance of long-term stable distances between the edge of the helix and the retroauricular region, as in the eclectic technique, described by Maniglia, allowing a more natural and lasting result.There are countless reasons to associate the concha and anti-helix correction. The eclectic technique removes the concha along the suture of the remaining cartilage in the mastoid region, preventing the narrowing or collapse of the external auditory canal.There is no consensus in the literature on the superiority of one technique. Toplu et al.,Our study obtained a similar result as described by Panettiere, since no statistical significance was found between the two techniques six months after the operation. Observing the differences between the cephalo-auricular angle and the scapho-conchal angle, it was noted that both techniques make the ear aesthetically acceptable. For the cartilage preservation technique, a significant difference was found between the measurements before and after six months (Our study is based on a sample size including two groups of ten patients each, representing the surgical intervention of 40 ears, which outcomes were analyzed by proper statistical methods. Hence, even considering that analyzing a sample size larger than the one used in our study can bring new perspectives concerning our findings, our results remain helpful for surgeons and further research on otoplasty.A careful analysis of the type and degree of auricular deformity is necessary to choose the best surgical technique. The choice also depends on the experience of the surgeon, who must obtain lasting and natural results. Both surgical and non-surgical approaches continue to require more research.The eclectic technique with conchal remaining suture in the mastoid region proved to be effective in protruding ear correction. It provides anchoring precision in the pinna. Through fixation, retro positioning combined with superior rotation gives a natural and singular aesthetic aspect, with unnecessary incisions or cartilaginous interruptions and the consequent risk to the unwanted healing result. The low prevalence of complications allows us to disseminate this technique. Surgical revisions, if necessary, are limited and accurate, usually easy to perform.