Otoplasty techniques in children: a comparative study of outcomes

ANZ J Surg. 2018 Oct;88(10):1071-1075. doi: 10.1111/ans.14386. Epub 2018 May 8.

Abstract

Background: Numerous otoplasty techniques have been described in the literature to correct prominent ears; however, few have focused on the complication rates. We reviewed our experience aiming to assess peri-operative care requirements and complication rates.

Method: We conducted a retrospective review of 207 otoplasty procedures performed in 119 patients over a 5-year period (2009-2014) at the Women's and Children's Hospital, Adelaide. Information pertaining to demographic details, length of stay, otoplasty technique and complications (early and late) were obtained.

Results: In the study period, 97% of the 119 patients had an overnight stay. There was an early complication of 2.2% (return to theatre for bleeding) in the modified Chongchet technique and 0.9% (wound infection) in the Mustarde technique. Late complications included suture extrusion (1.9%) with the Mustarde technique and hypertrophic scarring (2.2%) in the modified Chongchet technique. The recurrence rate requiring revision following modified Chongchet technique was 10% and Mustarde technique was 2.9%. The Mustarde otoplasty technique was associated with a slightly lower antiemetic requirement than the Chongchet technique (3.2 versus 14.3%, P = 0.032). Both techniques had comparable opioid analgesic requirement of 30-35% post-operatively (P = 0.248).

Conclusion: Our results are comparable to the huge variation in available literature. We note the higher revision rate following modified Chongchet technique. Both techniques had a low and acceptable rate of post-operative analgesia and antiemetic requirement. We are considering either otoplasty technique as a day surgery procedure within our unit with the provision of adequate patient support as a safe and economical advance.

Keywords: Chongchet; Mustarde; complication; otoplasty; prominauris; revision.

Publication types

  • Comparative Study

MeSH terms

  • Adolescent
  • Australia / epidemiology
  • Child
  • Child, Preschool
  • Cicatrix, Hypertrophic / etiology
  • Ear, External / abnormalities
  • Ear, External / surgery*
  • Female
  • Hemorrhage / etiology
  • Humans
  • Length of Stay
  • Male
  • Perioperative Care / standards*
  • Plastic Surgery Procedures / adverse effects
  • Plastic Surgery Procedures / methods*
  • Postoperative Complications
  • Recurrence
  • Reoperation / methods
  • Reoperation / statistics & numerical data
  • Retrospective Studies
  • Wound Infection / etiology