Ear Correction

Ear Correction, medical term Otopexy, describes the correction of protruding ears, the correction of asymmetries, or the reduction of strongly pronounced auricles through a surgical procedure. The decision for an intervention on the ears is usually made for aesthetic reasons. In certain cases functional restrictions may also require correction.

Abnormalities of the ear are mostly congenital and arise during embryonic development. In many cases an inadequately developed anthelix fold (vault of the auricle) or excess cartilage is present in the ear area. One speaks of protruding ears when the ears protrude at an angle greater than 30 degrees from the head or when the distance between the head and the ear is over 2 centimeters.

Protruding ears cause an enormous suffering for many affected persons. The unwanted protruding ears are often covered under suitable haircuts for fear of ridicule. Concerned persons typically had to endure mocking and teasing because of their ears since their childhood. Self-esteem can be impaired even at a young age and in the adult age a lower self-assurance feeling can result.

In order to avoid psychological stress during childhood and other consequences, it is usually advisable to have the protruding ears corrected before school enrollment. The optimal time for an otopexy is between the 5th and 6th year of life; however, it can also be performed in adult age.

Surgical Methods of Ear Correction

For the correction of protruding auricles, there are three conventional standard techniques:

In case of the Mustardé technique, first a skin incision is made on the backside of the auricle. Subsequently, the physician shapes the auricle and puts it into an optimal position by pulling it with a thread. Then the ear gets fixed at this position with a permanent suture. An advantage of this method is that the cartilage is hardly weakened because no additional incisions are made and no carving is performed. Thus permanent deformations can be practically excluded.

The Converse technique basically follows the same scheme. In order to make the cartilage more easily shapable and to reduce the tension of the later-inserted thread, however, incisions are also made in the cartilage. Once the ear is satisfactorily shaped, it is held in position with degradable sutures. This type of ear correction surgery allows for a particularly precise shaping of the ear cartilage.

In the Sternström technique, the property of cartilage to bend in the opposite direction after carving is utilized. Thus, the auricle attaches itself independently to the head without requiring a suture. This technique is not suitable for all patients due to the reduced elasticity of cartilage with increasing age.

While the standard techniques involve risks such as deformation, persistent numbness, inflammation of the cartilage or the wound, etc., the newer special technique for ear correction, the thread method, is more gentle. This minimally-invasive procedure does not require incisions into the skin and uses permanently remaining sutures, which hold the ear in position. The procedure takes about 15 to 30 minutes. In contrast to the standard techniques, bandages are not necessary after the procedure. The cartilage, however, is only deformed and not shaped, which is why it may regain its original position after some time.

Which of the techniques is most appropriate in the individual case is decided in the course of a consultation and depends on the type of the malformation and its manifestation. In children, surgery for ear correction is usually carried out under general anesthesia, whereas adults require only local anesthesia or twilight sleep.