Ears are part of our interaction and communication with our environment. The ears consists of three parts, the inner ear, middle ear, and the outer ear. The auricle forms the outer ear and collects incoming sounds and allows them to pass into the middle ear. The ear, which is functionally important enough to change our lives, is an organ with a high aesthetic value, affecting the external appearance of the person in terms of ear aesthetics and location.
Prominent ear is an anatomical disorder characterized by a large angle between the auricle and the skull. It is seen at a rate of 10% in childhood and genetic features are at the forefront. When viewed from the front and from the back, there is an opening between the head and the ear. The distance between the skull and the ear is 1-1.5 cm is considered normal. The discrepancies above this vary from person to person, but are considered prominent ears.
The ear shape begins to develop from infancy and is mostly completed until 5-6 years of age. From this age on, children enter into social life as they start school. As they gain new circle of friends, the number of people they are in contact with increases. Children with prominent ear problems are emotionally affected by the criticism of their friends about their prominent ears and mocking themselves in the new environment they enter. Even if they are not in infancy, children with prominent ears begin to experience social problems at school age and beyond.
Such problems can negatively affect the psychology of children in development and adolescence.
Structure and Anatomical Features of the Ear
Ears consist of three main parts:
- inner ear
- middle ear
- outer ear
The part outside the skull is the outer ear and is made up of cartilage. Unlike many cartilage structures in the body, it has a thin, curved structure. The formation of this curved structure and its stability at certain angles are the characteristics of both the cartilage and the muscles and ligaments that keep it stable from behind.
Why Prominent Ear Occurs
The outer ear, which is formed while in the mother's womb, continues its development and growth until the end of adolescence, like other body structures. However, unlike the others, the outer ear completes 80-90% of its normal size around the age of 5 years. In this process, the deterioration of the cartilage structure forming the ear and the insufficiency of the muscles and ligaments that give the ear angulation cause the prominent ear to form.
It is generally congenital.
Before the Operation
Since prominent ear surgery can be performed under local or general anesthesia, the points to be considered before the operation vary. Before either types of anesthesia, the person should consult with the surgeon in detail for detailed physical examination and measurements. During the consultation, the patient is informed in detail by the surgeeon about the procedure to be done, the results to be obtained and the possible risks. The patient who has any health problems that prevent surgery or the recovery should share with the surgeon.
If the patient takes blood thinners, it is better to discontiniue at least 5 days before the procedure to prevent possible bleeding problems during and after the operation.
How Is the Threatment?
Although it has been tried to treat congenital prominent ear problem in very early ages with bandages and pressures on the ear, most babies cannot get results. Because the formation of ear cartilage is not related to the structure of the cartilage itself. There are muscle and connective tissues behind the ear that shape these cartilages. These are either absent or unable to function enough in people with prominent ears. Therefore, during the surgery, support should be provided not only to retract the ear, but also to form cartilage recesses and protrusions. These supports are mostly made with the help of long-lasting threads. However, the surrounding muscle and connective tissues are used in order to assist the threads. Surgery is usually performed after the age of 5 years. Because by the age of 5, the ear structure development reaches 80-90% of the an adult ear. There is no upper limit for the age of surgery, but the following should be considered.
- 1. Ear structure and growth should be at a appropriate level. (After 5 years old)
- 2. It should be done before starting school, if possible, so that the child is not adversely affected psychologically.
- 3. Under normal conditions, there is no upper age limit for prominent ear surgery.
Anesthesia for Otoplasty
Local anesthesia is mostly preferred for prominent ear surgeries.
Local anesthesia is mostly preffered to be used for adult patients. Before otoplasty surgeries performed under local anesthesia, the patient can be hospitalized on the day of the operation without requiring fasting, and after the necessary analyzes and examinations are made, the operation starts.
Otoplasty surgeries under general anesthesia is preffered for school-age children and patient who prefer general anesthesia. Before the operation that will be performed under general anesthesia, the patient is required to fast. The patient should stop eating and drinking at least 6 hours before the surgery. Patient who do not have any problems preventing anesthesia is free to be hospitalized on the same day of the operation day and have the necessary analyzes and examinations before the surgery.
After the operation, the patients, who underwent the operation under local anesthesia, can return home to rest on the same day. The patients, who underwent the operation under general anesthesia should stay at the hospital for one night due to anesthesia.It is enough to use painkillers for a few days after the procedure.Since the newly shaped cartilages are kept fixed with threads, sports bandanas are used until the ear sticks with the tissues. This period is approximately 6 weeks.Since dissolvable sutures are used during the operation, it is not necessary to remove stitches after the operation.
Otoplasty Surgery Prices
Otoplasty Prices depend on
- The type of anesthesia to be applied,
- The methods to be used,Whether one or both ears is operated,
- There are different problems other than the auricle,
- Hospital standarts,
- Length of stay at the hospital,
When will I be able to see the results?
After the dressings are removed, you will see an immediate difference in the ear, although some residual swelling may remain.
What are the benefits of otoplasty?
It can help increase your self-esteem and confidence, especially if you have noticeably protruding and large ears.
What is the ideal age to have otoplasty surgery?
There’s no exact ideal age when it comes to receiving otoplasty surgery. In fact, most children around the age of 4 or 5 are eligible to undergo the surgery if their ears are fully developed.
What age is a suitable for ear aesthetic in children?
People also partially complete ear development at age 5. Until the age of 5, it is not necessary to intervene in the ear.
When can the patient start to work or return to daily life?
Until a day or two after ear surgery, pain can be managed with painkillers. Depending on the technique of the operation performed later, a bandana is worn. With this bandana, the patient can easily return to normal life. In some surgical techniques, the patient can return to his daily life without having to wear a bandana.
How long will it take for the ear to get the final state?
As in many surgical operations, we can see the final shape of the ear after 3 to 6 months.
What should be considered after the operation?
Post-operative cartilage infections should be avoided. Because cartilage infection spreads very fast and cartilage is a condition that can erupt. For this reason, the dressings should be used with great care and given antibiotics regularly. Also, it is not suitable to put on the ear for a week.
Is there a chance that surgery will be repeated in the old periods?
There is 10% to 20% of change. In this case, surgery may need to be repeated.
What are the risks of ear aesthetic?
In these surgeries, there are two important risks in general: first, because of a poorly executed operation, some issues may occur. Secondly, cartilage infections should be avoided.
What is laser-assisted otoplasty?
Prominent ear surgeries (otoplasty) incision is made from behind the ear, and many different tools can be used to make this incision like: With scalpel, cautery, laser or sapphire and its not right to say that one of these tools is better than the other.
Small bleeding during the incision is normal and the amount of bleeding does not change according to the cutting tools used. Resulting Bleeding from the skin cut during the operation is not the point of attention, the real point of attention is the incisions made to intervene in cartilage.
Cartilage incision must be made very carefully, otherwise the vessels on the cartilage may be damaged and intense bleeding may occur.
Whether the incision is made with laser or other cutting tools, the vessels on the cartilage must be cauterized.
Laser-assisted otoplasty attracts great attention because it sounds easier and painless, but contrary to popular belief, postoperative wound healing process may take more time than wound healing process when the operation performed using scalpel.
How can I know that I have prominent ears (bat ears)?
Ears with a space of 1-1.5 cm between the skull and the ear when viewed from the front and sides are considered bat ears.
Is there a non-surgical solution for prominent ears (bat ears)?
The definite solution is surgiacal solution. Many people hide their ears using hair, hats or scarves to avoid surgery, but these are not permanent solutions.
When should the surgery be performed?
Surgery is recommended at preschool period after the child’s ears growth is completed. Because school children are cynical, they might make fun of the child or call him/her with a sarcastic nicknames which can negatively affect the child's psychology.
However, it is common for families not to see the bat ears of their children as a problem and not working on correcting it, Therefore, according to the researches carried out, most otoplasty surgeries are performed in puberty and adulthood period.
Will I have a scar after otoplasty surgery?
Incisions are made behind the ear during surgery therefore its not easily seen. As time goes by, these scars will be mostly not visable within a period of 6-12 months.