Pinnaplasty
Prominent ears
Prominent ears are most often the result of a loss of the fold within the ear called the antihelix and a deep conchal bowl. If noted in the neonatal period, applying splints to keep the ear in place for a few months can correct the deformity. This can be achieved by using a commercial device such as the ear buddy system or simply using steristrips.
At what age can the surgery be performed?
The surgery should only be carried out when the cartilage has started to mature after about 4 years of age and when children have become conscious about the shape of their ears and have expressed a wish to have something done.
How is the surgery (Pinnaplasty) carried out?
Our preferred technique is to use the anterior scoring method where the front surface of the ear cartilage is gently scored “delicate scratches” and this results in the cartilage bending in the opposite direction. The position of the cartilage is secured using sutures.
The cartilage is approached by an incision behind the ear and the skin raised off the back of the ear exposing the cartilage
The ear cartilage is then incised and the front surface of cartilage is exposed.
The anterior (front) surface of the cartilage is scored in the region of the antihelix where there should be a fold. This results in the cartilage bending in the opposite direction.
Sometimes sutures are also used to secure the “bowl” of the ear to the covering of the bone behind the ear to secure it in place (Furness sutures)
Possible complications:
Haematoma (bleeding under the skin) - presents as pain and needs urgent attention as if left untreated, Perichondritis (inflammation) and deformity of the cartilage may occur. If your child needs continual regular pain control then they should be seen to have the dressing removed and the ear checked
Infection as with all surgical procedures, but this is rare.
Sometimes the ears will not be exactly matched as this will depend on the healing process. The position of the ear may also change over time.
What can go wrong?
Bleeding within the tissues of the ear - this can form a blood clot (Haematoma) which may need to be drained. Persistent pain is a sign that this may have occurred and needs urgent attention. If untreated, Perichondritis (inflammation) and deformity of the cartilage may occur. If your child needs continual regular pain control then they should be seen urgently and have the dressing removed and the ear checked
Infection as with all surgical procedures but this is rare.
Sometimes the ears will not be exactly matched as this will depend on the healing process but there should be a noticeable improvement. The position of the ear may also change over time
Extrusion of sutures:
Very rarely the sutures may start to come through the skin. This can happen as the body “ rejects” the stature material
