If you're
considering ear surgery...
Ear surgery,
or otoplasty, is usually done to set
prominent ears back closer to the head
or to reduce the size of large ears.
For the
most part, the operation is done on
children between the ages of four and
14. Ears are almost fully grown by age
four, and the earlier the surgery, the
less teasing and ridicule the child will
have to endure. Ear surgery on adults is
also possible, and there are generally
no additional risks associated with ear
surgery on an older patient.
If you're
considering ear surgery for yourself or
your child, this information will give
you a basic understanding of the
procedure-when it can help, how it's
performed, and what results you can
expect. It can't answer all of your
questions, since a lot depends on your
individual circumstances. Please be sure
to ask your doctor if there is anything
you don't understand about the
procedure.
All surgery carries
some uncertainty and risk
When ear
surgery is performed by a qualified,
experienced surgeon, complications are
infrequent and usually minor.
Nevertheless, as with any operation,
there are risks associated with surgery
and specific complications associated
with this procedure.
A small
percentage of patients may develop a
blood clot on the ear. It may dissolve
naturally or can be drawn out with a
needle.
Occasionally, patients develop an
infection in the cartilage, which can
cause scar tissue to form. Such
infections are usually treated with
antibiotics; rarely, surgery may be
required to drain the infected area.
Planning for
surgery
Most
surgeons recommend that parents stay
alert to their child's feelings about
protruding ears; don't insist on the
surgery until your child wants the
change. Children who feel uncomfortable
about their ears and want the surgery
are generally more cooperative during
the process and happier with the
outcome.
In the
initial meeting, your surgeon will
evaluate your child's condition, or
yours if you are considering surgery for
yourself, and recommend the most
effective technique. He or she will also
give you specific instructions on how to
prepare for surgery.
Where the surgery
will be performed
Ear
surgery is usually performed as an
outpatient procedure in a hospital, a
doctor's office-based surgical facility,
or a freestanding surgery center.
Occasionally, your doctor may recommend
that the procedure be done as an
inpatient procedure, in which case you
can plan on staying overnight in the
hospital.
Types of
anesthesia
If your
child is young, your surgeon may
recommend general anesthesia, so the
child will sleep through the operation.
For older children or adults, the
surgeon may prefer to use local
anesthesia, combined with a sedative, so
you or your child will be awake but
relaxed.
The surgery
Ear
surgery usually takes about two to three
hours, although complicated procedures
may take longer. The technique will
depend on the problem.
With one
of the more common techniques, the
surgeon makes a small incision in the
back of the ear to expose the ear
cartilage. He or she will then sculpt
the cartilage and bend it back toward
the head. Non-removable stitches may be
used to help maintain the new shape.
Occasionally, the surgeon will remove a
larger piece of cartilage to provide a
more natural-looking fold when the
surgery is complete.
Another
technique involves a similar incision in
the back of the ear. Skin is removed and
stitches are used to fold the cartilage
back on itself to reshape the ear
without removing cartilage.
In most
cases, ear surgery will leave a faint
scar in the back of the ear that will
fade with time. Even when only one ear
appears to protrude, surgery is usually
performed on both ears for a better
balance.
Getting back to
normal
Adults
and children are usually up and around
within a few hours of surgery, although
you may prefer to stay overnight in the
hospital with a child until all the
effects of general anesthesia wear off.
The
patient's head will be wrapped in a
bulky bandage immediately following
surgery to promote the best molding and
healing. The ears may throb or ache a
little for a few days, but this can be
relieved by medication.
Within a
few days, the bulky bandages will be
replaced by a lighter head dressing
similar to a headband. Be sure to follow
your surgeon's directions for wearing
this dressing, especially at night.
Stitches
are usually removed, or will dissolve,
in about a week.
Any
activity in which the ear might be bent
should be avoided for a month or so.
Most adults can go back to work about
five days after surgery. Children can go
back to school after seven days or so,
if they're careful about playground
activity. You may want to ask your
child's teacher to keep an eye on the
child for a few weeks.
Other ear problems
Besides
protruding ears, there are a variety of
other ear problems that can be helped
with surgery. These include: "lop ear,"
when the tip seems to fold down and
forward; "cupped ear," which is usually
a very small ear; and "shell ear," when
the curve in the outer rim, as well as
the natural folds and creases, are
missing. Surgery can also improve large
or stretched earlobes, or lobes with
large creases and wrinkles. Surgeons can
even build new ears for those who were
born without them or who lost them
through injury.
Sometimes, however, the correction can
leave a scar that's worse than the
original problem. Ask your surgeon about
the effectiveness of surgery for your
specific case.
More
natural-looking ears
Most
patients, young and old alike, are
thrilled with the results of ear
surgery. But keep in mind, the goal is
improvement, not perfection. Don't
expect both ears to match
perfectly-perfect symmetry is both
unlikely and unnatural in ears. If
you've discussed the procedure and your
expectations with the surgeon before the
operation, chances are, you'll be quite
pleased with the result.
