Precision in Otoplasty: Combining Reduction Otoplasty with Traditional Otoplasty

Goals/Purpose: Otoplasty for prominent ears is a routine procedure. A significant percentage of patients requesting otoplasty, however, have some degree of macrotia in addition to protruding ears. This clinical scenario requires ear reduction in addition to traditional otoplasty. There are relatively few studies in the literature that describe ear reduction, and those that do describe smaller subsets of patients.  The authors present a series of otoplasty patients over a three-year period in which 36% underwent ear reduction in addition to traditional setback otoplasty. 

Methods/Technique: A retrospective review was performed of the senior author’s otoplasty procedures from 2010 to 2013.  Charts were reviewed for patient demographics, pre-operative assessment, surgical technique used, complications, and need for revision. All otoplasty procedures, primary or secondary, were included in the series. 

Results/Complications: Over a three-year period, 84 total otoplasty procedures were performed.  Of these, 30 patients had some degree of scaphal reduction as a component of the otoplasty.  Nineteen of the patients had an otoplasty previously but were not completely satisfied. Complications were limited to suture protrusion behind the ear. None of the patients in this series have required re-operation.

Conclusion: Scaphal reduction to modify the contour of the upper auricle and/or decrease the overall size of the ear is a valuable adjunct to otoplasty. This technique may be indicated in a significant percentage of patients presenting for otoplasty.