Ear
surgery, or otoplasty, is usually done to set prominent ears back closer to the
head or to reduce the size of large ears.
Most surgeons recommend that parents stay alert to their child鈥檚 feelings about protruding ears; don鈥檛 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.
For
the most part, the operation is done on children between the ages of聽5 and
14, as ears are almost fully grown by age 5. At the Royal Children's Hospital we do not allow referrals under age 5.聽
If
you鈥檙e considering ear surgery for your child, this information
will give you a basic understanding of the procedure-when it can help, how it鈥檚
performed, and what results you can expect. It can鈥檛 answer all of your
questions, since a lot depends on your child's individual circumstances. Please be sure
to ask聽your surgeon if there is anything you don鈥檛 understand about the
procedure.
More natural-looking ears
Most
patients are thrilled with the results of ear surgery.
But keep in mind, the goal is improvement, not perfection. Don鈥檛 expect both
ears to match perfectly-perfect symmetry is both unlikely and unnatural in
ears. If you鈥檝e discussed the procedure and your expectations with聽your
surgeon before the operation, chances are, you鈥檒l be聽pleased with the
result.
Things to consider
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. Cartilage has memory and rarely
recurrence of the deformity can occur.
Planning for surgery
In
the initial meeting, your surgeon will evaluate your child鈥檚 condition, and
recommend the most effective technique. Your surgeon will also give you
specific instructions on how to prepare your child for surgery if required.
Where will the surgery be performed?
Ear
surgery is usually performed as a day procedure. Occasionally, your surgeon may
recommend that the procedure be done as an inpatient procedure, in which case
you can plan on your child staying overnight in the hospital. One adult may stay with your child overnight.
Type of anaesthesia
Our
surgeons recommend general anaesthesia, so your child will sleep through the
operation.
Other ear problems
Besides
protruding ears, there are a variety of other ear problems that can be helped
with surgery. These include: 鈥渓op ear,鈥 when the tip seems to fold down and
forward; 鈥渃upped ear,鈥 which is usually a very small ear; and 鈥渟hell ear,鈥 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鈥檚 worse than the original
problem. Ask your surgeon about the effectiveness of surgery for your child's specific
case.
Procedure
details
The surgery
Ear
surgery usually takes about 1 鈥 1 1/2 hours, although complicated procedures
may take longer. The technique will depend on the problem.
With
one of the more common techniques, the surgeon makes an 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
Children
are usually up and around within a few hours of surgery. It is rare to stay in
hospital overnight for this type of surgery.
The
patient鈥檚 head will be wrapped in a bulky bandage immediately following surgery
to promote the best moulding and healing. The ears may throb or ache a little
for a few days, but this can be relieved by medication.
After
a week, the bulky bandages will be removed. Occasionally, your surgeon will
suggest wearing a headband, full time immediately following removal of the bandages, and then at night for a further period of time.
Stitches
will usually dissolve in about a week.
Any
activity in which the ear might be bent should be avoided for a month or so.
Children can go back to school after seven days or so, if they鈥檙e careful about
playground activity. You may want to ask your child鈥檚 teacher to keep an eye on
your child for a few weeks.