Operation for lop-earedness is considered a forced measure in case of severe anomaly of the shells: in humans, the angle between the skull and ears is increased, the organ is protruding. A congenital anatomical feature is considered an aesthetic defect. Surgical intervention shown with pronounced asymmetry.
When is lop-earedness subject to surgical correction? The severity of the defect
Surgical intervention for lop-earedness is prescribed after a detailed examination of the patient and identification of the degree of the aesthetic defect.
There are several main forms of congenital anomaly:
- Severe (3rd) stage. The defect is pronounced, the auricle is protruded at a right angle;
- Middle (2nd) stage. The defect is visible to the naked eye, the ear is protruding at an acute angle.
- Easy (1st) stage. The defect is practically invisible, the auricle is protruded by no more than 25-30 °.
Lop-earedness is considered a congenital anomaly. The third degree of severity is formed as a result of a poorly developed antihelix. In some cases, it is completely absent. Sometimes patients have a noticeable protrusion of the outer ear caused by an increase in the mass and volume of cartilage.
In some cases, the patient's lobe protrudes. The defect is formed due to the peculiarities of the formation of a curl or an increase in the auricle. Macrotia is also referred to lop-earedness - in humans, the ears look abnormally large. Pathology develops against the background of the rapid growth of the bones of the skull or the organ of hearing itself. The deformity may affect one ear or both. Each case is different
Types of otoplasty
Depending on the degree of lop-earedness, there are several main types of otoplasty:
- cosmetic (aesthetic);
- reconstructive.
Operations differ in terms of type and cost.
Aesthetic otoplasty
Ear surgery for lop-earedness usually takes place under local anesthesia. This type of surgery is indicated for moderate to mild anomalies. Local or general anesthesia is used depending on the patient's age.
This type of operation is considered uncomplicated, but the patient must prepare for the procedure. The attending physician prescribes an examination to identify possible contraindications (including latent infections).
Some medications must be stopped 14 days before the proposed operation:
- blood thinning;
- hormonal;
- anticonvulsants.
In most cases, the operation lasts no more than 2-3 hours.
Reconstructive otoplasty
Reconstructive otoplasty allows you to eliminate gross congenital or trauma-acquired defects. Patients should remember that it is impossible to achieve complete symmetry in both ears. To achieve optimal results, it is necessary to reconstruct the right and left ear.
It is recommended to completely abandon alcoholic beverages and tobacco products 30 days before the proposed operation in order to minimize the risk of complications.
Before reconstructive otoplasty, the patient must pass a number of tests:
- blood for Rh factor and group;
- blood for creatinine, bilirubin, protein and sugar;
- blood clotting rate;
- analysis for drug compatibility;
- blood for hepatitis B, C in AIDS, syphilis and other sexually transmitted diseases;
- blood chemistry.
During reconstructive otoplasty, the doctor cuts the skin along the back of the ear. Excess skin and cartilage tissue is excised, the plastic surgeon models the correct position of the shell. The cartilage is fixed, sutures are applied. In most cases, they do not need to be removed, the catgut dissolves on its own. The edges of the skin are sutured. The operation takes an average of 4-6 hours.
Indications for surgery
Otoplasty is indicated not only for protruding ears. Partially lost hearing can be restored through surgery.
The main indications for conducting are considered:
- internal tears and ear injuries;
- psychological aspect;
- pronounced asymmetry;
- smoothness of the anterior part of the shell or antihelix;
- an increase in the distance between the back of the head and the ear;
- no result after correcting the shape of the ears by a non-operative method.
Most often, aesthetic or reconstructive otoplasty is used by people who experience psychological discomfort with lop-eared. They don't like the size and shape of the auricle.
Contraindications
Reconstructive and aesthetic otoplasty has a number of contraindications.
These include:
- AIDS;
- HIV;
- growth of benign or malignant neoplasms;
- poor blood clotting;
- thyrotoxicosis and other pathologies of an autoimmune nature;
- diabetes;
- the period of gestation and breastfeeding;
- menstruation;
- skin rashes in the area of surgical intervention;
- pathology of the chronic course in the stage of exacerbation.
The operation is not performed for people suffering from diseases of infectious etiology. If the patient has recently had ARVI or ARI, then it is recommended to postpone surgery for 2-3 weeks.
What methods are used?
There are several main methods for correcting protruding ears.
These include:
- shift of the shell back;
- antihelix fix.
Operations vary in technique. The type of surgical intervention is selected by a specialist depending on the severity of the aesthetic defect.
Shift back method
The classic way to fix a defect involves a number of manipulations. The plastic surgeon disinfects the affected area by wiping the skin with an alcohol solution. An incision is made on the back of the ear (1.5-2 cm).
Excess tissue is excised, the cartilage is most often partially removed and given the desired shape. The specialist applies seams no more than 2-3 mm long. The process uses needles of different sizes.
To avoid infection, sterile wipes or a bandage are applied to the seam. To relieve the swelling, an ice compress is applied to the back of the ear. In most cases, the operation is performed under local anesthesia. General anesthesia is rarely used. The duration of the operation varies within 45-120 minutes.
Antihelix deformation correction method
There are two ways to correct the deformation of the antihelix:
- modification of cartilage tissue;
- artificially shaping the antihelix.
In difficult cases, both options are possible. During the operation, plastic surgeons are guided by a number of criteria to simulate the correct size and shape.
Conditional landmarks:
- the projection of the lower point is the tip of the nose, the upper point is the outer corner of the eye;
- lobe length - no more than 20 mm;
- the width and length of a man's ear - 35 35.5 mm and 63-60.5 mm;
- width and length of a woman's ear - 32-3 2.5 mm and 59 mm;
- the angle between the head and the auricle is 90 °;
- the angle of inclination of the organ to the lateral part of the head is no more than 30 °.
By the location of the curl, the specialist determines the bend of the organ.
Preparing for surgery
Before the operation, the plastic surgeon must inform the patient about the course of the operation, the possible result and the various risks. The specialist explains in detail to the person his actions during postoperative rehabilitation. The surgeon must listen to the patient's expectations and come to an agreement with him.
Regardless of the type of otoplasty, taking tests before the procedure is a prerequisite. If no contraindications were found during the examination, the plastic surgeon appoints the exact date of the operation. The patient begins to prepare for the upcoming intervention in 14 days.
It is necessary to completely abandon alcoholic beverages and tobacco products. The usual diet is subject to adjustment: it is necessary to exclude completely fatty, salty, spicy foods, smoked meats and canned food from it. You need to partially limit the amount of salt and sugar consumed. The basis of the diet should be fresh vegetables, fruits, fish and protein products (including lean meat).
72 hours before otoplasty, it is necessary to completely abandon products that reduce blood viscosity:
| Category | Name | Description |
| Vegetables and fruits | Beet | Promotes blood thinning. Contains a large amount of vitamins, minerals and fiber. |
| Garlic | The composition contains phytoncides, selenium, sodium and potassium. Cleans blood vessels and thins the blood. | |
| Ginger | Contains substances that are involved in the formation of blood cells. Iron, manganese, copper normalize hemoglobin levels. | |
| Garnet | Contains amino acids and ascorbic acid. Thins blood, strengthens blood vessels. | |
| Lemon | The composition contains ascorbic acid and vitamin K. breaks down cholesterol and reduces blood viscosity. | |
| Berries | Mulberry | Contains essential oils and phytoncides. Black berries thin the blood. |
| Black currant | The composition contains ascorbic acid, lead, copper, silver and sulfur. The substances help to restore the rheological properties of blood. | |
| Cranberry | The B vitamins present in the composition are responsible for the formation of blood cells. K, PP restore lipid metabolism. | |
| Viburnum | Contains essential resinous oils, minerals and vitamins. Thins the blood. | |
| Soft drinks | Freshly squeezed juices | Before otoplasty, it is recommended to refrain from drinking apricot, pomegranate, orange and apple juices. |
| Cocoa | The drink helps to reduce blood viscosity and restore lipid metabolism. | |
| Green tea | The composition contains antioxidants, minimizing the risk of adhesion of erythrocytes and platelets. | |
| Other products | Kalanchoe and aloe juice | Contains essential oils to help thin and cleanse the blood. |
| Artichokes | The composition contains a large amount of vitamins (group B, K), which reduce blood viscosity. | |
| Gingko-Biloba | The plant stimulates the work of the heart and blood vessels. Essential oils, mineral compounds improve blood flow. | |
| Baking soda | Sodium bicarbonate restores the pH level in blood plasma. | |
| Apple cider vinegar | The composition contains compounds of an organic type that help reduce blood viscosity. | |
| Dried herbs and spices | Turmeric, basil and thyme contain antioxidants that restore blood flow. | |
| Beekeeping products | Honey and propolis contain salts, metals and vitamins that help thin the blood. | |
| Linseed oil | A source of omega-3 fatty acids. The product thins the blood. | |
| Fatty fish | Rich in phosphorus and other minerals. They thin the blood, prevent adhesions of platelets and erythrocytes. | |
| Cereal porridge | Oatmeal, buckwheat porridge help to restore the salt balance of the blood. | |
| Dried fruits | They are high in fiber and fructose. They improve the properties of plasma, thin the blood. | |
| Seeds, nuts | The composition contains essential oils, minerals and vitamins. Reduces blood viscosity. |
On the eve of surgery, the patient is instructed to wash his head and ears. Surgical intervention is performed on an outpatient basis, most often the patient is not admitted to a hospital after surgery. If otoplasty is performed under general anesthesia, then 4 hours before the procedure, the person must completely stop drinking and eating.
Types of operations and their features
There are several main types of otoplasty.
They are classified according to the type of conduct:
- Standard surgery (mechanical intervention). The incision is made with a scalpel. Excess tissue is excised by hand. The procedure takes 2-3 hours, the recovery period after surgery is 2-4 weeks. Scars can remain in the absence of the proper experience of the plastic surgeon.
- Laser intervention. A more modern method, during which the skin is cut with a laser beam. The operation takes 30-60 minutes. Most often, the healing process is faster than the standard method.
With lop-eared, correction without removing the cartilage is popular. After the incision, the cartilage is slightly folded back and fixed with special threads. Closed otoplasty involves the implementation of several punctures that allow access to the cartilage tissue. The type of operation is selected individually, the plastic surgeon must agree with the patient.
Suture technique
Suture otoplasty methods include:
- Furnas's method. During the operation, the area of the skin between the auricle and the skull expires. The cartilage is sutured to the temporal bone. In practice, the procedure is rarely carried out. The technique is indicated for people whose angle between the skull and the auricle is 90 ° or more.
- Mustard's method. During the operation, the correct antihelix is formed. With lop-earedness, it is most often absent. On the back of the ear, several sutures are applied, which form a fold.
- Ethenstrom-Stenstrom technique. This involves making a small incision on the back of the ear. On the front surface, the cartilage becomes thinner, sutures are applied, which allow you to give the auricle the correct shape.
Mustard otoplasty requires the surgeon to have proper experience. If the suture technique is not followed, the cartilage is turned inside out, the upper part of the ear is deformed. Mattress seams can be seen on the surface of the skin.
Seamless technique
The cartilage of the ear is quite elastic. Thanks to this, the plastic surgeon can give the hearing organ the desired shape. With the sutureless method, an incision is made on the back of the ear. The skin and part of the cartilage is excised.
The specialist gives the organ the desired shape without stitching. Several notches can be applied to the outer part of the cartilage.
Laser technique
Laser otoplasty is considered the most modern and effective method for correcting congenital ear anomalies. The procedure is performed under local anesthesia. The duration of the intervention does not exceed 60 minutes. During the operation, the specialist tries not only to give the hearing organ the correct shape, but also to preserve all its anatomical features.
After the procedure is completed, sterile dressings are applied to a part of the ear. The skin is cut with a laser beam. The deformed area of cartilaginous tissue is excised, the auricle is given the desired shape. The edges of the skin are sutured.
If the patient has large ears, then the incision is made on the outer surface. In this case, the cartilage is also excised using a laser.
Do I need to stay in the hospital after the intervention and for how long?
It makes no sense to stay in the hospital for a long time after surgery.If a sutureless operation was performed, then the patient is allowed to go home after 6-8 hours. When using the suture method, the person remains in the medical institution for another 24 hours.
How does it go, how long does the recovery period last, what can and cannot be done?
Ear surgery for lop-earedness does not require long-term rehabilitation. After seamless otoplasty, the rehabilitation period is 2-4 weeks. Recovery after the suture method takes 5-6 weeks. During this time, scars completely dissolve. Rehabilitation is aimed at stimulating regeneration processes, preventing complications and increasing the aesthetic effect.
The operation is considered completely safe. The patient must go to the hospital every 2-3 days. The patient is prescribed bed rest for 4-5 days after surgery. All physical activity should be completely excluded. It is allowed to return to full-fledged work activity 14 days after otoplasty.
Regular dressings minimize the risk of infection of the incision. In a hospital setting, the back of the ear is treated with an antiseptic and gauze soaked in furacilin or hydrogen peroxide is applied to it.
To eliminate pain, pain medications can be prescribed:
- Ketanov.
- Ketorol.
- Nimesil.
Compresses are used to eliminate puffiness. To make the process of tissue regeneration faster, an ointment that stimulates cell division is applied to the skin during dressing (for example, Levomekol). The stitches are removed 6-7 days after the operation, provided that silk threads were applied.
During the late postoperative period (3-4 weeks), the patient should follow a diet. The diet is dominated by easily digestible vegetables and meat rich in protein. It is necessary to completely exclude spicy, fatty and smoked foods. Sports are prohibited for 8 weeks. For the period, the patient is obliged to give up tobacco products and alcoholic beverages.
Avoid direct ultraviolet rays. The head is washed carefully, being careful not to get soap or shampoo on the back of the ears.
Possible complications and re-correction
During the rehabilitation period after otoplasty, a number of complications can be observed.
These include:
- Bleeding. A complication occurs when the vascular walls are damaged. After rupture, blood enters the skin, a hematoma forms.
- Wound infections. If antiseptic and aseptic measures are not followed, the risk of infection penetrating into the deep layers of the skin is quite high. Infection can provoke tissue suppuration.
- Keloid scar formation. A rough scar is formed due to the peculiarities of the skin or in the absence of basic hygiene measures.
Repeated otoplasty may be necessary after several years, despite the fact that during the surgery the specialist completely corrected the shape of the auricle. After an unsuccessful operation, pronounced asymmetry occurs. In this case, it is necessary to re-correct.
How old is otoplasty?
Ear surgery for lop-earedness is performed at any age. It is recommended to undergo a preliminary examination before the intervention. Experts advise to correct the shape of the shell before reaching the age of 14.
Cost of operations
Ear surgery for lop-earedness is considered an affordable procedure.
The cost varies depending on a number of factors;
- type of surgery;
- qualifications of a plastic surgeon;
- the location of the clinic.
In Moscow, St. Petersburg (including Moscow Region and Leningrad Region), the cost of seamless otoplasty starts at 30,000 rubles. Correction of the auricle using the Furnas or Mustard method will cost more - from 50,000 rubles.
Surgery for lop-eared ears is considered completely safe. Subject to medical prescriptions, the risk of complications in the postoperative period is minimal.The most painless is the laser method of otoplasty.
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