Double Triangular Cartilage Excision Otoplasty

Alessandro Gualdi, Janos Cambiaso-Daniel, Jonatann Gatti, Paul Wurzer, Michaela Sljivich, Saja S. Scherer, Giorgio Pietramaggiori, Dario Bertossi, Chiara Botti, Giovanni Botti

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Abstract

Background: Prominent ears have a negative impact on patients’ psychosocial well-being. There are numerous surgical correction techniques described, but the majority have high complication and recurrence rates. In this article, the authors present a stitchless technique that takes advantage of different approaches to minimize complications and recurrences. Methods: The authors prospectively studied patients who underwent a bilateral double triangular cartilage excision otoplasty in an outpatient setting. This prominent ear setback technique is based on a specific cartilage excision to mechanically collapse the ear without using any sutures through the cartilage. Postoperatively, surgical complications were classified according to the Clavien-Dindo classification. The patient-reported outcome was analyzed after completion of a questionnaire 6 months after surgery, and another clinical follow-up appointment was arranged 12 months after surgery. Results: Sixty patients (120 ears) with an average age of 24 years were studied, and the overall complication rate was 6 percent. Three ears (2.5 percent) developed superficial cutaneous necrosis at the anterior concha, and one ear (1 percent) required an additional correction for unsatisfactory pinna rotation. Also, 2.5 percent of the patients experienced a grade I complication, and 1 percent of the patients experienced a grade IIIa complication according to the Clavien-Dindo classification. No wound infections, hematomas, or hypertrophic scars were observed, and the patient-reported outcome showed satisfaction with the results. Conclusions: The authors’ findings show that the double triangular cartilage excision otoplasty is a safe procedure with low complication/recurrence rates. This stitchless technique should be included in each surgeon’s repertoire as an alternative to previously published surgical techniques. CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, IV.

Original languageEnglish (US)
Pages (from-to)348e-356e
JournalPlastic and Reconstructive Surgery
DOIs
StateAccepted/In press - Mar 1 2018
Externally publishedYes

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ASJC Scopus subject areas

  • Surgery

Cite this

Gualdi, A., Cambiaso-Daniel, J., Gatti, J., Wurzer, P., Sljivich, M., Scherer, S. S., Pietramaggiori, G., Bertossi, D., Botti, C., & Botti, G. (Accepted/In press). Double Triangular Cartilage Excision Otoplasty. Plastic and Reconstructive Surgery, 348e-356e. https://doi.org/10.1097/PRS.0000000000004175