With the advancement of modern surgical techniques, patients requiring ear reconstruction, or any other corrective ear surgery, can now expect good outcomes, with aesthetically satisfying results.
As with all surgery, however, there are no guarantees of success, and patients are advised to consult NHS ear specialists via the national centres of excellence when thinking about ear surgery of any kind.
The goal of corrective ear surgery is to restore balance to the face and shift unwanted attention away from prominent or misshapen ears. With fears about teasing at school, parents are often keen to have their children’s ears operated on at an early age. However, a child’s opinion, consent and cooperation are essential to a successful and satisfying cosmetic outcome. For this reason, many surgeons prefer to wait until a child is older to perform ear surgery.
What conditions might affect a patient in this area?
Conditions that affect people’s ears can be divided into two areas: congenital, meaning those conditions that people are born with, and ‘acquired’, meaning those that develop later in life due to accident or infection.
The main congenital conditions that affect people’s ears are:
• Prominent ears
• Cryptotia and other ear deformations
These conditions are explained in more detail in their own information guides- click the links above
The main acquired conditions are:
• Ear thickening or‘cauliflower’ ears
• Infection of the ears
• Skin cancer of the ear
The loss or damage of ears through trauma is now more common in UK than ever before and sadly more common than in any other country. Most ear-trauma injuries are caused by biting, but some are also due to sharp lacerations. Attempts to replant ears in an emergency environment often yield poor results. Following a surgical ‘tidy up’, the damaged area is left to heal, and is then reconstructed using the same surgical methods described for the treatment of microtia.
Acute swelling of the ear following trauma is usually due to a collection of blood clot (haematoma) under the skin. This should be dealt with as an emergency by surgical drainage through a small skin incision. In neglected cases the blood can become scarred and calcified leading to a thickened so called ‘cauliflower ear’. Such deformity is common in boxers and rugby players. Surgeons usually recommend that patients finish their sporting careers before seeking treatment. Treatment usually requires elevating the skin from the front of the ear and thinning the calcified thickened tissue to recreate the ear shape. A compressive dressing is applied.
Infections of the ear, often relating to piercings, are treated on a case-by-case basis. Unfortunately piercing of the cartilaginous part of the ear can result in late infection and loss of ear structure. This may then necessitate ear reconstruction with rib cartilage.
Skin cancer of the ear is usually treated by surgical excision and reconstruction, as described in the head and neck cancer information guide
Is ear surgery available on the NHS?
All interventions and procedures outlined in this section, both surgical and non-surgical, are usually available on the NHS – particularly where children are concerned. The correction of prominent ears in adults may need to be assessed on a case-by-case basis.
What surgery is available, and what techniques are involved?
As well as otoplasty, the term used to describe the surgical correction of prominent ears and ear reconstruction, splintage can be used, particularly in babies.
The cartilage in a baby’s ear is very soft and malleable, and can be moulded with the use of splints if prominent ears are obvious from birth. Splints are fitted into the outer groove (scaphoid fossa) of the ear and fixed by strips of tape, with the ear then taped to the side of the head using a broad strip of tape. The pressure of the splint corrects the tendency of the ear to stick out, while maintaining the proper contours of the ear. To be effective, splints can be required for as little as two weeks in newborn babies, or for up to four months in babies aged six months or over. However, parents should be careful with babies over the age of three months, as the splints themselves can present a choking hazard.
Splintage is a simple, safe and non-invasive procedure for the correction of prominent ears. However, there is only a limited window of time in which splints can be effectively applied. The decision to use splints is an aesthetic decision that ultimately rests with parents.
For more information on ear splints, go to the Ear Buddies website