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Ear surgery, or otoplasty,
is usually done to set prominent ears back closer to the head or to
reduce the size of large ears. Besides protruding ears, there are a
variety of other ear problems that can be helped with surgery. These
include: "lop ear," when the tip seems to fold down and forward;
"cupped ear," which is usually a very small ear; and "shell ear,"
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's worse than the original problem.
Ask your surgeon about the effectiveness of surgery for your
specific case.
For the most part, the
operation is done on children between the ages of 4 and 14. Ears are
almost fully grown by age four, and the earlier the surgery, the
less teasing and ridicule the child will have to endure. Ear surgery
on adults is also possible, and there are generally no additional
risks associated with ear surgery on an older patient.
Ear surgery usually takes
about two to three hours, although complicated procedures may take
longer. The technique will depend on the problem.
With one of the more common
techniques, the surgeon makes a small 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.
Risks
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.
Before and after surgery
In the initial meeting, your
surgeon will evaluate your child's condition, or yours if you are
considering surgery for yourself, and recommend the most effective
technique. He or she will also give you specific instructions on how
to prepare for surgery.
Ear surgery is usually
performed as an outpatient procedure in a hospital, a doctor's
office-based surgical facility, or a freestanding surgery centre.
Occasionally, your doctor may recommend that the procedure be done
as an inpatient procedure, in which case you can plan on staying
overnight in the hospital.
If your child is young, your
surgeon may recommend general anaesthesia, so the child will sleep
through the operation. For older children or adults, the surgeon may
prefer to use local anaesthesia, combined with a sedative, so you or
your child will be awake but relaxed.
Adults and children are
usually up and around within a few hours of surgery, although you
may prefer to stay overnight in the hospital with a child until all
the effects of general anaesthesia wear off.
The patient's 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.
Within a few days, the bulky
bandages will be replaced by a lighter head dressing similar to a
headband. Be sure to follow your surgeon's directions for wearing
this dressing, especially at night.
Stitches are usually
removed, or will dissolve, in about a week.
Any activity in which the
ear might be bent should be avoided for a month or so. Most adults
can go back to work about five days after surgery. Children can go
back to school after seven days or so, if they're careful about
playground activity. You may want to ask your child's teacher to
keep an eye on the child for a few weeks.
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