Lop Ear/ Otoplasty / Otopexy
The possible abnormalities in the shape of the ear
The cartilage is almost always responsible for abnormalities in shape.
Three factors play a role ( see picture)
The most frequent combination is an unfolded antihelix with an open conchascapal angle.
Timing of the operation
Lop ears are corrected frequently during childhood. It is recommended not to operate on children smaller than 6 years and general anesthesia will be used. Once the children are about 12 local anesthesia can be done. The operation can always be done as an outpatient procedure.A written permission from parent or guardian is needed
How is it done ?
The bandage needs to stay in place for about 4 days, bridging the period where infection could occur.After this period, a tennis band needs to be worn for about 4 weeks to prevent the folding back of the ear during the night.Pain is more prominent in adults but can be reduced with paracetamol 1-2 gr per day for a few days.
.Long and short term complications
This is the most common complication. The ear has a strong vascular supply. Small arteries can start bleeding after surgery.The suture needs to be reopened to identify the bleeding vessel and coagulate it.
Infection is not caused by contamination during the surgery but because of bad hygiene afterwards.It is therefore essential that the bandage should stay in place for about 4 days, to give the wound a chance to close before it can get infected.
An infection of the cartilage gives deformation of the cartilage, so it should be avoided by preventive measures at all costs.I never saw one infection during my career.
Sutures piercing the skin on the back side
I put non resorbable sutures to remodel the ear. The ends of these sutures can - in rare occasions -perforate the skin from the inside and cause small local infections .Depending on the situation, the old sutures are replaced with new sutures.They are not replaced in case the new cartilaginous structure is solid and does not't need further support.