Otoplasty, or bat ear correction, is a surgical procedure designed to correct a congenital prominence with one or both ears.
In general, prominent ears stick out because of two reasons:
- The antihelical fold or the fold down the middle of the ear has not formed properly during the development of the ear, or
- There is a prominence of the conchal fossa in the middle of the ear.
Either one or both of these abnormalities may be present. It is not unusual for the degree of prominence to be different between the two ears so that one ear sticks out more than the other.
Surgery involves admission to hospital, either as a day case or as a single overnight stay. Following administration of a general anaesthetic under sterile conditions in theatre, local anaesthetic is injected into the ear. An incision is made in the back of the ear to allow access to the cartilage on the front of the ear.
The prominent conchal bowl or conchal fossa is corrected and the antihelical fold or fold is recreated. Usually a number of fine stabilising sutures are also inserted at the same time. A relatively intricate and finely shaped dressing is then applied to all the crevices and troughs within the ear to support and mould the ear in the early postoperative period. Gauze and then bandaging is then placed over the ears, and then this is secured in a bandage around the scalp and both ears.
It is critically important that this bandage stays in place for the next one week to two weeks after surgery.
After surgery, you will be discharged either to a day surgery area or back to the ward to stay overnight. Initially you have no pain in your ears. However, as the local anaesthetic wears off, you will gradually become aware of the return of sensation to your ears and experience some mild pain.
Because the nerve supply to the base of the ear is shared with the nerve to the upper part of your stomach, the early return of sensation to the ear is not infrequently accompanied by a mild feeling of nausea, and in rare cases may even result in vomiting in the early postoperative period.
With modern pharmacology and anaesthesia, it is possible to minimise this nausea. Because of this, it is important that you do not attempt to leave hospital until you have regained full sensation in your ear so that you are not caught feeling car sick on the way home.
The sutures used are dissolving sutures and do not need to be removed. It is critically important that you keep the dressing clean and dry and, most importantly, that you do not attempt to remove the bandages. If you notice undue amounts of pain after you leave hospital, it is important that you contact us so that we can ensure that the bandages are not too tight and are not causing localised pressure in any part of your ear. Do not attempt to remove or undo the bandages by yourself.
In the unlikely event that the bandage becomes dislodged (this is usually after tossing and turning during the night), it is important that you return to hospital so that we can change the bandages. Do not attempt to get your local hospital, your local doctor or your family/ friend to re-apply the bandage.
You would normally be on antibiotics for a period of one week to ten days after surgery.
After this time, you are able to shower and get your hair wet, although it is important that you gently towel your hair dry and possibly use a hair dryer but on the low heat setting.
It is important that you refrain from heavy exercise or from immersion in water such as swimming for ten days after surgery. Do not participate in contact sports during this time.
You will notice after having the bandages removed that there is some mild swelling in your ears on both sides, and this normally resolves over the next two to three weeks.
How do I know if my child is a suitable candidate for having set-back otoplasty?
The important decision here is to make an assessment on whether or not your child will be able to wear the bandages and keep them in place for the ten days after surgery. As mentioned above, this is the most important part of the operation. If you do not believe that your child will tolerate the bandages for the ten days, then we would strongly advise against surgery.
Obviously, do not hesitate to contact us if you have any questions regarding this operation.