Comparison of two incisionless otoplasty techniques for prominent ears in children Suheyl Haytoglu a , Tahir Gokhan Haytoglu b , Nuray Bayar Muluk c, *, Gokhan Kuran a , Osman Kursat Arikan a a Adana Numune Training and Research Hospital, ENT Clinics, Adana, Turkey b Istanbul Training and Research Hospital, Department of Plastic, Reconstructive and Aesthetic Surgery, Istanbul, Turkey c Kırıkkale University, Faculty of Medicine, ENT Department, Kırıkkale, Turkey 1. Introduction Prominent ears are the most common congenital deformity in the head and neck region. Incidence for Caucasians are described about 5% and for microtia, it is 0.01% [1]. Otoplasty is now considered as a procedure with both aesthetic and functional purposes because it can lead a psychological trauma, especially in children being ridiculed by their peers [2]. By the age of 5, the development of the auricle nearly completed, it is an appropriate time to correct the prominent ear before the child start school [3,4]. Otoplasty is one of the most frequent aesthetic surgical procedures in children and adolescents. Several techniques can give satisfactory results, but few address all the components of the prominent ear deformity [5]. International Journal of Pediatric Otorhinolaryngology 79 (2015) 504–510 A R T I C L E I N F O Article history: Received 7 November 2014 Received in revised form 10 January 2015 Accepted 13 January 2015 Available online 20 January 2015 Keywords: Incisionless otoplasty Prominent ears Visual analogue scale (VAS) Global aesthetic improvement scale (GAIS) Auriculocephalic distance A B S T R A C T Objectives: In the present study, we applied two incisionless suture techniques for otoplasty: Haytoglu et al.’s modification of incisionless otoplasty technique and Fritsch’s incisionless otoplasty technique for correction of prominent ears. Methods: In this prospective study, 60 patients with prominent ears were included in the study. In Group 1, 55 ears of 30 patients (25 bilateral and 5 unilateral) were operated with Haytoglu et al.’s modification of incisionless otoplasty technique. In Group 2, 57 ears of 30 patients (27 bilateral and 3 unilateral) were operated with Fritsch’s incisionless otoplasty technique. For comparison of two methods, auriculoce- phalic distances were measured at three levels which were level 1 (the most superior point of the auricle), level 2 (the midpoint of the auricle) and level 3 (level of the lobule) pre-operatively (preop); and measurements were repeated at the end of the surgery (PO 0-day ), 1st month (PO 1-Mo ) and 6th month (PO 6-Mo ) after the surgery, in both groups. Patient satisfaction was evaluated using a visual analog scale (VAS). Moreover, Global Aesthetic Improvement Scale (GAIS) was rated by an independent, non- participating plastic surgeon at 6 months after the surgery. Results: Operation time was 15.9 Æ 5.6 min in Group 1 (Haytoglu et al.’s) and 19 Æ 4.7 min in Group 2 (Fritsch). Hematoma, infection, bleeding, keloid scar formation, sharp edges or irregularities of the cartilage were not observed in any group. Suture extrusion was detected in 14.03% of Group 1 and 16.1% of Group 2. No statistically significant difference was observed between auriculocephalic distances at levels 1–3 of groups at preop, PO 0-day , PO 1-Mo and PO 6-Mo separately. Similarly, difference in auriculocephalic distances (preop values-PO 6-Mo values) was not detected as statistically significant in Groups 1 and 2 at three levels. In both techniques, No statistically significant difference was observed in patient satisfaction at 6th months after the operation which was measured using Visual Analogue Scale (VAS) on 0 to 100 scales. According to GAIS, the patients were rated as 92.9% ‘‘improved’’ and 7.1% ‘‘no change’’ in Group 1; as 94.6% ‘‘improved’’ and 5.4% ‘‘no change’’ in Group 2. Conclusions: Due to the similar results, Haytoglu et al.’s and Fritsch’s incisionless otoplasty techniques are good options in the treatment of prominent ears, especially in pediatric patients with isolated inadequate development of antihelical ridge, and with soft auricular cartilage. ß 2015 Elsevier Ireland Ltd. All rights reserved. * Corresponding author. Tel.: +90 312 4964073/+90 532 7182441; fax: +90 312 4964073. E-mail addresses: nbayarmuluk@yahoo.com, nurayb@hotmail.com (N. Bayar Muluk). Contents lists available at ScienceDirect International Journal of Pediatric Otorhinolaryngology jo ur n al ho m ep ag e: ww w.els evier .c om /lo cat e/ijp o r l http://dx.doi.org/10.1016/j.ijporl.2015.01.014 0165-5876/ß 2015 Elsevier Ireland Ltd. All rights reserved.