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Comparison of Cartilage Scoring and Cartilage Sparing Techniques in Unilateral Otoplasty: A Ten-Year Experience

Szychta, Pawel MD, PhD*†; Stewart, Ken J. MD, FRCS(Ed)(Plast)*

doi: 10.1097/SAP.0b013e3182503c38
Head and Neck Surgery

We identified the optimal operative technique of unilateral otoplasty among cartilage-scoring or posterior-suturing methods. All unilateral otoplasties repaired in South East Scotland in 10 years were analyzed. Using visual analog scale, outcomes were scored by blinded professional panel and by patients. Case notes were interrogated for postoperative complications. Of 81 patients, 40 with full photographic records were included in the study. Cosmetic outcomes and symmetry scores in patients who underwent posterior suturing with fascial flap were significantly better than cartilage scoring and posterior suturing without fascial flap. Early complications were significantly more common in cartilage-scoring and posterior-suturing techniques without fascial flap than posterior suturing with fascial flap. In conclusion, posterior suturing with fascial flap represents cosmetically superior technique in unilateral otoplasty. It allows for intraoperative adjustment of posterior sutures, resulting in symmetric ears. The technique seems to be associated with fewer short-term complications, often responsible for pediatric patient distress.

From the *Department of Plastic and Reconstructive Surgery, Royal Hospital of Sick Children, Edinburgh, United Kingdom; and †Research Institute, Department of Oncological Surgery and Breast Diseases, Polish Mother’s Memorial Hospital, Poland.

Received June 20, 2011, and accepted for publication, after revision, February 13, 2012.

Conflicts of interest and sources of funding: none declared.

Reprints: Ken J. Stewart, MD, FRCS(Ed)(Plast), Department of Plastic and Reconstructive Surgery, St John’s Hospital, Howden Road West, Livingston, West Lothian EH54 6PP, United Kingdom. E-mail:

© 2013 by Lippincott Williams & Wilkins