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If
You're Considering Ear Surgery...
Ear surgery, or otoplasty, is
usually done to set prominent ears back closer to the head or to
reduce the size of large ears.
For the most part, the operation
is done on children between the ages of four 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.
If you're considering ear surgery
for yourself or your child, this information will give you a basic
understanding of the procedure-when it can help, how it's performed,
and what results you can expect. It can't answer all of your
questions, since a lot depends on your individual circumstances.
Please be sure to ask your doctor if there is anything you don't
understand about the procedure.
All
Surgery Carries Some Uncertainty and Risk
When ear surgery is performed by
a qualified, experienced surgeon, 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.
Planning For Surgery
Most surgeons recommend that
parents stay alert to their child's feelings about protruding ears;
don't insist on the surgery until your child wants the change.
Children who feel uncomfortable about their ears and want the
surgery are generally more cooperative during the process and
happier with the outcome.
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.
Where The Surgery Will Be Performed
Ear surgery is usually performed
as an outpatient procedure in a hospital, a doctor's office-based
surgical facility, or a freestanding surgery center. 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.
Types of Anesthesia
If your child is young, your
surgeon may recommend general anesthesia, so the child will sleep
through the operation. For older children or adults, the surgeon may
prefer to use local anesthesia, combined with a sedative, so you or
your child will be awake but relaxed.
The
Surgery
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.
Getting Back to Normal
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 anesthesia wear off.
The patient's head will be
wrapped in a bulky bandage immediately following surgery to promote
the best molding 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.
Other Ear Problems
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.
More Natural-Looking Ears
Most patients, young and old
alike, are thrilled with the results of ear surgery. But keep in
mind, the goal is improvement, not perfection. Don't expect both
ears to match perfectly-perfect symmetry is both unlikely and
unnatural in ears. If you've discussed the procedure and your
expectations with the surgeon before the operation, chances are,
you'll be quite pleased with the result.
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