Long-term results of posterior suturing with postauricular fascial flap otoplasty.
BACKGROUND
Posterior suturing with postauricular fascial flap otoplasty has previously been shown to be associated with a significantly reduced rate of complications and better aesthetic outcome when compared with the anterior scoring and posterior suturing techniques. This study evaluates the long-term results of this technique.


METHODS
A retrospective casenote analysis of all paediatric patients who underwent otoplasty within a four-year period were retrieved. Sixty patients (112 ears) met the inclusion criteria (mean age 8.5 years; range 4 to 14). The perpendicular distance from the mastoid to the helical rim at the Frankfort line was recorded preoperatively and immediately postoperatively. Patients were invited to a follow up clinic where further measurements were taken by two observers. Photographs were evaluated by an independent blinded observer.


RESULTS
The clinical recurrence rate was 4.5%. Thirty patients (57 ears) attended the follow-up clinic (mean 3.9 years since surgery). Mean loss of medialisation was 0.7 mm (6.2%), with loss of medialisation of > or =1 mm seen in 26 ears (46%), and improvement in medialisation of > or =1 mm in 15 ears (26%). Mean visual analogue scores for overall appearance and symmetry were higher at follow-up than at six weeks postoperatively. There was no relationship between measurements or visual analogue scores and duration since surgery.


CONCLUSIONS
In conclusion posterior suturing with braided polyester permanent sutures covered with a postauricular fascial flap results in longevity of postoperative appearance and symmetry with low clinical recurrence rates and with excellent patient and parent satisfaction.
Schaverien
M V
MV
Department of Plastic Surgery, Royal Hospital for Sick Children, Sciennes Road, Edinburgh, UK.
Al-Busaidi
S
S
Stewart
K J
KJ
D002648:Child; D002675:Child, Preschool; D004431:Ear, External / Q000601:surgery; D004954:Esthetics; D005205:Fascia / Q000637:transplantation*; D005260:Female; D006801:Humans; D008297:Male; D013506:Otologic Surgical Procedures / Q000379:methods*; D011183:Postoperative Complications / Q000517:prevention & control; D012189:Retrospective Studies; D013524:Surgical Flaps; D013536:Suture Techniques; D016896:Treatment Outcome