title: Comparison of two incisionless otoplasty techniques for prominent ears in children.
abstract: OBJECTIVE
  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, auriculocephalic 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±5.6min in Group 1 (Haytoglu et al.'s) and 19±4.7min 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.
authors: Adana Numune Training and Research Hospital, ENT Clinics, Adana, Turkey.
authors: Suheyl
authors: S
authors: Haytoglu
authors: Istanbul Training and Research Hospital, Department of Plastic, Reconstructive and Aesthetic Surgery, Istanbul, Turkey.
authors: Tahir Gokhan
authors: TG
authors: Haytoglu
authors: Kırıkkale University, Faculty of Medicine, ENT Department, Kırıkkale, Turkey. Electronic address: nbayarmuluk@yahoo.com.
authors: Nuray
authors: N
authors: Bayar Muluk
authors: Adana Numune Training and Research Hospital, ENT Clinics, Adana, Turkey.
authors: Gokhan
authors: G
authors: Kuran
authors: Adana Numune Training and Research Hospital, ENT Clinics, Adana, Turkey.
authors: Osman Kursat
authors: OK
authors: Arikan
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D054644:Ear Auricle / Q000002:abnormalities* / Q000601:surgery*; D004425:Ear Cartilage / Q000473:pathology / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D061646:Operative Time; D017060:Patient Satisfaction; D011446:Prospective Studies; D019651:Plastic Surgery Procedures / Q000379:methods*; D013536:Suture Techniques; D016896:Treatment Outcome
keywords: Auriculocephalic distance; Global aesthetic improvement scale (GAIS); Incisionless otoplasty; Prominent ears; Visual analogue scale (VAS)