The London Centre for Ear Reconstruction
Ear Deformity
The correction of serious ear deformity (microtia, cryptotia and total or partial ear loss through trauma, failed surgery or cancer) is an exacting task. Mr Gault no longer works within the NHS but his work is recognised by a number of PCT’s as eligible for NHS funding. Your GP should be able to advise you of your options under the Patient Choice scheme.
A deformed ear may be apparent at birth or soon after, or may be acquired later in life through trauma, piercing, surgery or cancer, for example. In the first year or two of life, many ear deformities can be corrected by moulding using Ear Buddies™ splints, avoiding teasing and surgery later.
Prominent (sticking out or bat) ears
Bat ears can be corrected at birth or soon after by moulding with Ear Buddies™ splints. After the age of 5, otoplasty or pinnaplasty can be performed under local or general anaesthetic. A suture technique is safest, minimising the risk of haematoma and infection associated with anterior scoring.
before
afterEar reduction
Sometimes the ear is too large in all dimensions. Other ears are too tall and thin, and in some only the upper third is out of balance, so that it looks like an upturned pyramid. Using an incision hidden in the folds of ear, usually just inside the rim, the ear can be re-modelled into a more attractive shape.
before
afterLobe reduction
It is possible to make large ear lobes smaller. By incorporating an ill-placed or unwanted piercing hole, this patient had a combined ear and ear lobe reduction with elimination of an unattractive piercing.
before
afterEar piercing problems
Piercing holes can elongate, particularly when heavy earrings are worn, and eventually the ear lobe splits. Piercing of the upper ear can lead to infection and even ear loss, requiring reconstruction.
before
afterLop ear and Cup ear
If uncorrected by moulding using Ear Buddies™ splints at birth, a lop ear can be corrected by surgery later. Moulding using Ear Buddies™ splints may improve a cup ear, but when the tissues are severely constricted, they must be surgically released.
before
afterCryptotia (the hidden ear)
Moulding using Ear Buddies™ splints can correct cryptotia if started early enough. Surgical release is possible later in life.
before
afterFolded-over helical rim
If uncorrected by moulding using Ear Buddies™ splints at birth, a folded-over helical rim can be corrected by surgery later.
before
afterRim augmentation
The rim of the ear can be augmented using a dermis graft.
before
afterCorrection of deformity due to anterior scoring surgery for bat ears
The safest technique for correction of prominent ears employs sutures (above). Although anterior scoring surgery can be successful in most cases, haematoma formation is unpredictable, and in a small but significant number of cases, the ear becomes severely deformed. Other complications of anterior scoring surgery include tethering of the ear (telephone ear) and buckling of the rim.
before
afterTotal ear reconstruction is sometimes necessary (see here).
before
afterRelevant publications
Gault DT and Rothera M
Management of Congenital Deformities of the External and Middle Ear
- a chapter for Scott Brown’s Otorhinolaryngology, Head and Neck Surgery, 7th Edition Arnold
Gore S, Myers S, Gault D
Mirror ear: a reconstructive technique for substantial tragal anomalies or polyotia
Journal of Plastic, Reconstructive and Aesthetic Surgery 59, 499-504 2006
Ridings P, Gault DT and Khan L. (l994)
Reduction in post operative vomiting after surgical correction of prominent ears
British Journal of Anaesthesia - 72 : 592 - 593
Horlock N, Misra A, Gault D.
The postauricular fascial flap as an adjunct to Mustarde and Furnas type otoplasty.
Plastic and Reconstructive Surgery 108: 6 1487 - 1490, 2001.
Tan ST & Gault DT. (1994)
When Do Ears Become Prominent?
British Journal of Plastic Surgery 47: 573 - 574
Tan ST, Shibu MM & Gault DT. (1994)
A Splint for Correction of Congenital Ear Deformities
British Journal of Plastic Surgery 47 : 575 - 578
Gault DT, Grippaudo FR & Tyler M. (1995)
Ear Reduction
British Journal of Plastic Surgery 48: 30 - 34
Gault DT. (1995)
Invited commentary on:
Congenital anomalies of the auricle: correction through external splints
European Journal of Plastic Surgery 18: 291 - 292
Laing H & Gault DT. (1995)
Bat Ears - A European Perspective
Christmas Edition of the British Medical Journal 311: 1715
Graham KE & Gault DT. (1997)
Endoscopic Assisted Otoplasty: a preliminary report
British Journal of Plastic Surgery 50: 47-55
Horlock N, Grobbelaar AO & Gault DT. (1998)
5-year Series of Constricted (lop & cup) Ear Corrections: Development of the mastoid hitch as an adjunctive technique
Plastic and Reconstructive Surgery 102: 2325-2332
Graham KE and Gault DT. (1998)
Clinical Experience of Endoscopic Otoplasty (Letter)
Plastic & Reconstructive Surgery 102:2275
Gault DT. (1998)
Ear Splintage
Face 5: 211-212