Correction of Failed Surgery
After set-back (pinnaplasty or otoplasty) surgery to the ear
Currently about one third of all the ear surgeries undertaken by Mr Gault are to correct problems which have resulted from previous procedures, usually to set back the ears, performed at other centres.
Although good results can be achieved even in severe cases of severe ear deformity, patients should be aware that the ear may never look as natural as it might have done had their original surgery been successful.
Safe ear surgery
Any operation around the ear can lead to a destructive infective episode. The ear can be lost after a procedure as simple as eardrum reconstruction. The ear canal is sometimes colonised by potential pathogens, particularly a bacterium called pseudomonas, and great care should be taken to clean the recesses of the ear before surgery. Eczema behind the ear should be treated before surgery as organisms within the rash can lead to significant destruction. Surgery should NEVER be undertaken around the ear area in the presence of a rash.
Problems after anterior scoring surgery
The most common post-surgery problem, however, is related to bleeding which develops after bat ear correction (surgery for prominent ears), after the use of cartilage scoring techniques. Although 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. Total ear reconstruction is sometimes necessary
Bleeding and tight bandages alone can cause tissue loss because of the effects of increased pressure on the tissues. If infection develops in the small pool of blood which collects, then this can worsen matters. The suture technique for correction of prominent ears is the safest, and when combined with a fascial flap (Gault technique), the most reliable. In the United Kingdom, compensation for ear loss after failed pinnaplasty surgery is in the region of £20- 40,000.
Complications of cartilage scoring surgery
- Rim buckling and rim kinks
- Over done set back (telephone ear)
- Loss of balance between the ear thirds
- Long and thin shapes sometimes result
- Ear segments
- Hole in ear
- Destruction of antihelix