Non-surgical Ear Pinning Otoplasty

Prominent ear is not an uncommon deformity with 5% prevalence in population. Although there is no physiological handicap in this deformity, it affects the psychology and social integration, especially in children. Therefore, surgery is usually required at even a younger age [1, 5]. Since the surgery was first performed by Dieffenbach in 1845, many surgical techniques have been developed to correct this deformity. More than 200 techniques are in use for the correction of prominent ears, including the percutaneous technique, cartilage sparing, cartilage splitting, perichondroplasty, and incisionless and endoscopic techniques. The availability of various techniques suggests that there is no single globally accepted and ideal procedure .
The incisionless ear pinning (non-surgical otoplasty) technique is also not completely new. It has been is use for decades including the anterior scoring and suturing percutaneously. Peled et al. [6] defined the technique for the antihelix, whereas Fritsch illustrated concho-mastoid and lobe sutures.
In our study, the mean age of the patients was 15 years. There were 11 males and 5 females. There are variations in the literature regarding the age of operation and sex according to each country because the aesthetic complaint is the main indication for surgery. In the literature, the mean age of patients ranges from 7 to 38 years, and 35% to 70% are female patients, and this percentage increases after the age of 20 years.
The incisionless technique we are using is safe and easy to perform. It has less complications than other techniques described in the literature. It provides good results with natural appearance, and there is no need for dressing or bandage or hospitalization. Only 2 of the 32 (6.2%) ears had a slight protrusion and needed reoperation to just increase the suture tension. Three ears developed exposure of the suture knot, which were embedded again under local anesthesia in the clinic. There were no perichondritis or hematoma or other complications. Among the 16 patients, 14 were satisfied (88% satisfaction rate).
After analyzing the data of 3,493 patients in the literature who underwent otoplasty for prominent ear, Sadhra et al. [8] stated that the hematoma incidence ranges from 1.4% to 3.8%, infection from 0.4% to 1.3%, wound problems from 1.4% to 5.1%, suture problems from 0.8% to 2.6%, pain from 5.4% to 23%, and revision surgery from 2.9% to 7.7%
Regarding postoperative complications, Punj et al. [9] stated that bleeding occurred in 2.2%, wound infection in 0.9%, and recurrence rate in 10% in Chongchet technique and 2.9% in Mustarde technique. Both the techniques may need antiemetics (3.2% to 14.3%) and opioid analgesics (30% to 35%) postoperatively
Smittenberg et al. [10] reported a high percentage of complications in cartilage cutting. It was about 20%, of which 7% needed reoperation. Maricevitch et al. [11] reported a complication rate of 12.8%. Valentines stated that the complication rate is about 10%, and that 10% of these complications needed reoperation.