Deformation of the auricle is a violation of the shape or integrity of the outer part of the ear, which occurred as a result of a congenital disorder of the development of an organ or injury.
The content of the article:
Classification of deformities of the auricles
Features of surgical correction of ear deformities
Complications of plastic correction of deformed auricles
Deformation of the auricle
Given the degree and complexity of the deformation of the auricle, the existing defect may be exclusively cosmetic or cause hearing impairment, up to its complete loss. In medicine, both unilateral and bilateral deformities are diagnosed. It is possible to eliminate the existing defect of a congenital or acquired type with the help of plastic surgery, practicing otoplasty. In order to determine the degree of hearing impairment — immediately before the operation — the patient should be examined by an otolaryngologist.
The deformation of the auricle is diagnosed immediately after the birth of the child, for this a simple examination of the newborn by a doctor is enough. The main cause of deformities of the congenital type is a violation of fetal development during uterine development, when the outer rim of the auricle and the underlying cartilages were formed incorrectly. With the wrong structure of these areas, the location of the auricle occurs at a large angle relative to the skull. With the formation of such a cosmetic defect as hearing loss, the symmetry of the auricles is violated, while they can have a sufficiently large size. Although the deformation of the auricle of this type does not have a negative effect on the hearing function, it is the cause of a violation of the mental and emotional state of the child, which is caused by constant ridicule from peers.
An important point in the elimination of existing defects in childhood is the readiness of the child for surgical intervention. The best period for the operation is considered to be preschool age, however, if the deformation does not affect the mental state, then the intervention can be postponed until adolescence, when the child himself will understand the importance and necessity of performing the operation.
Plastic surgery in the process of intervention solves the main tasks: correcting the shape and creating symmetry between the auricles and relative to other parts of the face.
Classification of deformities of the auricles
The basic principle of classification of deformities of the auricles is laid down in the nature of their origin, hence it is customary to divide defects into the following types:
congenital defects;
defects of the acquired type.
If a person is diagnosed with a deformity of the auricle, the causes of which lie in a developmental disorder during the first three months of carrying a child, this is a birth defect. In the process of forming the external parts of the ear, deformations can have the following characteristics:
excessive development of cartilage tissues, which violates the proportionality of the auricle and makes it large (macrotia);
the position of the ears relative to the temporal bone is not parallel, but at an angle from 31 to 90 degrees (lop-eared);
the upper part of the cartilage of the auricle is bent inward and directed to the bottom;
violation of the anatomical shape of the earlobe (double lobe, excessively developed, fused), as well as the complete absence of the earlobe;
a change in the shape of the ear curl (rudimentary formations on the curl, the absence of a curl and a tubercle of the auricle, an expanded ear curl with the position of the upper part of the cartilage outward);
partial development of the auricles (small ear sizes, flat or ingrown ears) — microtia.
If almost every one of the defects — for the most part — refers to cosmetic, then microtia of the auricles may be associated with an overgrowth of the auditory canal, which leads to impaired hearing function or to its complete absence. In some clinical cases, microtia is a consequence of underdevelopment of the facial bones on the affected side. Bilateral microtia is a serious birth defect, with impaired hearing function, facial symmetry, development of the bones of the lower jaw, speech is also impaired, and the patient receives a disability group.
Another important criterion for the classification of deformities of the auricles is the degree of complexity, there are three of them in medicine:
the auricle is underdeveloped, but there are areas of the organ that are developed at a sufficient level;
the auricle has a roller-shaped shape;
complete absence of the auricle.
In addition to congenital defects, there are deformations of the auricles of the acquired type. The main reason for their formation are:
injuries that occurred in the ear area (for example, injury, violation of equipment and safety rules at the enterprise);
diseases characterized by inflammatory processes occurring inside the ear;
surgical interventions performed poorly;
burns;
exposure to chemicals.
Most often, specialists diagnose an acquired deformity of the ear, called a keloid scar. The nature of its appearance is diverse. The defect may be the cause of inflammatory diseases or injuries suffered, manifested in the form of skin growths in the lobe or the entire ear. The formation of a keloid scar can occur even after a normal earlobe puncture.
Also , deformities of the auricles are diagnosed by the following types:
partial — a defect of the lower, upper or middle part of the auricle;
subtotal — cartilage of the ear fossa is present or completely absent;
full — the absence of an ear.
Features of surgical correction of ear deformities
Plastic surgery is engaged in the elimination of congenital as well as acquired defects of the outer ear in medicine, practicing the technique of otoplasty. This method of surgical treatment is a rather complex operation, which is directly related to the structure of the outer ear.
Most often, doctors diagnose such a congenital defect as hearing loss, while the angle of the auricle relative to the bones of the skull may be insignificant, or it may be clearly noticeable. Sometimes lop-eardness can be only on one side, along with this defect, doctors often diagnose a lack of symmetry between the auricles on both sides.
It is best to plan the implementation of otoplasty at preschool age, when the child has not yet turned 7 years old. This period is due to the fact that the psychological state of the child does not suffer, he is not the object of ridicule of his peers, and the further development of the auricles will continue in the anatomically correct position. The human auricle grows up to the age of nine, but if the child does not understand the need for surgical intervention, then otoplasty can be postponed until adolescence. The opportunity to have plastic surgery on the auricles remains at any age.
Patients in more mature years feel the need for otoplasty when they want to rejuvenate their appearance and make the proportions of the face aesthetically attractive.
Given the complexity of surgical intervention, the patient should be aware of a number of contraindications, in the presence of which the surgeon will not be able to correct the defect.
Contraindications include:
pathological non-coagulability of blood or a violation of this function caused by taking medications;
pathology of internal organs;
the presence of infectious processes;
tumors of a malignant or benign nature;
ascending inflammatory processes of the ear;
increased blood pressure;
diabetes mellitus;
high probability of keloid scar formation.
Depending on the degree of deformation of the auricle, the otoplasty operation can last from half an hour to two hours.
The main characteristic of otoplasty is its implementation in several stages, most often two operations are enough, but sometimes more of them may be required. The interval between interventions is from two to four months, which is due to the complex structure of the outer ear, the small number of soft tissues available in the area behind the ear. In order to create any part of the outer ear, doctors use a transplant from the patient’s own tissues. The most suitable is the cartilage of the costal area.
Immediately before the operation, the surgeon is obliged to inform the patient about all manipulations, as well as about the final result that will be achieved at the end of each stage of the operation. It is also important to clarify how the rehabilitation period will take place, how long it will last.
Two methods of otoplasty are practiced in plastic surgery:
aesthetic surgery is performed in order to change the size and shape of the auricles, solves the problems of hearing loss and broken symmetry between the auricles, helps to correct most cosmetic congenital and acquired defects of the auricles;
reconstructive surgery — helps to get rid of severe deformities of the auricles, solves the problems of the absence of ear sections by recreating them from the graft.
Regardless of what type of surgery is necessary in a particular clinical case, during otoplasty surgeons work with both soft tissues of the auricle and areas of cartilage. Before the operation, the doctor necessarily performs an assessment of the condition of the soft tissues of the auricle, determines the complexity and type of deformation, and already on the basis of these indicators determines the type of otoplasty performed.
In the case when the patient is diagnosed with severe deformity and absolute restoration of the ear is necessary, the operation involves the introduction of general anesthesia. Simple deformities can be eliminated under local anesthesia.
Complications of plastic correction of deformed auricles
The main problems that the patient faces after otoplasty are the accumulation of blood clots in the area where the plastic surgery was performed. In the absence of proper antiseptic care, the patient may become infected with a postoperative wound. With individual characteristics of the skin, a rough keloid scar may form.
