Using bilaterally fascioperichondrial flaps with a distal and a proximal base combined with conventional otoplasty.
Abstract
Prominent ears are the most common aesthetic abnormality of the external ear. Mustardè sutures and conchal setback are usually used for otoplasty, additional various cartilage-manipulation methods are also presented. One adjunctive technique that is often used involves the elevation of a fascial flap beneath which is sutured for additional cover, potentially reducing the risk of complications and recurrence. In the literature, this flap is traditionally raised with a proximal or distal base but it can be raised both distally and proximally with a number of advantages as we demonstrate. This article presents a technique to raise the fascioperichondrial flap with both a proximal and a distal base as an addition to conventional otoplasty. One hundred consecutive patients, followed up for at least 12 months, have been reviewed. One hundred ninety otoplasties were performed in 100 patients (10 unilateral), 65 women and 35 men. The mean age was 20.6 years, and the mean follow-up time was 16.3 months, respectively. No patient has developed skin necrosis or suture extrusion. In two patients (One bilateral and one unilateral for a total of three ears) a further procedure has been required to improve symmetry (1.5%). Using the retro auricular fascioperichondrial flap combined with other techniques offers good results and can be used as a standard procedure in the surgical treatment of prominent ears.
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Other noncomparative cohorts describing a cartilage-sparing technique with a postauricular flap have reported similarly low incidences of extrusion ranging from 0% to 3%, and recurrence rates ranging from 0% to 8% of ears.
“Other noncomparative cohorts describing a cartilage-sparing technique with a postauricular flap have reported similarly low incidences of extrusion ranging from 0% to 3%, as well as recurrence rates ranging from 0% to 8% of ears. 19,22-24,28”
Combined techniques have been shown to reduce recurrence rates compared with the Mustardé method alone, although they may not be as effective as the fascioperichondrial flap technique.
“According to the literature, combined techniques have been shown to reduce recurrence rates compared with the Mustardé method alone, although they may not be as effective as the fascioperichondrial flap technique [18,19].”
From Comparative Analysis of Mustardé, Fascioperichondrial Flap, and Combined Otoplasty Techniques: Clinical Outcomes and Recurrence Rates in 365 Patients (2025) · cites this paper as [19]
Supportive techniques aim to reduce both recurrence and suture-related complications by providing a well-vascularized tissue barrier over the suture line.
“To address these limitations, several supportive techniques have been introduced, with particular emphasis on the postauricular fascial flap and its variations (e.g., perichondrio-adipo-dermal flap and modified bilateral fascioperichondrial flap). These methods aim to reduce both recurrence and suture-related complications by providing a well-vascularized tissue barrier over the suture line [15,16”
From Comparative Analysis of Mustardé, Fascioperichondrial Flap, and Combined Otoplasty Techniques: Clinical Outcomes and Recurrence Rates in 365 Patients (2025) · cites this paper as [19]
Several studies have modified cartilage-sparing otoplasty by including a postauricular fascial flap to cover the postauricular sutures.
“Several studies have modified cartilage-sparing otoplasty by including a postauricular fascial flap to cover the postauricular sutures. 17,19-30”
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- Authors
- Irkoren, S., Kucukkaya, D., Sivrioglu, N., & Ozkan, H. S.
- Venue
- European Archives of Oto-Rhino-Laryngology
- Published
- 2013-05-14
- Volume
- 271
- Issue
- 6
- Pages
- 1389-1393
- ISSN
- 0937-4477 (ISSN-L)
- 1434-4726
- OpenAlex
- W2051164581
- Cited by
- 17
- References
- 34
- Citations by year
- 2026: 1 · 2025: 1 · 2024: 2 · 2023: 1 · 2022: 2 · 2021: 1 · 2020: 1 · 2018: 3 · 2017: 2 · 2016: 1 · 2015: 1 · 2013: 1
- FWCI
- 0.98
- Type
- journal article
- Language
- en
- Open access
- closed
- Licence
- www.springer.com/tdm (tdm)
- Locations
- European Archives of Oto-Rhino-Laryngology (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Surgery › Reconstructive Facial Surgery Techniques
- Health Sciences › Medicine › Surgery › Nasal Surgery and Airway Studies
- Health Sciences › Medicine › Genetics › Congenital Ear and Nasal Anomalies
- Keywords
- prominent ears, otoplasty, ear reconstruction, postoperative complications, ear symmetry
- MeSH terms
- Adolescent, Adult, Child, Ear, External, Female, Humans, Male, Middle Aged, Retrospective Studies, Surgical Flaps, Suture Techniques, Cohort Studies, Patient Satisfaction, Young Adult, Dermatologic Surgical Procedures
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