Comparison of cartilage scoring and cartilage sparing otoplasty: a study of 203 cases.
Abstract
Unlabelled The Edinburgh experience of different methods of otoplasty techniques in 203 patients (406 ears) over a five-year period is reviewed.Materials and methods The patients were divided into three groups - Group A (anterior cartilage scoring), Group B (cartilage sparing in the fashion of posterior suturing) and Group C (posterior suturing refined with posterior fascial flap). Demographic details, operation technique, operation time, grade of the surgeon, suture materials, early and late complications, recurrence and revision rates, patients' and physicians' comments at the follow-up clinic were retrieved from the case notes. The pre- and the post-operative photographs were assessed by a blinded lay observer and a physician and scored on a visual analogue scale. Median follow-up was 11 months.Results The recurrence rate was 11.0%, 8.0% and 4.8% in Groups A, B and C, respectively (p = 0.0214). Complications were more common in Group A (8.8%) and Group B (7.9%) compared to Group C (1.2%) (p = 0.0208). The cosmetic result was judged best in Group C. In our experience, cartilage-sparing otoplasty refined with the post-auricular fascial flap results in significantly reduced complication rate and improved aesthetic outcome.
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Mandal et al. reported suture extrusion in 1% and recurrence in 4.8% of ears after cartilage-sparing otoplasty with a postauricular fascial flap, compared with 2% and 8%, respectively, after cartilage-sparing otoplasty without a postauricular flap.
“This significant protective effect of adding a postauricular flap was also reported by Mandal et al., 17 who reported suture extrusion in 1% and recurrence in 4.8% of ears after cartilage-sparing otoplasty with a postauricular fascial flap, compared with 2% and 8%, respectively, after cartilage-sparing otoplasty without a postauricular flap.”
The success of the Mustardé technique is influenced by several variables, including the surgeon's experience, patient age, cartilage elasticity, and the suture material.
“The success of the Mustardé technique is known to be influenced by several variables, including the surgeon’s experience, patient age, cartilage elasticity, and the suture material [7,10,22].”
From Comparative Analysis of Mustardé, Fascioperichondrial Flap, and Combined Otoplasty Techniques: Clinical Outcomes and Recurrence Rates in 365 Patients (2025) · cites this paper as [7]
Studies using a postauricular fascial flap have generally reported a low incidence of suture extrusion and recurrence, possibly due to the additional coverage and support provided by the postauricular flap.
“These studies have generally reported a low incidence of suture extrusion and recurrence, possibly due to the additional coverage and support provided by the postauricular flap. 17,23”
Suture extrusion has been reported to be the most common complication after cartilage-sparing otoplasty.
“Suture extrusion has been reported to be the most common complication after cartilage-sparing otoplasty. 17,18”
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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References 12 · Cited by 83
- Authors
- Mandal, A., Bahia, H., Ahmad, T., & Stewart, K. J.
- Affiliations
- Royal Hospital for Sick Children (GB)
- Corresponding author
- Stewart, K.J.
- ORCID
- Bahia, H.
- Venue
- Journal of Plastic, Reconstructive & Aesthetic Surgery
- Publisher
- Elsevier BV
- Published
- 2006-11
- Volume
- 59
- Issue
- 11
- Pages
- 1170-1176
- ISSN
- 1748-6815 (ISSN-L)
- OpenAlex
- W2168248719
- Cited by
- 83
- References
- 12
- Citations by year
- 2026: 2 · 2025: 1 · 2024: 5 · 2023: 4 · 2022: 5 · 2021: 3 · 2020: 7 · 2019: 3 · 2018: 9 · 2017: 4 · 2016: 4 · 2015: 5 · 2014: 5 · 2013: 8 · 2012: 5
- FWCI
- 2.36
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of Plastic Reconstructive & Aesthetic Surgery (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
- otoplasty, auricular cartilage, recurrence, postoperative complications, cosmetic outcome
- MeSH terms
- Adolescent, Child, Child, Preschool, Ear Cartilage, Esthetics, Female, Follow-Up Studies, Humans, Intraoperative Period, Male, Recurrence, Reoperation, Retrospective Studies, Surgical Flaps, Suture Techniques, Treatment Outcome, Patient Satisfaction, Plastic Surgery Procedures
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