Comparison of cartilage-scoring and cartilage-sparing otoplasty: a retrospective analysis of complications and aesthetic outcome of 1060 ears.
Abstract
BACKGROUND: Various techniques are used to correct prominent ears. The authors describe their experience with four different otoplasty techniques in 565 patients with congenital deformities of the ears (1060 ears) that were performed in their hospital during an 11-year period (2002 to 2012). METHODS: The authors divided the techniques into two groups: group I, cartilage-sparing techniques (i.e., IA, Mustardé; and IB, Furnas); and group II, cartilage-cutting techniques (i.e., IIA, Chongchet; and IIB, concha shell reduction). The authors compared early and late and minor and major complications, recurrence rates, and revision surgery. Furthermore, aesthetic outcome was scored by three different groups (consultant plastic surgeons, plastic surgery residents, and laymen) on a visual analogue scale using a blinded random selection of preoperative and postoperative photographs. RESULTS: The percentage of complications without the need for reoperation was 20 percent and 21 percent in the cartilage-sparing and cartilage-cutting groups, respectively (p = 0.44). In 6 percent of all cases, a reoperation of the otoplasty was required (7 percent and 6 percent in the cartilage-sparing and cartilage-cutting groups, respectively). Aesthetic postoperative results showed that the cartilage-cutting group scored significantly lower on postoperative shape (p = 0.04), result (p = 0.03), and satisfaction (p = 0.04) compared with the cartilage-sparing group. CONCLUSIONS: The study shows that patients who have undergone operations with cartilage-sparing or cartilage-cutting techniques have a similar rate of complications and need for reoperation. However, the cartilage-sparing techniques have a better aesthetic outcome, as judged by the different groups. CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, III.
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Our suture extrusion rate of 16.8% falls within the range described in the literature but remains slightly higher than average rates reported.
“Our suture extrusion rate of 16.8% falls within the range described in the literature; however, remains slightly higher than average rates reported.”
From Outcomes and Complications of the Mustardé Otoplasty: A “Good–Fast–Cheap” Technique for the Prominent Ear Deformity (2020) · cites this paper as [12]
The higher suture extrusion rates seen in this study may be secondary to prolonged follow-up times.
“This may be secondary to prolonged follow-up times in our study, as our median follow-up time of 104 weeks (range, 98–187 weeks) in the suture extrusion group exceeds the median follow-up of 52 weeks (range, 26–52 weeks) across what is seen in the literature.2,12”
From Outcomes and Complications of the Mustardé Otoplasty: A “Good–Fast–Cheap” Technique for the Prominent Ear Deformity (2020) · cites this paper as [12]
Direct placement of sutures beneath the skin may increase the risk of long-term complications, such as suture extrusion and recurrence.
“Although this technique effectively repositions the auricle closer to the mastoid region, direct placement of sutures beneath the skin may increase the risk of long-term complications, such as suture extrusion and recurrence [12,14].”
From Comparative Analysis of Mustardé, Fascioperichondrial Flap, and Combined Otoplasty Techniques: Clinical Outcomes and Recurrence Rates in 365 Patients (2025) · cites this paper as [12]
Reported complications of cartilage-sparing techniques include suture extrusion, granuloma formation, and recurrence rates of up to 25%.
“Nonetheless, these techniques are not without drawbacks. Reported complications include suture extrusion, granuloma formation, and recurrence rates of up to 25% [12,13,14].”
From Comparative Analysis of Mustardé, Fascioperichondrial Flap, and Combined Otoplasty Techniques: Clinical Outcomes and Recurrence Rates in 365 Patients (2025) · cites this paper as [12]
Cartilage-deforming techniques are generally associated with an increased risk for postoperative shape deformity.
“cartilage-deforming techniques are generally associated with an increased risk for postoperative shape deformity, 16”
Cartilage-sparing techniques showed better aesthetic results.
“cartilage-sparing techniques showed better aesthetic results. 16”
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- Authors
- Smittenberg, M. N., Marsman, M., Veeger, N. J. G. M., & Moues, C. M.
- Affiliations
- Medisch Centrum Leeuwarden (NL)
- Venue
- Plastic & Reconstructive Surgery
- Published
- 2018-04
- Volume
- 141
- Issue
- 4
- Pages
- 500e-506e
- ISSN
- 0032-1052 (ISSN-L)
- OpenAlex
- W2795145782
- Cited by
- 33
- References
- 19
- Citations by year
- 2026: 2 · 2025: 2 · 2024: 6 · 2023: 3 · 2022: 5 · 2021: 4 · 2020: 5 · 2019: 5 · 2018: 1
- FWCI
- 3.92
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Plastic & Reconstructive Surgery (publishedVersion)
- PubMed (publishedVersion)
- University of Groningen research database (University of Groningen / Centre for Information Technology) (submittedVersion)
- 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, prominent ears, recurrence, reoperation, cosmetic outcome, patient satisfaction, Mustardé technique
- MeSH terms
- Adolescent, Adult, Aged, Child, Child, Preschool, Ear Cartilage, Esthetics, Female, Follow-Up Studies, Humans, Infant, Male, Middle Aged, Postoperative Complications, Reoperation, Retrospective Studies, Patient Satisfaction, Outcome Assessment, Health Care, Plastic Surgery Procedures, Ear Auricle, Young Adult
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