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Preventing suture extrusion and recurrence in Mustardé and Furnas otoplasties by using laterally based postauricular dermal flap, long-term results.
Abstract
BACKGROUND: Prominent ear deformity (PD) is an unacceptable condition of pinna that affects 5% of the population and is associated with emotional stress, behavioral disturbances, and social restrictions in relationships. Conchal hypertrphy, inadequate formation of antihelical fold, earlobe placement ahead than it should be, or various combinations of these changes are main characteristics of PD. Many surgical techniques have been described for the PD.The authors' aim was to present laterally based postauricular dermal flap combination with cartilage-sparing methods and effectiveness of this technique in suture extrusion prevention and reducing the rate of recurrence with long-term results. METHODS: Forty-one patients had bilateral and 6 patients had unilateral PD, a total of 47 patients with a mean age of 14.48 were operated by using this combined procedure. A laterally based supraperichondrial dermal flap was prepared from a deepithelized elliptical postauricular incision. Mustarde and Furnas suture techniques were used solely for PD correction. The dissected laterally based dermal flap was fixed to the mastoid bone with sutures in stretched position after reshaping the auricular cartilage with sutures. RESULTS: The average helix-mastoid distance was (mm) 16.28 ± 2.36, concha-mastoid angle was 25.71 ± 0.96° on 12-month measurements. The helix-mastoid distance showed an increase of 1 to 3 mm, in the concha-mastoid angle measurements of 1° to 2°. Statistically significant changes were observed between the average preoperative, postoperative 1. month, postoperative 12. month helix-mastoid distances (mm), and month concha-mastoid angle (°) measurements (P = 0.0001). CONCLUSIONS: The laterally based postauricular dermal flap technique is an effective method to prevent suture extrusion and recurrence which are the most important complications of otoplasty procedure and easy to apply.
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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”
Basat et al investigated a laterally based postauricular dermal flap combined with cartilage-sparing techniques, demonstrating significant improvements in helix-mastoid distance and concha-mastoid angle at 1 and 12 months postoperatively, with no recurrences.
“Basat et al89 investigated a laterally based postauricular dermal flap combined with cartilage-sparing techniques, demonstrating significant improvements in helix–mastoid distance and concha–mastoid angle at 1 and 12 months postoperatively, with no recurrences.”
From Otoplasty Surgical Techniques and Clinical Outcomes: A Practical Review (2026) · cites this paper as [89]
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Correction of prominent ears by concha-mastoid sutures
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“Mustarde concha-schapal and Furnas concha-mastoid suture are most often used in cartilage-sparing methods.(11,12) Although the use of cartilage-sparing methods increases, suture extrusion, the suture line granuloma formation, deformity relapsing due to suture fatigue, and cartilage memory are the most important compli…”
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Boroditsky, M. L., Van Slyke, A. C., & Arneja, J. S. (2020) · Plastic and Reconstructive Surgery - Global Open · doi:10.1097/gox.0000000000003103 · Cited by 30
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Otoplasty Surgical Techniques and Clinical Outcomes: A Practical Review
Kaleeny, J. D., & Janis, J. E. (2026) · Plastic and Reconstructive Surgery - Global Open · doi:10.1097/gox.0000000000007404
“More recently, in 2016, Basat et al 89 investigated a laterally based postauricular dermal flap combined with cartilage-sparing techniques, demonstrating significant improvements in helix–mastoid distance and concha–mastoid angle at 1 and 12 months postoperatively, with no recurrences.”
Modified Island Technique for Prominent Ears
Mayer, H. F., & Loustau, H. D. (2017) · Aesthetic Plastic Surgery · doi:10.1007/s00266-017-1034-5
Cartilage-Sparing Otoplasty: An Overview of the Mustardé and Furnas Suture Techniques
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Bat Ear Correction Steps and Outcomes for Better Life Support
Shawky, M. A., Shawky, M. A., Zaghloul, A. I., & Zakaria, N. Z. (2024) · Indian Journal of Otolaryngology and Head & Neck Surgery · doi:10.1007/s12070-024-04872-9
Metadata
- Authors
- Basat, S. O., Ceran, F., Askeroglu, U., Aksan, T., Orman, C., Yazar, M., Uscetin, I., Akan, M., & Bozkurt, M.
- Affiliations
- Istanbul Medipol University (TR)
- Venue
- Journal of Craniofacial Surgery
- Published
- 2016-09
- Volume
- 27
- Issue
- 6
- Pages
- 1476-1480
- ISSN
- 1049-2275 (ISSN-L)
- OpenAlex
- W2466483663
- Cited by
- 15
- References
- 26
- Citations by year
- 2026: 1 · 2024: 4 · 2020: 4 · 2019: 3 · 2018: 1 · 2017: 2
- FWCI
- 2.21
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of Craniofacial 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 (clinical) › Congenital Ear and Nasal Anomalies
- Keywords
- otoplasty, suture extrusion, recurrence prevention, Mustardé technique
- MeSH terms
- Adolescent, Ear, External, Humans, Surgical Flaps, Suture Techniques, Sutures, Treatment Outcome
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