Outcomes and complications of incisionless otoplasty - A retrospective observational study and a review of the literature.

Introduction: Incisionless otoplasty is a more recently described technique to correct prominent ears. It is thought to provide a more natural cosmetic look, easier to perform, and achieve quicker recovery when compared to conventional otoplasty. The safety and efficacy of the procedure is not well characterised as there is limited data on outcomes and complications.

Methods: This was a retrospective study to evaluate outcomes and complications of incisionless otoplasty. We included all children who underwent incisionless otoplasty by a single surgeon over a 9-year period at a tertiary paediatric ear, nose and throat (ENT) unit.

Results: A total of 32 children were included in this study (62 ears operated on). Using facial dimension measurements to analyse preoperative and postoperative photographs, the proportion of prominent ears reduced from 43/56 (76.8%) to 8/45 (17.8%). The children reported good cosmetic outcomes in 38/40 (95.0%) ears. Assessment of preoperative and postoperative photographs considered 34/39 (87.2%) to have good cosmetic result. The following rates of complications were observed: infection, 6/62 (9.7%); blistering, 14/62 (22.6%); bleeding, 1/62 (1.6%); suture breakage/extrusion, 8/62 (21.9%); skin necrosis, 1/62 (1.6%). Further otoplasty procedures were done on five ears (8.3%).

Conclusions: Incisionless otoplasty was associated with high success and satisfaction rates. A previously undescribed complication of early postoperative erythema, swelling and blistering may be unique to this technique. This procedure should be further evaluated to identify risk factors and preventative measures to reduce complications.