Outcomes and Complications of the Mustardé Otoplasty: A “Good–Fast–Cheap” Technique for the Prominent Ear Deformity

Abstract

Background: The Mustardé otoplasty is a commonly used procedure for the correction of the prominent ear deformity. Complication rates related to suture extrusion and long-term outcomes are variable in the literature. The study’s purpose was to examine the efficacy and safety of the Mustardé otoplasty and its resource utilization, using an “iron triangle” methodology incorporating quality, time, and cost. Methods: Retrospective data were collected on patients under 18 years who underwent primary Mustardé otoplasty between 2009 and 2018. Patient demographics, intraoperative details, complications, follow-up, and satisfaction were collected and analyzed. Results: There were 119 Mustardé otoplasties performed on 68 patients, with a median follow-up of 72 weeks (24–476 weeks). In total, 51 of the 68 patients underwent bilateral procedures. The median operative time was 95 minutes (31–133 minutes), translating to a facility case cost of $2046. A total of 24 complications were reported in 17 patients. Minor complications included the following: suture extrusion (n = 20), hematoma (n = 1), and suture abscess (n = 1). Major complications included reoperation (n = 2). The series had a revision rate of 1.7% (n = 2). No additional procedures were documented at other hospitals in the province. The majority (97%) of ear outcomes demonstrated both patient and surgeon satisfaction. Conclusions: The Mustardé otoplasty demonstrated a high efficacy in the correction of the prominent ear, with low reoperation rates and high patient and surgeon satisfaction. The procedure demonstrated intriguing results in resource utilization, with brief operative times, a “knife and fork” supply chain, and minimal overall case costs. This technique qualifies as a good, fast, and cheap outpatient otoplasty option.

Otoplastia en oreja prominente

“…A continuación se realiza una incisión elíptica de la piel retroauricular, preservando el pericondrio y resecando la piel redundante. Esto permitirá la exposición adecuada del pericondrio, incluyendo la concavidad de la concha en caso de ser necesaria su reseccion 13,22 . Se diseca elevando la piel hasta llegar al borde del hélix.…”

“…Se diseca elevando la piel hasta llegar al borde del hélix. En el caso de existir músculos retroauriculares prominentes, éstos deben ser seccionados, preferentemente, con electrocauterización 22 . En el caso que el cartílago sea muy grueso, se debe crear un túnel subpericóndrico a nivel de la cara anterior del cartílago sobre el antihélix, para realizar un raspado de la superficie cartilaginosa, generando que éste quede libre de tensión y sea más flexible 3 .…”

Bilateral Keloid Formation after Otoplasty in the Presence of Prolonged Mask Wearing

“…Prominent ears (PEs) are commonly attributed to hereditary factors or intrauterine malposition, which can result in school-age children being bullied. 1 Consequently, otoplasty is frequently performed during the preschool years. Auricular protrusion typically arises due to a hyperplastic cavum conchae or dysplastic/hypoplastic antihelix.…”

Development of a High-Fidelity, 3D Printed Otoplasty Surgical Simulator

“…3 The complication rate for otoplasty ranges from 0.4% to 24% with the more common complications being pain, itching, healing problems, and hematoma formation. 7,8 Revision rates of otoplasty have been reported to be around 13.6%. 7 Currently, otoplasty is taught to residents by observation, cadaveric procedures, and supervised operations.…”

“…7,8 Revision rates of otoplasty have been reported to be around 13.6%. 7 Currently, otoplasty is taught to residents by observation, cadaveric procedures, and supervised operations. 2 While this procedure is relatively easy to learn, the variability in outcomes and level of finesse required necessitates adequate practice.…”