Performance-optimized otoplasty.

[OBJECTIVES] This study proposes a new surgical alternative for the most common deformity in the ears, the so-called "protruding/prominent ears", which is a condition that affects 5% of the Caucasian population (Goulart et al. in Rev Bras Cir Plast 26:602-607, 2011). This technique comes with the benefits of reduced surgical time, shallow learning curve, and a low revision rate.

[METHODS] We studied a total of 213 patients with an indication for otoplasty from January 2020 to January 2021. Women made up 65% of the study population, while men made up 35%, with an average age of 21 years, the youngest being 7 years of age. The technique presented here corrects all the deformities that cause protruding ears and can be performed together with other ear surgeries, such as surgical treatment of macrotia and lobuloplasty. All surgeries were performed in an outpatient setting under local anesthesia and sedation.

[RESULTS] All surgeries followed a performance-optimized protocol, with an average total surgical time of 45 min for a bilateral approach. Revision surgery was needed in 2% of cases, with the most frequent complaint being asymmetry in the upper third of the ears. The complication rate was approximately 7.5%, with 1 case of hematoma, 1 case of mild infection, 2 cases of altered ear sensitivity, 3 cases of keloid scar formation, 6 cases of asymmetry in the upper third of the ears, and 3 cases of irregularities or spikes in the antihelix cartilage. Patient satisfaction was measured using the McDowell/Wright Objectives and Outcome Index (McDowell in Plast Reconstr Surg 41:17-27).

[CONCLUSION] The proposed performance technique is a viable alternative to optimize the surgical time of otoplasty in an outpatient setting. This technique can be performed together with other corrective ear surgeries, has a shallow learning curve, and has a low revision rate.

[LEVEL IV] Evidence obtained from multiple time series with or without the intervention, such as case studies.