Otoplasty Surgical Techniques and Clinical Outcomes: A Practical Review

Background: Otoplasty corrects auricular deformities, which affect 5%-10% of the global population and can significantly impact psychological well-being, especially in children. This review examined various otoplasty surgical techniques, clinical outcomes, complications, and emerging innovations, with a focus on prominent ear correction. Methods: A literature search was conducted in November 2024 on PubMed/MEDLINE and Web of Science using the query "otoplasty," identifying 1397 studies from 1915 to 2024. Studies were included if they detailed operative techniques, patient data (population >30), and mastoid-to-helical rim measurements. Exclusions included nonhuman studies, case reports, and incomplete data. Data extracted study characteristics, operative techniques, and complication rates. The Oxford Centre for Evidence-Based Medicine framework classified studies by evidence level. Results: Eighteen studies with 1590 patients and 3060 ears were included. The average patient age was 16.0 years, with a mean follow-up of 24.5 months. The average preoperative mastoid-to-helical rim measurement was 27.1 mm, reduced to 15.4 mm postoperatively. Suture extrusion (5.4%) was the most common complication. Meta-analysis showed a pooled recurrence rate of 2.8% and revision rate of 2.1%. Cartilage-sparing techniques, as well as 4-0 polypropylene (Prolene) and 4-0 braided polyester (Ethibond) cartilage fixation sutures, showed favorable outcomes. Conclusions: This review summarizes decades of research, highlighting effective techniques such as modified Mustardé-Furnas methods and cartilage-sparing approaches. Innovations and advancements in otoplasty, such as lasers, minimally invasive surgery, and postoperative care, demonstrate the field's evolution. Future research should focus on refining techniques and exploring animal models to improve otoplasty procedures.