Ear surgery

Description:
Thousands of otoplasties are performed successfully each year. The surgery may be done in the surgeon's office-based facility, in an outpatient surgical facility, or in a hospital. It may be performed under a local anesthetic which numbs the area around the ears, or under a general anesthetic which will cause sleep through the entire operation. The procedure usually lasts about 2 hours, depending on the extent of the surgery.

The most commonly employed technique is one in which the surgeon makes incisions in the back of the ear and removes skin to expose the ear cartilage. Sutures are used to fold the cartilage to reshape the ear. The same result in some instances can be achieved without sutures by cutting or abrading the cartilage before folding it. The skin incisions are sutured closed. The ear is brought closer to the head by creating a more pronounced fold (called the antihelix) in the central portion of the ear.

Indications:
The procedure can be performed on a child after the age of 4 years when ear growth is almost complete. When disfigurement is severe ("lop ears") a child should have surgery early to avoid possible emotional stress when he or she enters school.

What to Expect After:
The ears are covered with a bulky, moderate pressure dressing following surgery. There is some tenderness and discomfort that is easily controlled by medication. If the surgery is done in a hospital, release is usually the same day or the day after the operation.

Convalescence:
Within 2 to 4 days, the outer pressure dressings are removed but the patient is asked to wear a light head dressing for 2 to 3 weeks to promote healing. Faint scars are concealed in the flexion creases behind the ears; there are no incisions in front of the ears. The decision on when to return to school or work and normal activities depends on how fast healing occurs.

Risks:
Postoperative complications such as blood clots and infection are uncommon. A second operation may become necessary if a "pin back" ear occasionally protrudes again.

Cost:
The cost of any surgery varies highly between different surgeons, between medical facilities that offer this type of operation, and in different parts of the country. The cost is broken into three parts: the surgeon's fee, the anesthesiologist's fee, and the hospital charges, which include the operating room, the medications, and nursing care. An anesthesiologist's fee averages $350 to $400 per hour. Hospital charges (basic room rate) are about $1,500 to $1,800 per day (more for the intensive care unit (ICU) or a private room). There is likely to be a medications charge of about $200 - $400, and additional charges for other supplies used. Complications, preoperative laboratory tests, the need for an assisting surgeon, and other factors can greatly affect costs.

Operative facility costs and fees vary widely. Total surgical fees range from $950 to $3,500 or more, depending on the complexity and length of the operation. Additional expenses will depend upon the anesthesia used and where surgery takes place.

Most insurance plans do not offer complete coverage since otoplasty generally is carried out on an elective basis. The surgeon's fees and other costs may be partially or fully paid by your insurance carrier if surgery is deemed necessary to correct disfigurement from improper development.


This is an illustration of the external, middle, and inner ear. The detailed section is of the eardrum and the three tiny bones that conduct sound from the drum to the cochlea.



This is an illustration of the outside of the ear showing normal landmarks and several abnormal features including: earlobe creases, a preauricular pit, and a preauricular tag.