The Cartilage-Sparing Versus the Cartilage-Cutting Technique: A Retrospective Quality Control Comparison of the Francesconi and Converse Otoplasties

Abstract

From a total of 281 patients with protruding ears who underwent a bilateral otoplasty between 1990 and 2001, a group of 28 (10%) was selected for a retrospective quality control study. The goal was to compare two methods of otoplasty, the Francesconi, a cartilage-sparing technique, and the Converse, a cartilage-cutting technique, in terms of objectively measurable and subjectively discernable differences in results. Objective parameters included measurement of the three cephaloauricular distances and the conchoscapal angle. An independent plastic surgeon performed the evaluation by means of a systematic evaluation system for rating cosmetic surgical procedures and a 5-point visual analog scale for rating satisfaction. The patients' subjective rate of satisfaction also was investigated using the 5-point scale. The mean medial and inferior cephaloauricular distances were significantly smaller in the Francesconi group. The concoscaphal angle was 90 degrees, or less in all the patients of the Francesconi group, but more than 90 degrees in eight patients (57%) of the Converse group (p = 0.041). Accordingly, the independent surgeon found adequate correction of protrusion in 86% of the Francesconi group and 50% of the Converse group (p = 0.050). His satisfaction rate was significantly in favor of the Francesconi technique (p = 0.006). Not unexpectedly, the patients' satisfaction rate was comparably high in both groups, and there was no statistical difference between them. In conclusion, the quality control led to a clear preference of the Francesconi over the Converse otoplasty. In addition, the assessment of the postoperative results with the systematic evaluation system offered an excellent information base by which to judge the results of otoplasty. Consequent use of this evaluation system will lead to progress in the surgical procedure.

In Vivo Electromechanical Reshaping of Ear Cartilage in a Rabbit Model

“…4 Of these, the corrective method found to be most appropriate has been approached subjectively, with minimal quantifiable data. 5 To overcome the limitations of conventional surgery, minimally invasive reshaping techniques (including laser, 6 radiofrequency, 7 and enzymatic digestion 8 ) have been developed. Electromechanical reshaping (EMR) of cartilage is a minimally invasive technique that was introduced previously 9 but is still experimental.…”

Correction of ear malformations by laser‐assisted cartilage reshaping (LACR)

“…Such a deformity can lead to serious psychological disturbances from childhood onward. As 85% of the auricular growth is complete by the age of 3 years and the cartilaginous portions of the ear have nearly reached their permanent dimensions by the time the child is 6 to 7 years old [1], surgery is encouraged before the child reaches school-age. Otoplasty is a demanding procedure, as witnessed by the multitude of ( > 40) currently used techniques.…”

Cartilage reshaping for protruding ears: A prospective long term follow‐up of 32 procedures

“…After this period, the deformity is fixed and a surgical therapy is usually necessary. Otoplasty is a demanding procedure, as witnessed by the multitude of (>40) currently used techniques [7]. Despite the abundance of techniques, complication rates are often high [8].…”