Surgeon(s): ***

‍Assistant Surgeon(s):  ***

‍Preoperative Diagnosis: ***

‍Postoperative Diagnosis: Same

‍Procedure(s): Otoplasty - Conchal bowl reshaping (Furnas maneuve; Otoplasty - Antihelical folds (Mustarde maneuver)

‍Anesthesia: General

‍Implants: None

‍Specimen:***

‍Drains: None

‍Fluids: See anesthesia record

‍EBL: Minimal

‍Complications: None

‍Counts:  Correct x2

‍Indications: ​***

‍Findings: As expected

‍Procedure in Detail:

‍The patient was seen in the preoperative holding area with a H&P was updated, consents were verified, surgical site marked, and all questions and concerns related to the proposed procedure were discussed in detail.  The patient was transferred to the operating room by the anesthesia team.  The patient underwent general anesthesia with endotracheal intubation. Tegaderms were placed over the eyes. The patient was prepped and draped in the standard fashion for maxillofacial procedures.  A time-out was performed and the procedure began.

The face, ears were prepped with chlorhexidine scrub.

Otoplasty Conchal bowl reshaping: (Left)

The ears were then anesthetized with 5 cc 2% lidocaine with 1:100,000 k epinephrine. A 15 blade was used to make a curvilinear incision along the posterior ear. A full thickness subperichondral flap was then elevated. Attention was then directed to the post-auricular tissue. Dissection proceeded down to mastoid fascia. Posterior auricularis was encountered and excised to create space for the ear to recess into. Excess conchal bowl cartilage was shaved and the ear examined for appropriate projection.

Otoplasty antihelical folds: (left)

The antihelical fold was then addressed.. 4-0 prolene sutures were then placed x 1 in the Mustarde fashion. Closure with 5-0 plain gut on the posterior incision

Otoplasty Conchal bowl reshaping: (Right)

The ears were then anesthetized with 5 cc 2% lidocaine with 1:100,000 k epinephrine. A 15 blade was used to make a curvilinear incision along the posterior ear. A full thickness subperichondral flap was then elevated. Attention was then directed to the post-auricular tissue. Dissection proceeded down to mastoid fascia. Posterior auricularis was encountered and excised to create space for the ear to recess into. A strip of full thickness cartlidge was removed to help with excess projection. 3-0 PDS was used to place Furnas sutures for the conchal bowl to the mastoid periosteum.

Otoplasty antihelical folds: (left)

The antihelical fold was then addressed.. 4-0 prolene sutures were then placed x 2 in the Mustarde fashion. Closure with 5-0 plain gut on the posterior incision Attention directed to the bilateral earlobes. An elipse of skin was taken posteriorly from each ear lobe to help reduce projection. Closure with 5-0 fast gut.

At the end of the procedure the ears has decreased projection as planned without evidence of telephone deformity. VPS was placed into the ears in the conchal bowl and posteriorly behind the hear and allowed to harden. The ears were then dressed with guaze and kerlex.

‍

The patient's face was then cleaned and the posterior pharynx was suctioned. An OG tube was used to suction out the contents of the stomach. Tegaderms were removed from the eyes. Dressings were placed. The patient was then transferred back to the care of the anesthesia team for extubation and recovery.

‍