Carbon Dioxide Laser-Assisted Cartilage Reshaping Otoplasty: A New Technique for Prominent Ears

Objectives/Hypothesis: Most otoplasty techniques are variations of suturing and sculpting concepts. Thick cartilage and its tricky everlasting reshaping is a difficult task in suture techniques. It is more difficult to predict and control the final result in cartilage sculpting techniques. Animal studies demonstrated temperature-dependent cartilage stress relaxation during laser application resulting in stable shape changes. The aim of this study was to describe a novel surgical technique of carbon dioxide laser-assisted cartilage reshaping (CO2 LACR) otoplasty and to show its outcome. Study Design: Prospective case series study. Methods: Sixteen patients with 32 prominent ears were involved prospectively. Carbon dioxide laser evaporation of the perichondrium and partial thickness of the medial surface of auricular cartilage and a pair of parallel laser incisions on scaphal and conchal lines were performed. The cartilage was fixed with absorbable Vicryl mattress sutures. Demographics, early and late postoperative outcomes, patients/parents and doctors satisfaction in the follow-up were studied. Results: A total of 32 ears underwent repair. Patients ages ranged from 4 to 7 years (mean, 5.5 years). Average follow-up was 2.4 years. No cases required revision surgery. In late assessment 14 patients were pleased, two were satisfied, and no patients were unsatisfied. All patients had four to six of the six criteria for surgical success as defined by the study without complications. Conclusions: The present technique of CO2 LACR otoplasty resulted in endurance of auricular appearance and symmetry, with good to satisfactory outcome to patient/parent.