Otoplasti
Özet
Otoplasti, baş boyun bölgesinde en sık görülen doğuştan şekil bozukluklarından biri olan kepçe kulak deformitesini düzeltmek amacıyla uygulanan estetik bir cerrahi prosedürdür. Kulak kepçesi gelişiminin yaklaşık %85'ini 3 ila 6 yaş civarında tamamladığı için, çocukların maruz kalabileceği psikososyal streslerin ve akran zorbalığının önüne geçmek adına ameliyatlar genellikle 5-7 yaş arasında tercih edilmektedir. Deformitenin temel nedenleri arasında antihelikal kıvrımın yetersiz gelişimi ve konkal kıkırdak fazlalığı yer alır. Cerrahi yaklaşımlar kıkırdak koruyucu ve kıkırdak invaziv olmak üzere iki ana kategoriye ayrılmaktadır; kıkırdak bütünlüğünü bozmadan dikişlerle şekillendirme sağlayan Mustarde ve Furnas teknikleri günümüzde en popüler koruyucu yöntemlerdendir. Otoplastinin temel hedefleri, kulak protrüzyonunu azaltmak, simetrik, doğal bir kıvrım oluşturmak ve mastoid ile heliks arasındaki anatomik mesafeleri ideal sınırlara getirmektir. Ameliyat sonrası erken dönemde hematom, enfeksiyon ve cilt nekrozu gibi komplikasyonlar görülebilirken; geç dönemde dikiş ekstrüzyonu, keloid oluşumu veya telefon kulak gibi istenmeyen deformiteler gelişebilir. Başarılı bir sonuç için hastaya özgü preoperatif planlama ve titiz cerrahi teknik şarttır.
Otoplasty is an aesthetic surgical procedure performed to correct prominent ear deformity, which is one of the most common congenital craniofacial anomalies. Since the external ear reaches approximately 85% of its development between 3 to 6 years of age, surgery is frequently performed between 5-7 years of age to eliminate severe psychosocial stressors, anxiety, and bullying among pediatric populations. The primary anatomical causes of the deformity are an underdeveloped or unfolded antihelical fold and concal cartilage hypertrophy or excess. Surgical approaches are broadly classified into cartilage-sparing and cartilage-invasive techniques; the Mustarde and Furnas techniques, which reshape the ear using permanent sutures without resecting cartilage, remain the most popular cartilage-sparing methods. The definitive goals of otoplasty include correcting projection, establishing natural contours, and restoring ideal helix-to-mastoid distances. Early postoperative complications encompass hematoma, wound infection, and skin necrosis, whereas late complications include suture extrusion, hypertrophic scars, keloids, or undesirable results such as the telephone ear deformity. Achieving optimal, symmetric, and long-lasting outcomes requires comprehensive preoperative evaluation and customized, patient-centric technical execution.
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