Otoplasty in children less than four years of age: surgical technique.

The appropriate age for otoplasty remains controversial. Most surgeons wait until the child is aged 5 years or older to perform otoplasty. In this article, the results are reported in a series of 12 patients in whom otoplasty was performed before the age of 4 years. The approach used consists of a logical sequence for recreation of the antihelical fold, conchal reduction, reduction of the conchomastoid angle, and lobule setback. Follow-up in these patients ranges from 1 to 7 years, with a median follow-up interval of 3 years. No auricular growth disturbances were noted as a result of the surgery. Recurrent auricular prominence was noted in only 1 (8%) of the 12 patients, comprising 4.8% of the operated ears. Experience using this approach demonstrates that otoplasty can be performed from the age of 9 months or older with safety, reliability, and a high level of satisfaction on the part of the affected families.