Cartilage splitting without stitches: technique and outcomes.

IMPORTANCE Otoplasty procedures usually involve cartilage sparing, with stitches or cartilage scoring. These techniques have been widely reviewed in the literature. The technique reported in this study requires neither stitches nor rasping but rather a complete separation of the helix and antihelix, with nontransfixing incisions to break the cartilaginous springs. OBJECTIVES To evaluate the technical details, aesthetic results, and complications in a series of otoplasty procedures involving cartilage splitting without stitches. DESIGN, SETTING, AND PARTICIPANTS We conducted a retrospective review of patients who underwent otoplasty procedures between January 2004 and September 2010, by the same senior surgeon. MAIN OUTCOMES AND MEASURES File data on complications, recurrences, and revision rates were collected. An aesthetic evaluation of the postoperative results was conducted by a panel of 3 plastic surgeons and 3 lay observers. RESULTS Our series included 58 patients, with a mean age of 16 years. No recurrences were reported. Six patients (10%) experienced minor complications. No revisions were needed. No chondritis or skin necrosis was noted. The aesthetic results were very good for 36 patients (62%) by the plastic surgeons and 39 patients (68%) by lay observers. The remaining aesthetic results were judged as good. CONCLUSIONS AND RELEVANCE The Jost otoplasty procedure described herein requires no nonabsorbable sutures to bend the cartilage, avoiding many complications. The technique is safe, reliable, and reproducible, with predictable and permanent outcomes. It is also useful for secondary otoplasty after failed Stenström or Mustarde otoplasty. LEVEL OF EVIDENCE 4.