Zusammenfassung
Die abstehende Ohrmuschel als geringgradige Ohrfehlbildung tritt insgesamt bei ca. 5 % der deutschen Bevölkerung auf und kann bei Kindern, aber auch Erwachsenen zu schweren emotionalen Problemen führen. Für das operative Anlegen abstehender Ohrmuscheln (Otoklisis) wird in der Regel ein kombiniertes Verfahren aus Schnitt-, Ritz- und Nahttechniken verwendet. Die Wahl des Operationsverfahrens richtet sich dabei nach dem Schweregrad der Ohrfehlbildung sowie den individuellen Knorpeleigenschaften des Ohres. So findet man bei Kindern im Alter bis zu 10 Jahren häufig noch einen weichen, elastischen bzw. leicht verformbaren Ohrknorpel. In diesem Fall reichen häufig schonende Nahttechniken wie z. B. eine Naht-Technik nach Mustardé aus, um ein kosmetisch gutes und dauerhaftes Ergebnis zu erzielen. Bei Erwachsenen hat der Ohrknorpel häufig bereits eine rigide Konsistenz, sodass hier nicht selten eine Kombination aus Schnitt-, Ritz- und Nahttechniken erforderlich ist. Neben einer Verkleinerung des Ohrmuschel-Schädel-Winkels auf 15 - 20 ° sind bei dieser Operation eine Betonung der Anthelixfalte und eine glatte Helixkante ohne Konturunterbrechung erwünscht. Gelegentlich kann eine Lobulopexie zum Anlegen eines abstehenden Ohrläppchens oder in seltenen Fällen eine Ohrkonchareduktion bei Konchahyperplasie zusätzlich erforderlich sein. Da die postoperativen Komplikationen nicht selten zu schwerwiegenden Deformierungen der Ohren führen können, sollte grundsätzlich jedes Ohr individuell hinsichtlich seiner Problembereiche analysiert und die für den Knorpel schonendste Operationstechnik verwendet werden.
Schlüsselwörter
Otoklisis - Kombination aus Schnitt-, Ritz- und Naht-Technik - Knorpeleigenschaften - Risiken
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Priv.-Doz. Dr. med. Andreas Naumann
Leitender Oberarzt der Klinik und Poliklinik für Hals-Nasen-Ohrenheilkunde
Universitätsklinikum des Saarlandes
Kirrberger Straße
66421 Homburg/Saar
eMail: hnoanau@uniklinikum-saarland.de
