{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,19]],"date-time":"2026-09-19T01:33:22Z","timestamp":1789781602929,"version":"4.0.1"},"reference-count":18,"publisher":"Oxford University Press (OUP)","issue":"9","license":[{"start":{"date-parts":[[2022,4,9]],"date-time":"2022-04-09T00:00:00Z","timestamp":1649462400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2022,8,24]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Prominent ear deformity occurs in 5% of the general population and has been treated by otoplasty for many years to address the psychosocial challenges of having such a deformity. There is extensive literature but no consensus on the best method to address potential surgical complications, including suture extrusion.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Objectives<\/jats:title>\n                  <jats:p>The aim of this article was to describe a surgical technique designed to reduce suture extrusion following otoplasty surgery by placing free soft tissue grafts between Mustard\u00e9 sutures and postauricular skin.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>Two hundred and eleven patients who underwent otoplasties with soft tissue grafts between January 2017 and January 2020 were included in this study. All surgeries were performed by 2 facial plastic surgeons with more than 20 years of experience each, practicing in Toronto, Canada. Patients were followed up to assess for suture extrusion between 12 and 36 months (median, 21 months) postoperatively. The rates of suture complications and extrusion were compared with those previously reported in the literature.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Only 2 patients out of 211 (0.47%) had unilateral suture extrusion and were treated with suture removal. This is dramatically lower than the upper values reported in the literature, which average 5.55% (range, 0%-22.2%).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>A soft tissue graft separating the Mustard\u00e9 sutures and postauricular skin acts as a barrier, and can be used in conjunction with traditional surgical techniques. By adding this graft in the proposed manner, there is additional tissue reinforcing the suture repair, thereby reducing the rates of suture complications and extrusion without increasing the operative time.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Level of Evidence: 4<\/jats:title>\n                  <jats:p\/>\n               <\/jats:sec>","DOI":"10.1093\/asj\/sjac079","type":"journal-article","created":{"date-parts":[[2022,4,9]],"date-time":"2022-04-09T00:24:14Z","timestamp":1649463854000},"page":"NP571-NP575","source":"Crossref","is-referenced-by-count":5,"title":["Utilization of Free Soft Tissue Grafts in Otoplasty: A Simple Yet Effective Way to Avoid Suture Extrusion"],"prefix":"10.1093","volume":"42","author":[{"given":"Islam","family":"Alzayadneh","sequence":"first","affiliation":[{"name":"Department of Otolaryngology-Head and Neck Surgery, University of Toronto , Toronto, ON , Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8924-9811","authenticated-orcid":false,"given":"Eran","family":"Glikson","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology-Head and Neck Surgery, University of Toronto , Toronto, ON , Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jordan","family":"Shapiro","sequence":"additional","affiliation":[{"name":"Schulich School of Medicine and Dentistry , London, ON , Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ella","family":"Rival","sequence":"additional","affiliation":[{"name":"Faculty of Health Sciences, McMaster University , Hamilton, ON , Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zachary","family":"Solomon","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology-Head and Neck Surgery, University of Toronto , Toronto, ON , Canada"},{"name":"Crescent School , Toronto, ON , Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Philip","family":"Solomon","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology-Head and Neck Surgery, University of Toronto , Toronto, ON , Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2022,4,9]]},"reference":[{"key":"2022082414084431500_CIT0001","doi-asserted-by":"crossref","first-page":"27","DOI":"10.1097\/PRS.0b013e3181aa0e9d","article-title":"Treatment of prominent and constricted ear anomalies","volume":"124","author":"Janz","year":"2009","journal-title":"Plast Reconstr Surg."},{"key":"2022082414084431500_CIT0002","first-page":"2111","article-title":"The psychological, social and educational impact of prominent ears: a systematic review","volume-title":"J Plast Reconstr Aesthet Surg","author":"Jones","year":"2020"},{"key":"2022082414084431500_CIT0003","first-page":"588","article-title":"Complications following correction of prominent ears: an audit review of 122 cases","volume-title":"Br J Plast Surg.","author":"Jeffery","year":"1999"},{"issue":"C","key":"2022082414084431500_CIT0004","doi-asserted-by":"crossref","first-page":"170","DOI":"10.1016\/S0007-1226(63)80100-9","article-title":"The correction of prominent ears using simple mattress sutures","volume":"16","author":"Mustard\u00e9","year":"1963","journal-title":"Br J Plast Surg."},{"issue":"3","key":"2022082414084431500_CIT0005","doi-asserted-by":"crossref","first-page":"491","DOI":"10.1016\/S0094-1298(20)32155-6","article-title":"Correction of prominent ears with multiple sutures","volume":"5","author":"Furnas","year":"1978","journal-title":"Clin Plast Surg."},{"key":"2022082414084431500_CIT0006","doi-asserted-by":"crossref","first-page":"19","DOI":"10.1016\/j.bjps.2008.06.043","article-title":"Complications of otoplasty: a literature review","author":"Limandjaja","year":"2009","journal-title":"J Plast Reconstr Aesthet 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Oto-Rhino-Laryngology."},{"issue":"1","key":"2022082414084431500_CIT0010","doi-asserted-by":"crossref","first-page":"65","DOI":"10.1016\/j.bjps.2005.04.060","article-title":"The Patient Outcomes of Surgery-Head\/Neck (POS-Head\/Neck): a new patient-based outcome measure","volume":"59","author":"Cano","year":"2006","journal-title":"J Plast Reconstr Aesthet Surg."},{"issue":"2","key":"2022082414084431500_CIT0011","doi-asserted-by":"crossref","first-page":"205e","DOI":"10.1097\/PRS.0000000000006997","article-title":"Management of congenital auricular anomalies","volume":"146","author":"Joukhadar","year":"2020","journal-title":"Plast Reconstr Surg."},{"issue":"1","key":"2022082414084431500_CIT0012","doi-asserted-by":"crossref","first-page":"28e","DOI":"10.1097\/PRS.0000000000008105","article-title":"Revisiting primary otoplasty: surgical approach to the prominent ear","volume":"148","author":"Savetsky","year":"2021","journal-title":"Plast Reconstr 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