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Mustarde technique of otoplasty is probably the most famous and practical among all otoplasty procedures especially in our centers. Yet it possesses the risk of suture extrusion, stitch granulomas and recurrence. Such complications have been reported, albeit few, yet they are bothersome to patients and their families. Placing tissues between the suture lines and the postauricular incision whether grafts or fascial flaps have been reported to reduce these complications.This study was set to evaluate the effectiveness of elevating a post-auricular fascial flap to cover the sutures in Mustarde and Furnas techniques for reducing the risk of suture extrusion and granulomas and possibly recurrence.Eleven patients with prominent ears (21 ears) fit our inclusion criteria. Nine of them were males and two females. They underwent suture otoplasty with post-auricular fascial flap in Burn and Plastic Surgery Hospital in Sulaimania from December 2011 to July 2015. Their mean age was 15.5 years, with a mean follow-up period of 242 days (ranged from 66 days to 431 days. Polydioxanone suture was used in (6 ears), and polypropylene suture was used in (15 ears).We achieved 91% satisfaction rates among patients and their families (only one patient was unsatisfied). One patient developed partial recurrence of the middle half of antihelix in one side (4.7%). Another one developed bleeding that only needed pressure and change dressing in the left ear (4.7%).  Adding fascial flap to cover the sutures appears to be beneficial in preventing suture extrusions and granulomas and possibly recurrence by acting as another supporting layer.

The Effectiveness of Posturicular Fascial Flap as an Adjunct to Suture Otoplasty