Novel antihelix instrument guided folding technique: A modification of Mustarde otoplasty

Prominauris is the most common congenital ear deformity, presenting in 5 % of the global population, and most patients endorse negative experiences or aesthetic dissatisfaction as motivation for corrective otoplasty. Mustarde-Furnas is a popular otoplasty technique among pediatric patients. Given the cosmetic intention, result consistency is highly important in otoplasty, which our modification of the Mustarde technique aims to address. A retrospective chart review of pediatric patients with prominauris treated with our modified Mustarde technique at Children's Hospital between 2018 and 2025 was undertaken. The technique utilizes a drill barrel to physically control the neo-antihelix fold, and the tension of the Mustarde sutures; combined with Furnas sutures, for conchal setback. Demographics, auricle measurements, operative details, complications, and revisions were evaluated with descriptive statistics and paired t-tests. Thirty-five patients were included (mean age 12 years, range: 4-19). Significant differences between the pre- and post-operative measurements for three auricular points (mm) were found including superior helical [p < 0.001, mean difference (MD) = 7.67], and, superior and inferior external auditory canal [p < 0.001, MD = 9.35; p < 0.001, MD = 4.88, respectively]. No statistically significant differences were found between each measurement change and the measurement change in the corresponding contralateral auricle measurement (p > 0.05). Revision rate was 5.7 % (2/35), indicated for scar revision and recurrence. The latter prompted a suture switch, and no recurrence followed. The significant differences found across all auricular measurements, and the consistency of results between each auricle pair, demonstrate the potential efficacy of this modified-Mustarde technique for reliable otoplasty for aesthetic satisfaction and applications to trainee education.