The effectiveness of scoring and bipolar diathermy on ear carliage behavior: exvivo study

A common unsatisfactory long-term outcome of otoplasty is undercorrection and residual deformity. Aggressive scoring with a scalpel blade can cause unattractive and painful ridging, especially in older patients with stiffer cartilage. We developed an ex vivo pig ear model to compare the effectiveness of bipolar diathermy with blade scoring for cartilage warping. Strips of cartilage harvested from Landrace pig ears were subjected to bipolar diathermy (group A), blade scoring (group B), and blade scoring combined with reverse-side bipolar diathermy (group C). The strip deflection and cartilage tension were measured for each group. No statistical difference (P <= 0.05) was detected between group A and group B for both outcomes. Scoring combined with bipolar diathermy resulted in highly significant increases in both deflection (P <= 4.69-6) and tension (P <= 2.9-4). In conclusion, bipolar diathermy and scoring are equally effective in warping cartilage. Scoring combined with bipolar diathermy is highly synergistic and produces more robust warping than scoring alone. This may help reduce both long- and short-term problems with undercorrection by allowing stronger conchal correction without producing the unattractive ridging that occurs with aggressive scoring.