1.1 Incisionless otoplasty comprises a variety of surgical techniques, carried out via minimal percutaneous access, that have been poorly described in the evidence, which includes a very small number of patients. The evidence on efficacy and safety is inadequate both in quality and quantity, and therefore the procedure should only be used with special arrangements for clinical governance, consent and audit or research.
1.2 Clinicians wishing to undertake incisionless otoplasty should take the following actions.
Inform the clinical governance leads in their Trusts.
Ensure that patients and/or their parents or carers understand the uncertainty about the procedure's safety and efficacy, and provide them with clear written information. In addition, the use of NICE's information for patients ('Understanding NICE guidance') is recommended.
Audit and review clinical outcomes of all patients having incisionless otoplasty (see section 3.1).
1.3 Further research on incisionless otoplasty should describe the precise surgical techniques used and should report both short- and long-term outcomes, including the need for further procedures.