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Mohamed EN, Elshahat A, Hany HED, Shafik FR, Lashin R. Segmentation of the 3D printed mirror image auricular model to ease sculpture of the costal cartilages in total auricular aesthetic reconstruction. Asian J Surg 2023; 46:5429-5437. [PMID: 37248160 DOI: 10.1016/j.asjsur.2023.05.040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2023] [Revised: 04/06/2023] [Accepted: 05/12/2023] [Indexed: 05/31/2023] Open
Abstract
BACKGROUND Recently, three-dimensional (3D) models have been used more frequently than the traditional two-dimensional (2D) models as an intraoperative guide to ease sculpture of costal cartilages in total auricular aesthetic reconstruction in cases of microtia. Usually, 3D imaging techniques are used to create compact ear models, however, there is insufficient clinical knowledge of using them to create segmented 3D auricular models for cartilage framework reconstruction. IN THIS STUDY: assessment of the advantages of segmentation of 3D models over the traditional compact 3D models in total auricular aesthetic reconstruction has been discussed. PATIENTS AND METHODS In the current study, 16 patients who underwent total auricular aesthetic reconstruction using 3D models were included, patients were divided into two groups (Group I, 8 patients had total auricular aesthetic reconstruction using compact 3D printed mirror image model). Whereas (Group II, 8 patients had total auricular aesthetic reconstruction using segmented 3D printed mirror image model into auricular subunits. Then, each subunit was used for reconstruction of the corresponding part of the auricle. In both groups the patient's unaffected ear was mirrored and used as a reference to reconstruct the affected side. RESULTS The results were evaluated in both groups. The overall operative and carving times were found to be less in Group II; Also, postoperative aesthetic outcome and patient satisfaction were favorable in this group. CONCLUSION Using segmentation of 3D printed models in total auricular aesthetic reconstruction had less intraoperative time, better aesthetic results, and high postoperative patient satisfaction.
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Affiliation(s)
- Eman Nagy Mohamed
- The Department of Plastic, Burn and Maxillofacial Surgery, Faculty of Medicine, Ain- Shams University, Cairo, Egypt.
| | - Ahmed Elshahat
- The Department of Plastic, Burn and Maxillofacial Surgery, Faculty of Medicine, Ain- Shams University, Cairo, Egypt.
| | - Hossam El-Dien Hany
- The Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Ain-shams University, Egypt.
| | - Fady Rezk Shafik
- The Department of Plastic, Burn and Maxillofacial Surgery, Faculty of Medicine, Ain- Shams University, Cairo, Egypt.
| | - Riham Lashin
- The Department of Plastic, Burn and Maxillofacial Surgery, Faculty of Medicine, Ain- Shams University, Cairo, Egypt.
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Schraw JM, Benjamin RH, Shumate CJ, Canfield MA, Scott DA, McLean SD, Northrup H, Scheuerle AE, Schaaf CP, Ray JW, Chen H, Agopian A, Lupo PJ. Patterns of co-occurring birth defects in children with anotia and microtia. Am J Med Genet A 2023; 191:805-812. [PMID: 36541232 PMCID: PMC9928897 DOI: 10.1002/ajmg.a.63081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2022] [Revised: 12/02/2022] [Accepted: 12/05/2022] [Indexed: 12/24/2022]
Abstract
Many infants with anotia or microtia (A/M) have co-occurring birth defects, although few receive syndromic diagnoses in the perinatal period. Evaluation of co-occurring birth defects in children with A/M could identify patterns indicative of undiagnosed/unrecognized syndromes. We obtained information on co-occurring birth defects among infants with A/M for delivery years 1999-2014 from the Texas Birth Defects Registry. We calculated observed-to-expected ratios (OER) to identify birth defect combinations that occurred more often than expected by chance. We excluded children diagnosed with genetic or chromosomal syndromes from analyses. Birth defects and syndromes/associations diagnosed ≤1 year of age were considered. We identified 1310 infants with non-syndromic A/M, of whom 38% (N = 492) were diagnosed with co-occurring major defects. Top combinations included: hydrocephalus, ventricular septal defect, and spinal anomalies (OER 58.4); microphthalmia and anomalies of the aorta (OER 55.4); and cleft lip with or without cleft palate and rib or sternum anomalies (OER 32.8). Some combinations observed in our study may represent undiagnosed/atypical presentations of known A/M associations or syndromes, or novel syndromes yet to be described in the literature. Careful evaluation of infants with multiple birth defects including A/M is warranted to identify individuals with potential genetic or chromosomal syndromes.
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Affiliation(s)
- Jeremy M. Schraw
- Department of Pediatrics, Baylor College of Medicine, Houston, TX USA
| | - Renata H. Benjamin
- Department of Epidemiology, Human Genetics & Environmental Sciences, UTHealth School of Public Health, Houston, TX USA
| | - Charles J. Shumate
- Birth Defects Epidemiology and Surveillance Branch, Texas Department of State Health Services, Austin, TX USA
| | - Mark A. Canfield
- Birth Defects Epidemiology and Surveillance Branch, Texas Department of State Health Services, Austin, TX USA
| | - Daryl A. Scott
- Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, TX USA
| | - Scott D. McLean
- Department of Pediatrics, Baylor College of Medicine, Houston, TX USA
| | - Hope Northrup
- Department of Pediatrics, Division of Medical Genetics, McGovern Medical School at the University of Texas Health Science Center at Houston (UTHealth), Houston, TX USA
- Children’s Memorial Hermann Hospital, Houston, TX USA
| | - Angela E. Scheuerle
- Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas, TX USA
| | | | - Joseph W. Ray
- Department of Pediatrics, Division of Medical Genetics and Metabolism, University of Texas Medical Branch, Galveston, TX USA
| | - Han Chen
- Department of Epidemiology, Human Genetics & Environmental Sciences, UTHealth School of Public Health, Houston, TX USA
- Center for Precision Health, School of Biomedical Informatics, University of Texas Health Science Center at Houston, Houston, TX USA
| | - A.J. Agopian
- Department of Epidemiology, Human Genetics & Environmental Sciences, UTHealth School of Public Health, Houston, TX USA
| | - Philip J. Lupo
- Department of Pediatrics, Baylor College of Medicine, Houston, TX USA
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Paul A, Achard S, Simon F, Garcelon N, Garabedian EN, Couloigner V, Celerier C, Denoyelle F. Congenital abnormalities associated with microtia: A 10-YEARS retrospective study. Int J Pediatr Otorhinolaryngol 2021; 146:110764. [PMID: 33992972 DOI: 10.1016/j.ijporl.2021.110764] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/19/2020] [Revised: 02/08/2021] [Accepted: 05/07/2021] [Indexed: 11/24/2022]
Abstract
OBJECTIVE Microtia is a congenital auricular malformation, often part of a syndromic form (35%-55% of cases). The accurate prevalence of associated malformations remains to be determined with regard to the heterogeneous results of the previous studies. This study aims to describe in a large population cohort the abnormalities associated with microtia and to determine the most suitable assessment for these children. METHODS This is a retrospective and observational cohort study collecting data from the medical records of children affected by microtia, diagnosed or followed-up between 2007 and 2017. Data were collected via a computer database. Clinical data, as well as imaging or genetic results, were noted. RESULTS Six hundred ninety four children were included, 587 (84.6%) with unilateral and 107 (15.4%) with bilateral microtia. Inner ear malformations were observed in 14.1% of the ears. The main associated anomalies were hemifacial microsomia (29%), velopharyngeal insufficiency (9%), ophthalmologic (6.2%), vertebral (5.9%), cardiac (5.5%) and kidney (3%) abnormalities. Main identified entities were Goldenhar, Treacher-Collins and Guion-Almeida syndromes. CONCLUSION A comprehensive clinical assessment must be completed when microtia is diagnosed. Besides screening well-known oculo-auriculo-vertebral spectrum malformations, velopharyngeal insufficiency should be systematically sought. Specialized care must be provided to the very frequently associated hemifacial macrosomia. Mild forms of this last malformation may correspond to Guion-Almeida syndrome, especially in cases of learning disability.
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Affiliation(s)
- Antoine Paul
- Pediatric Otolaryngology and Head and Neck Surgery Department, Necker Enfants-Malades Assistance Publique - Hôpitaux de Paris, Université de Paris, Paris, France.
| | - Sophie Achard
- Pediatric Otolaryngology and Head and Neck Surgery Department, Necker Enfants-Malades Assistance Publique - Hôpitaux de Paris, Université de Paris, Paris, France
| | - François Simon
- Pediatric Otolaryngology and Head and Neck Surgery Department, Necker Enfants-Malades Assistance Publique - Hôpitaux de Paris, Université de Paris, Paris, France
| | - Nicolas Garcelon
- Plateforme Data Science - Institut des Maladies Génétiques Imagine, Inserm, Centre de Recherche des Cordeliers, UMR 1138 équipe 22, Institut Imagine, Université Sorbonne-Paris Cité, Paris, France
| | - Erea Noel Garabedian
- Pediatric Otolaryngology and Head and Neck Surgery Department, Necker Enfants-Malades Assistance Publique - Hôpitaux de Paris, Université de Paris, Paris, France
| | - Vincent Couloigner
- Pediatric Otolaryngology and Head and Neck Surgery Department, Necker Enfants-Malades Assistance Publique - Hôpitaux de Paris, Université de Paris, Paris, France
| | - Charlotte Celerier
- Pediatric Otolaryngology and Head and Neck Surgery Department, Necker Enfants-Malades Assistance Publique - Hôpitaux de Paris, Université de Paris, Paris, France
| | - Françoise Denoyelle
- Pediatric Otolaryngology and Head and Neck Surgery Department, Necker Enfants-Malades Assistance Publique - Hôpitaux de Paris, Université de Paris, Paris, France
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Paput L, Czeizel AE, Bánhidy F. Possible multifactorial etiology of isolated microtia/anotia--a population-based study. Int J Pediatr Otorhinolaryngol 2012; 76:374-8. [PMID: 22227122 DOI: 10.1016/j.ijporl.2011.12.012] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2011] [Revised: 12/10/2011] [Accepted: 12/13/2011] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To test the possible multifactorial-threshold model in the origin of isolated microtia/anotia (IMA). METHOD The observed number of IMA in the first degree relatives of cases affected was compared with the expected number of affected first degree relatives based on the multifactorial-threshold model in the population-based large dataset of the Hungarian Case-Control Surveillance of Congenital Abnormalities, 1980-1996. RESULTS Of 354 cases with IMA, 14 (4.0%) had the affected first degree relatives with IMA. There was a low and similar rate of familial occurrence of IMA in parents and siblings of cases. The observed numbers of affected first degree relatives of cases with IMA and their expected numbers did not show significant difference (p=0.47). Some other findings (e.g. male excess and the interaction of triggering environmental factors with polygenic predisposition) confirmed this hypothesis. CONCLUSIONS The familial pattern of cases with IMA does not reject the hypothesis that the multifactorial-threshold model, i.e. gene-environmental interaction, may be the explanation for the origin of this congenital abnormality group, although the number of familial cases was quite small in the study.
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Affiliation(s)
- László Paput
- Department of Oto-Rhino-Laryngologic and Head/Neck Surgical Department, National Center for Healthcare Audit and Improvement, Budapest, Hungary.
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Paput L, Bánhidy F, Czeizel AE. Association of drug treatments in pregnant women with the risk of external ear congenital abnormalities in their offspring: a population-based case-control study. Congenit Anom (Kyoto) 2011; 51:126-37. [PMID: 21848996 DOI: 10.1111/j.1741-4520.2011.00319.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
The objective of this study was to evaluate the possible association of drug treatments in pregnant women with a higher risk of congenital abnormalities of the external ear, particularly microtia/anotia, in their children. The frequency of drug treatments was compared in the mothers of cases with isolated or multiple (syndromic) ear abnormalities and in the mothers of three different controls: controls matched to cases, all controls (these controls had no defects) and malformed controls in the population-based large dataset of the Hungarian Case-Control Surveillance of Congenital Abnormalities. There was no significantly higher use of any drug in the mothers of 354 cases with isolated external ear abnormalities than in the mothers of different controls. However, of 156 cases with multiple ear abnormalities, 11 had mothers with hydroxyethylrutosidea treatment and a characteristic pattern of congenital abnormalities was found in these children. Four cases with multiple ear abnormalities were born to epileptic mothers treated with valproate, phenytoin and polytherapy in two cases. Drug treatments are not important in the origin of isolated ear abnormalities. However, a higher risk of multiple ear abnormalities was found in children born to mothers with treatment of hydroxyethylrutosidea or antiepileptic drugs during pregnancy.
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Affiliation(s)
- László Paput
- Department of Oto-Rhino-Laryngologic and Head/Neck Surgical Department, National Center for Healthcare Audit and Improvement, Budapest, Hungary.
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