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Alshehri AA, Al Hadi AM, Alyami LHA, Al Sulaiman IN, Al Hadi EM, Al Hareth SY. The Prevalence and Awareness of Congenital External Ear Deformity among the School-Age Group: A Cross-Sectional Study. Facial Plast Surg 2024. [PMID: 39293484 DOI: 10.1055/s-0044-1790569] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/20/2024] Open
Abstract
INTRODUCTION AND PURPOSE Congenital outer ear deformities stem from a sequence of disturbances during fetal auricular cartilage embryonic development. A significant gap exists in understanding their prevalence among the school-age group in Saudi Arabia. This cross-sectional study aims to address this knowledge gap to raise awareness about the impact of such disorders. METHODOLOGY This cross-sectional study targeted parents of children in the school-age group. A multistage cluster sampling technique was employed to ensure the representation of schools. A self-administered Google form survey was used. Data were analyzed using IBM SPSS Statistics for Windows, Version 28.0 (IBM Corp., Armonk, NY). RESULTS Our study revealed that the majority were males (56.2%), aged 6 to 10 years (49.3%), and attended primary school (69.5%). Chronic illnesses were present in 7.1% of children, with hearing impairment most prevalent (25.9%). Congenital ear deformities affected 2.7% of children, primarily Stahl's ear (35.4%). Limited knowledge about these deformities was observed among respondents (30.3%), yet a significant majority (73.9%) expressed belief in the potential of community awareness to decrease deformity prevalence. The awareness levels were impacted by parental education but showed no significant association with the child's age, gender, or presence of chronic diseases. CONCLUSION Our study underscores the noteworthy occurrence of congenital ear deformities among the school-age group, coupled with a notable lack of awareness. Parental education emerges as a key factor influencing awareness levels. It is imperative to prioritize initiatives to bolster awareness and early detection to promote child health.
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Zhang L, Huang J, Lei Y, Li X. Efficiency of ear molding for treating constricted ears of different severity. Am J Otolaryngol 2024; 45:104397. [PMID: 39059160 DOI: 10.1016/j.amjoto.2024.104397] [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: 04/03/2024] [Revised: 05/13/2024] [Accepted: 07/17/2024] [Indexed: 07/28/2024]
Abstract
PURPOSE To investigate the treatment time and efficiency of constricted ears of different severity after correction. MATERIALS AND METHODS We included the patients with constricted ear presented to our hospital for treatment between December 2021 and December 2023 in this retrospective analysis. The patients were divided into class I, II and III groups based on the severity of the constriction. Then we collected the data on classification of severity from each patient, together with sex, family history, age at initial correction, being informed upon diagnosis after birth, as well as utilization of auricle correction system. Logistic regression analysis was performed to identify the factors associated with the treatment time and efficiency. RESULTS The correction system yielded a high effective rate in the constricted ears. The treatment time in class II was significantly longer compared with those of class I after adjusting these parameters. Compared with the cases of class I, those with a class III showed significant attenuation in the symptoms and conditions (95 % CI: 0.034, 0.365; P < 0.001), after adjusting the age at initial correction, being informed upon diagnosis after birth, and utilization of auricle correction system. There were no statistical differences between class II and III in the treatment efficiency after correction. CONCLUSIONS The Amazing Ear Correction System was effective in treating constricted ear, yielding satisfactory treatment efficiency. Patients with class II constriction required longer treatment time compared with those of class I. The treatment outcome in the class I constriction was better than that of class III.
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Affiliation(s)
- Li Zhang
- Department of Pediatrics, Haidian District Maternal and Child Health Care Hospital, Beijing 100091, China.
| | - Jincheng Huang
- Emergency and Business Management Office, Chengdu Center for Disease Control and Prevention, Chengdu 610041, China
| | - Yanzhe Lei
- Department of Pediatrics, Haidian District Maternal and Child Health Care Hospital, Beijing 100091, China
| | - Xiaoou Li
- Department of Pediatrics, Haidian District Maternal and Child Health Care Hospital, Beijing 100091, China
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Sulibhavi A, Reddy SP, Butts SC, Schmalbach CE. Ear Molding in Children-Timing, Technique, and Follow-up: A Systematic Review. Facial Plast Surg Aesthet Med 2024. [PMID: 38963392 DOI: 10.1089/fpsam.2023.0321] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/05/2024] Open
Abstract
Background: Nonsurgical management of congenital ear anomalies using molding devices shows efficacy but lacks standardization of treatment protocols and outcome measures. Learning Objective: To compare ear molding techniques and identify factors related to treatment outcomes. Design Type: Systematic review of the literature (1990-2021). Methods: Studies reporting molding for congenital ear anomalies were assessed. PRISMA guidelines were used. Data extracted included: age at treatment initiation, treatment duration, correction rates, and complications. Data analysis included descriptive statistics and outcomes were compared using the Student t-test. Results: In total, 37 studies with 3,341 patients (mean patients per study, 95; range, 5-488) were included. Infants in whom treatment was initiated at 4.8 weeks (median, 3.7; range, 0.9-8.8 weeks) were treated for 5.1 weeks (median 4.7, range 2.6-7.6 weeks) with 11.0 months follow-up (median 11.4, range 1.4-21.0 months). Individualized devices (physician-customized) were used more (62.2% of studies) than commercial devices. No difference in correction (p = 0.44) or complication rates (p = 0.19) was identified between devices. Totally, 70.3% of studies reported complications and 40.5% of studies included long-term follow-up data. Conclusions: The available evidence supports initiating ear molding in the first weeks of life to be most effective, yet outcome data should be standardized in future studies to improve evidence quality.
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Affiliation(s)
- Anita Sulibhavi
- Department of Otolaryngology Head and Neck Surgery, Lewis Katz School of Medicine, Temple University, Philadelphia, Pennsylvania, USA
| | - Sai P Reddy
- Lewiz Katz School of Medicine at Temple University, Philadelphia, Pennsylvania, USA
| | - Sydney C Butts
- Department of Otolaryngology, Division of Facial Plastic and Reconstructive Surgery, SUNY Downstate Medical Center, Brooklyn, New York, USA
| | - Cecelia E Schmalbach
- Department of Otolaryngology Head and Neck Surgery, Lewis Katz School of Medicine, Temple University, Philadelphia, Pennsylvania, USA
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4
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Huang J, Zou K, Yuan P, Yang M, Miao Y, Zhao L, Fan Y. Correction of congenital auricle deformities with ear mould: A systematic review and meta-analysis. Int J Pediatr Otorhinolaryngol 2024; 179:111903. [PMID: 38574649 DOI: 10.1016/j.ijporl.2024.111903] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Revised: 11/30/2023] [Accepted: 02/27/2024] [Indexed: 04/06/2024]
Abstract
OBJECTIVE To assess the effectiveness and safety of ear moulds for congenital auricle deformities. METHODS Databases including Medline, EMBASE, Cochrane Library, Chinese BioMedical Literature Database (CBM) and Web of Science were systematically reviewed. Randomised controlled trials (RCT), non-randomised control trials (non-RCT), quasi-randomised control trials (quasi-RCT) and self-controlled before-after trials were also included. Data extraction was independently conducted by two authors. The Risk Of Bias In Non-randomised Studies of Interventions (ROBIN-I) was used to evaluate the risk bias. Heterogeneity was assessed using I2 and chi-square tests. Effective rate, adverse reaction rate and their 95%CI were calculated. Funnel plots, Begg's test as well as sensitivity and subgroup analyses were performed. RESULTS The analysis encompassed ten studies, comprising one RCT and nine self-controlled before-after trials, involving 1860 ears (1248 children). The pooled effective rate and adverse reaction rate of ear mould were 91% (95% CI: 0.87-0.94) and 9% (95%CI: 0.02-0.17), respectively. No serious adverse reactions were reported. The effective rate of ear mould intervention showed no significant difference between age at correction≤42 days group (90%, 95%CI: 0.85-0.94) and that >42 days group (93%, 95%CI: 0.83-0.99). Similarly, there was no statistical difference in the correction efficiency between duration of wearing ear mould≤30 days group (90%, 95%CI: 0.85-0.94) and that >30 days group (92%, 95%CI: 0.86-0.96). The effective rate for correcting cryptotia ear (98%, P < 0.001), cup ear (93%, P = 0.004) and prominent ear (90%, P = 0.014) was higher than that of helical rim deformity (66%). CONCLUSIONS In the short term, the use of ear moulds is effective and safe in correcting congenital auricle deformities. Notably, the correction efficacy for cryptotia, cup ear and prominent ear deformities surpasses that of helical rim deformities. However, further research is required to ascertain the impact of the duration of wearing on the correction of congenital auricle deformities.
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Affiliation(s)
- Jincheng Huang
- Chengdu Center for Disease Control and Prevention, Sichuan Province, 610041, China
| | - Kun Zou
- West China Second Hospital/West China Maternity and Children's Hospital, Chengdu, Sichuan province, 610041, China; West China Research Centre for Rural Health Development, Sichuan University, Chengdu, Sichuan province, 610041, China
| | - Ping Yuan
- Department of Epidemiology and Health Statistics, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan province, 610041, China
| | - Min Yang
- West China Research Centre for Rural Health Development, Sichuan University, Chengdu, Sichuan province, 610041, China; Faculty of Health, Art and Design, Swinburne Technology University, Melbourne, Australia
| | - Yunqi Miao
- Chengdu Center for Disease Control and Prevention, Sichuan Province, 610041, China
| | - Li Zhao
- West China Second Hospital/West China Maternity and Children's Hospital, Chengdu, Sichuan province, 610041, China; Department of Health Policy and Management, West China School of Public Health and West China Fourth Hospital, Chengdu, Sichuan province, 610041, China.
| | - Yanjun Fan
- National Center for Women and Children's Health, China Center for Disease Control and Prevention, Beijing, 100050, China
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5
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Vella JB. Pediatric Otoplasty and Auricular Molding. Facial Plast Surg Clin North Am 2024; 32:95-103. [PMID: 37981420 DOI: 10.1016/j.fsc.2023.07.006] [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] [Indexed: 11/21/2023]
Abstract
With the advent of widespread use of commercial ear molding products, the literature addressing the indications for and timing of perinatal intervention in auricular deformations and malformations has increased significantly. Although the rationale for perinatal ear molding seems to be hormonally mediated, the common assertion that breastfeeding may prolong the window of effective intervention remains without convincing evidence. The common auricular anomalies as well as indications, timing, and methodology of effective intervention including ear molding or surgical otoplasty are reviewed herein.
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Affiliation(s)
- Joseph B Vella
- Department of Otolaryngology-Head and Neck Surgery, Division of Facial Plastic and Reconstructive Surgery, Rutgers Cleft and Craniofacial Center, Rutgers-Robert Wood Johnson Medical School, 10 Plum Street, 5th Floor, New Brunswick, NJ 08901, USA.
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6
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Lemperle G, Kassem-Trautmann K, Kühn S, Borsche A. Open Otoplasty Through Ventral Skin Incision and Abrasion of the Antihelix Under Vision. Aesthetic Plast Surg 2024; 48:378-387. [PMID: 37828365 DOI: 10.1007/s00266-023-03668-6] [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: 06/30/2023] [Accepted: 09/09/2023] [Indexed: 10/14/2023]
Abstract
BACKGROUND Common otoplasties through incisions behind the ear with blind scoring or scratching the anterior perichondrium often leave an irregular surface of the antihelix. METHOD To avoid these tiny side effects, a skin incision along the ventral antihelical fold (scapha) is used to thin and fold the flat antihelix under vision. After local anesthesia of the ventral ear skin, an incision along the scapha allows its blunt lifting toward the concha and to expose the cartilaginous antihelix. Its future shape is marked and the thickness of the cartilage is thinned with a dermabrader by approximately half or until one sees the gray of the inner cartilage. The now missing perichondrium causes the antihelix to fold by itself with an absolute smooth surface and is fixed with three absorbable mattress sutures. RESULTS The technique has been developed in 1985 in Frankfurt and has since been performed on over 1000 patients with optimal results and a low complication rate. The skin flap is so well perfused that no skin necrosis and only 5.7% wound healing problems were experienced. CONCLUSION This approach from ventral is safe, timesaving, and avoids contour irregularities of the antihelix often seen after traditional techniques. It can be left to beginners in plastic surgery without hesitation. The fear of hypertrophic scars or even keloids can be dispelled with the fact that ear keloids only occur after wound infection. LEVEL OF EVIDENCE IV This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.
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Affiliation(s)
- Gottfried Lemperle
- Department of Plastic and Aesthetic, Reconstructive and Hand Surgery, Agaplesion Markus Krankenhaus, Wilhelm-Epsteinstr. 4, 60431, Frankfurt am Main, Germany.
| | | | - Shafreena Kühn
- Department of Plastic and Aesthetic, Reconstructive and Hand Surgery, Agaplesion Markus Krankenhaus, Wilhelm-Epsteinstr. 4, 60431, Frankfurt am Main, Germany
| | - André Borsche
- Department of Plastic, Reconstructive and Aesthetic Surgery, Diakonie-Krankenhaus, Ringstr.64, 55543, Bad Kreuznach, Germany
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Burns HR, Dinis J, Ding Y, Buchanan EP. Seminars in Plastic Surgery: Pediatric Ear Anomalies and Reconstruction. Semin Plast Surg 2023; 37:287-298. [PMID: 38098685 PMCID: PMC10718655 DOI: 10.1055/s-0043-1775888] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2023]
Abstract
Congenital ear anomalies affect 15 to 20% of neonates and can be categorized as either auricular deformations or malformations. Deformations involve a fully developed, albeit abnormally shaped, chondrocutaneous framework, which makes them amenable to correction with ear molding within the first few months of life. Malformations involve hypoplastic or fully absent auricular structures that require augmentation with alloplastic and/or autogenous reconstruction. The goal of this article is to outline the various auricular deformities and malformations, followed by a description of the latest clinical management options, both nonsurgical and surgical, by auricular anomaly.
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Affiliation(s)
- Heather R. Burns
- Michael E. DeBakey Department of Surgery, Division of Plastic Surgery, Baylor College of Medicine, Houston, Texas
- Division of Plastic Surgery, Texas Children's Hospital, Houston, Texas
| | - Jacob Dinis
- Michael E. DeBakey Department of Surgery, Division of Plastic Surgery, Baylor College of Medicine, Houston, Texas
- Division of Plastic Surgery, Texas Children's Hospital, Houston, Texas
| | - Yang Ding
- Michael E. DeBakey Department of Surgery, Division of Plastic Surgery, Baylor College of Medicine, Houston, Texas
- Division of Plastic Surgery, Texas Children's Hospital, Houston, Texas
| | - Edward P. Buchanan
- Michael E. DeBakey Department of Surgery, Division of Plastic Surgery, Baylor College of Medicine, Houston, Texas
- Division of Plastic Surgery, Texas Children's Hospital, Houston, Texas
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8
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Hui LB, Li MH, Liu Y. Ear Molding for Congenital Auricular Deformities: Efficacy and Factors Affecting Outcomes. EAR, NOSE & THROAT JOURNAL 2023:1455613231181192. [PMID: 37309132 DOI: 10.1177/01455613231181192] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/14/2023] Open
Abstract
Objective: This study's aim was to assess the effectiveness of ear molding for congenital auricular deformities, analyze the factors affecting prognosis, and provide more clinical data supporting nonsurgical correction for this condition. Methods: A prospective study of a consecutive series of infants treated with ear molding from January 2021 to December 2022 in the department of otolaryngology, Second Affiliated Hospital of Harbin Medical University, was conducted. Demographic and clinical information were collected, and photographs of the ear were taken before and after treatment. Treatment efficacy and the relevant influencing factors were evaluated. Results: Thirty-five patients, including 59 with congenital ear anomalies, underwent noninvasive ear molding. The deformity type, treatment initiation age, and number of treatment cycles affected treatment efficacy. Earlier treatment initiation was associated with a shorter treatment period. Treatments were started earlier if decision-makers were more anxious. Conclusion: The earlier the neonatal auricle deformity is treated, the shorter the treatment time and the more ideal the clinical effect will be. Early noninvasive treatment for microtia is valuable. Early detection and parental awareness and education can help children receive treatment earlier and improve the success rate.
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Affiliation(s)
- Lin-Bi Hui
- Department of Otolaryngology/Head and Neck Surgery, Second Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang, P. R. China
| | - Ming-Hua Li
- Department of Otolaryngology/Head and Neck Surgery, Second Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang, P. R. China
| | - Ying Liu
- Department of Otolaryngology/Head and Neck Surgery, Second Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang, P. R. China
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9
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Zou Q, Zhao S, Wang D, Chen P, Yang L, Gao M, Liu Y, Zhao C, Li S, Yang J. Comparison of two conchal formers for nonsurgical correction on Conchal Crus. Laryngoscope Investig Otolaryngol 2023; 8:279-286. [PMID: 36846421 PMCID: PMC9948584 DOI: 10.1002/lio2.987] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2022] [Revised: 09/26/2022] [Accepted: 11/18/2022] [Indexed: 12/23/2022] Open
Abstract
Objectives Conchal Crus is a kind of congenital auricular deformation which is often overlooked. Few studies reported a large number of cases. We compared the efficacy of EarWell and self-made conchal formers on Conchal Crus to summarize our experience of correction and to find out the influencing factors. Methods Two groups of Conchal Crus babies underwent conchal correction with the EarWell and self-made conchal formers respectively. The combined auricular deformities in these babies were corrected with EarWell Infant Ear Correction System. Conchal Crus deformity was classified as severe and mild. Auricular and conchal morphologic outcomes were graded as excellent, good, and poor. Results The auricular morphologic results were comparable between the two groups. There was no significant difference in the effective (excellent plus good) rate between the two groups, but the excellent rate for conchal results in the Self-made group was significantly higher than that in the EarWell group. The former incidence of pressure ulcers was significantly lower than the latter. Multinomial regression analysis showed that the more severe conchal deformity was, the less likely the conchal shape tended to be improved. Conclusion Both conchal formers could correct Conchal Crus effectively. The self-made conchal former could make more excellent conchal fossae and lead to less pressure ulcers at the Conchal Crus. The degree of Conchal Crus deformity was an important influencing factor in the conchal correction outcome. Level of evidence 4.
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Affiliation(s)
- Qijuan Zou
- Department of Otolaryngology Head and Neck SurgeryBeijing Tongren Hospital, Capital Medical UniversityBeijingChina
- Key Laboratory of Otolaryngology Head and Neck SurgeryMinistry of Education, Capital Medical UniversityBeijingChina
| | - Shouqin Zhao
- Department of Otolaryngology Head and Neck SurgeryBeijing Tongren Hospital, Capital Medical UniversityBeijingChina
- Key Laboratory of Otolaryngology Head and Neck SurgeryMinistry of Education, Capital Medical UniversityBeijingChina
| | - Danni Wang
- Department of Otolaryngology Head and Neck SurgeryBeijing Tongren Hospital, Capital Medical UniversityBeijingChina
- Key Laboratory of Otolaryngology Head and Neck SurgeryMinistry of Education, Capital Medical UniversityBeijingChina
| | - Peiwei Chen
- Department of Otolaryngology Head and Neck SurgeryBeijing Tongren Hospital, Capital Medical UniversityBeijingChina
- Key Laboratory of Otolaryngology Head and Neck SurgeryMinistry of Education, Capital Medical UniversityBeijingChina
| | - Lin Yang
- Department of Otolaryngology Head and Neck SurgeryBeijing Tongren Hospital, Capital Medical UniversityBeijingChina
- Key Laboratory of Otolaryngology Head and Neck SurgeryMinistry of Education, Capital Medical UniversityBeijingChina
| | - Mengdie Gao
- Department of Otolaryngology Head and Neck SurgeryBeijing Tongren Hospital, Capital Medical UniversityBeijingChina
- Key Laboratory of Otolaryngology Head and Neck SurgeryMinistry of Education, Capital Medical UniversityBeijingChina
| | - Yujie Liu
- Department of Otolaryngology Head and Neck SurgeryBeijing Tongren Hospital, Capital Medical UniversityBeijingChina
- Key Laboratory of Otolaryngology Head and Neck SurgeryMinistry of Education, Capital Medical UniversityBeijingChina
| | - Chunli Zhao
- Department of Otolaryngology Head and Neck SurgeryBeijing Tongren Hospital, Capital Medical UniversityBeijingChina
- Key Laboratory of Otolaryngology Head and Neck SurgeryMinistry of Education, Capital Medical UniversityBeijingChina
| | - Sijia Li
- Department of Otolaryngology Head and Neck SurgeryBeijing Tongren Hospital, Capital Medical UniversityBeijingChina
- Key Laboratory of Otolaryngology Head and Neck SurgeryMinistry of Education, Capital Medical UniversityBeijingChina
| | - Jinsong Yang
- Department of Otolaryngology Head and Neck SurgeryBeijing Tongren Hospital, Capital Medical UniversityBeijingChina
- Key Laboratory of Otolaryngology Head and Neck SurgeryMinistry of Education, Capital Medical UniversityBeijingChina
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10
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Chen L, Li C, He A, Tong H, Lu X, Yang R, Chen X, Wu X, Wang X, Wang S, Ma J, Fu Y, Zhang T. Changes of Age-related Auricular Cartilage Plasticity and Biomechanical Property in a Rabbit Model. Laryngoscope 2023; 133:88-94. [PMID: 35385162 DOI: 10.1002/lary.30124] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2021] [Revised: 02/18/2022] [Accepted: 03/15/2022] [Indexed: 02/02/2023]
Abstract
OBJECTIVES Ear molding is an emerging technique that can correct auricular deformities. Treatment initiation time is the most important prognostic determinant of ear molding. Here, we aimed to examine why auricular cartilage plasticity appeared to diminish with age. Thus, we characterized age-related changes in the biomechanical, biochemical, and morphological properties of auricular cartilage. METHODS New Zealand rabbits were used as the experimental animal. We examined immature [postnatal 0 day (P0), 5 days (P5), 15 days (P15)], young [2 months (2M)], and mature [6 months (6M)] rabbits. Rabbits' ears were splinted and folded using adhesive fixation strips. Folding duration ranged from 1 day to 5 days to 10 days. Photographs were taken to calculate the retained fold angle. Cartilage morphology and extracellular matrix (ECM) content were examined histologically (using hematoxylin-eosin, Safranin O, elastic Van Gieson, and Masson's trichrome). Water content, DNA content, and cell density were also analyzed. Biomechanical properties were measured using a Nano indenter. RESULTS Immature ears had smaller angles after strip removal, and the angled deformation lasted a longer time. Cartilage matrix compositions, including glycosaminoglycan (GAG), elastin fiber, and collagen, increased over development. The water content, DNA content, and cell density decreased with age. Young's modulus was significantly higher in mature cartilage. CONCLUSIONS Here, we successfully established an animal model of ear molding and demonstrated that immature cartilage was associated with better plasticity. We also found that the cartilage's biomechanical property increased with the accumulation of ECM. The biomechanical change could underlie age-related shape plasticity. LEVEL OF EVIDENCE NA Laryngoscope, 133:88-94, 2023.
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Affiliation(s)
- Lili Chen
- ENT institute, Eye & ENT Hospital, Fudan University, Shanghai, China.,Department of Facial Plastic and Reconstructive Surgery, Eye & ENT Hospital, Fudan University, Shanghai, China
| | - Chenlong Li
- ENT institute, Eye & ENT Hospital, Fudan University, Shanghai, China.,Department of Facial Plastic and Reconstructive Surgery, Eye & ENT Hospital, Fudan University, Shanghai, China
| | - Aijuan He
- ENT institute, Eye & ENT Hospital, Fudan University, Shanghai, China.,Department of Facial Plastic and Reconstructive Surgery, Eye & ENT Hospital, Fudan University, Shanghai, China
| | - Hua Tong
- ENT institute, Eye & ENT Hospital, Fudan University, Shanghai, China.,Department of Facial Plastic and Reconstructive Surgery, Eye & ENT Hospital, Fudan University, Shanghai, China
| | - Xinyu Lu
- ENT institute, Eye & ENT Hospital, Fudan University, Shanghai, China.,Department of Facial Plastic and Reconstructive Surgery, Eye & ENT Hospital, Fudan University, Shanghai, China
| | - Run Yang
- ENT institute, Eye & ENT Hospital, Fudan University, Shanghai, China.,Department of Facial Plastic and Reconstructive Surgery, Eye & ENT Hospital, Fudan University, Shanghai, China
| | - Xin Chen
- ENT institute, Eye & ENT Hospital, Fudan University, Shanghai, China.,Department of Facial Plastic and Reconstructive Surgery, Eye & ENT Hospital, Fudan University, Shanghai, China
| | - Xu Wu
- ENT institute, Eye & ENT Hospital, Fudan University, Shanghai, China.,Department of Facial Plastic and Reconstructive Surgery, Eye & ENT Hospital, Fudan University, Shanghai, China
| | - Xin Wang
- ENT institute, Eye & ENT Hospital, Fudan University, Shanghai, China.,Department of Facial Plastic and Reconstructive Surgery, Eye & ENT Hospital, Fudan University, Shanghai, China
| | - Shuqi Wang
- ENT institute, Eye & ENT Hospital, Fudan University, Shanghai, China.,Department of Facial Plastic and Reconstructive Surgery, Eye & ENT Hospital, Fudan University, Shanghai, China
| | - Jing Ma
- ENT institute, Eye & ENT Hospital, Fudan University, Shanghai, China.,Department of Facial Plastic and Reconstructive Surgery, Eye & ENT Hospital, Fudan University, Shanghai, China
| | - Yaoyao Fu
- ENT institute, Eye & ENT Hospital, Fudan University, Shanghai, China.,Department of Facial Plastic and Reconstructive Surgery, Eye & ENT Hospital, Fudan University, Shanghai, China
| | - Tianyu Zhang
- ENT institute, Eye & ENT Hospital, Fudan University, Shanghai, China.,Department of Facial Plastic and Reconstructive Surgery, Eye & ENT Hospital, Fudan University, Shanghai, China.,NHC Key Laboratory of Hearing Medicine, Fudan University, Shanghai, China
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11
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Efficacy of Classic Ear Molding for Neonatal Ear Deformity: Case Series and Literature Review. J Clin Med 2022; 11:jcm11195751. [PMID: 36233618 PMCID: PMC9571398 DOI: 10.3390/jcm11195751] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2022] [Revised: 09/20/2022] [Accepted: 09/26/2022] [Indexed: 11/24/2022] Open
Abstract
Background: We analyzed an original case series of the classic ear-molding method and evaluated the efficacy and complication rate of the method compared to commercial ear-molding products by meta-analysis to draw conclusions on the efficacy of the classic method. Methods: From January 2019 to March 2022, we selected patients who underwent classic ear molding for newborn ear deformities at our institution and reviewed the patient age, treatment time, efficiency and complications. Additionally, the PubMed, EMBASE, and Scopus databases were searched, and meta-analysis (following the PRISMA guidelines) was performed. Results: In the case study, the success rate (excellent and good outcomes) of the classic ear-molding method was 92.6%. The mean age at application and mean duration of application were 5.81 ± 6.09 days and 32.13 ± 7.90 days, respectively. In the systematic review, the classic method group showed a statistically smaller success rate (proportion of 0.79) and statistically smaller complication rate (proportion of 0.05) than the commercial product group (proportion of 0.83). Conclusions: Compared with commercial products, classic ear molding has remarkable and comparable therapeutic effects on neonatal auricular deformities. Additionally, the classic ear-molding method is more suitable for infants with auricular deformities from socioeconomically vulnerable areas. Thus, the classic ear-molding method could be a better option for congenital ear anomalies than commercial ear-molding products.
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12
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Wu D, Li L, Zhou M. Treatment of congenital auricle malformation with EarWell Ear Correction Kit: A meta-analysis. EAR, NOSE & THROAT JOURNAL 2022:1455613221122589. [PMID: 36007158 DOI: 10.1177/01455613221122589] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVE The effectiveness of EarWell Ear Correction Kit in the treatment of congenital auricle malformation and the incidence of complications are not particularly clear, so we carried out this study to provide a better reference for plastic surgeons to use EarWell Ear Correction Kit in the treatment of congenital auricle malformation. METHODS We searched the Chinese and English databases including PubMed, Embase, the Cochrane Library, China National Knowledge Infrastructure, Wanfang, and VIP information databases. RESULTS Through this meta-analysis, we found that the effective rate of EarWell Ear Correction Kit was 89.1%. The incidence of complications using EarWell Ear Correction Kit for correction of congenital auricular deformity was 11.4%. In terms of complications, the incidence of skin lesions was 9% and the incidence of dermatitis was 3.4%. CONCLUSION EarWell Ear Correction Kit has high efficiency in the correction of congenital auricular deformity and a low incidence of complications. It can be used for the treatment of congenital auricular deformity in patients within 6 months of birth.
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Affiliation(s)
- Dan Wu
- Department of Burn and Plastic Surgery, Zibo Central Hospital, Zibo, China
| | - Liang Li
- Department of Burn and Plastic Surgery, Zibo Central Hospital, Zibo, China
| | - Ming Zhou
- Department of Joint and Sports Medicine, Zibo Central Hospital, Zibo, China
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Noninvasive ear molding in the correction of ear anomalies: A systematic review and meta-analysis. Int J Pediatr Otorhinolaryngol 2022; 159:111189. [PMID: 35716418 DOI: 10.1016/j.ijporl.2022.111189] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/30/2021] [Revised: 04/10/2022] [Accepted: 05/22/2022] [Indexed: 11/24/2022]
Abstract
OBJECTIVE Ear molding has been used for the treatment of congenital external ear anomalies. The purpose of this study is to systematically review ear molding therapy and perform a meta-analysis to determine its efficacy. METHODS A systematic review and meta-analysis of the literature was conducted using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The PubMed and Embase databases from January 2009 to April 2021 were searched. Individual studies were eligible for inclusion if they evaluated noninvasive ear molding for congenital ear anomalies, featured at least 50 ears, and were published in English. RESULTS 15 studies (one RCT and 14 clinical series) with a total of 1729 children undergoing molding of 2508 ears were identified and included in the meta-analysis. Meta-analysis of the eight studies with reported success rates as determined by clinician assessment showed an overall success rate in 87.4% of ears. Meta-analysis of the three studies with reported efficacy as assessed by laypersons showed an overall success rate of 92%. All studies reported a variety of minor skin-related complications in the ear, such as eczema, excoriation, infection, irritation, rash (allergic or nonallergic), and ulceration. Generally, complications were not reported to be serious and were noted to resolve with minimal to no intervention. CONCLUSION To the authors' knowledge, this study represents the largest modern systematic review and meta-analysis analyzing the efficacy of ear molding. A review of the 15 studies included suggests that ear molding is an effective and safe treatment for congenital ear anomalies with a high success rate. However, the strength of this body of evidence is reduced by a lack of comparative studies, heterogeneous patient populations, treatment protocols, and ear assessment scales.
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Evolution of Anomaly-Specific Techniques in Infant Ear Molding: A Ten-Year Retrospective Study. Plast Reconstr Surg 2022; 150:394-404. [PMID: 35671454 DOI: 10.1097/prs.0000000000009335] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Congenital ear anomalies occur in at least one-third of the population, and less than one-third of cases self-correct. Ear molding is a nonoperative alternative to surgery that spares operative morbidity and allows for significantly earlier intervention. In this retrospective study, the senior author developed a tailored approach to each specific type of ear deformity. The use of modifications to adapt standard ear molding techniques for each unique ear are described. METHODS The authors conducted a retrospective, institutional review board-approved study of 246 patients who underwent ear molding by a single surgeon. The procedure reports for each case were reviewed to develop step-wise customization protocols for existing EarWellTM and InfantEarTM systems. RESULTS This review included 385 ears in 246 patients. Patient age at presentation ranged from less than 1 week to 22 weeks. Presenting ear deformities were subclassified into mixed (37.4%), helical rim (28.5%), prominent (10.6%), lidding/lop (9.3%), Stahl's ear (3.6%), conchal crus (3.3%), and cupping (2.8%). Two patients (0.8%) had cryptotia. Deformity subclass could not be obtained for 11 patients (4.5%). Recommended modifications to existing ear correction systems are deformity-specific: cotton tip applicator (CTA)/setting material (Stahl's ear), custom dental compound mold (lidding/lop and cupping), scaphal wire (helical rim), CTA/protrusion excision (prominent), and custom dental compound stent (conchal crus). CONCLUSIONS Presentation of ear anomalies is heterogenous. This ten-year experience demonstrates that the approach to ear molding should be dynamic and customized, using techniques beyond those listed in system manuals to complement each ear and to improve outcomes.
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Wu H, Niu Z, Li G, Li Y, Wang B, Qian J, Wang Y, Jiang H, Chen Y, Han Y. Nonsurgical Treatment for Congenital Auricular Deformities: A Systematic Review and Meta-analysis. Aesthetic Plast Surg 2022; 46:173-182. [PMID: 34231021 DOI: 10.1007/s00266-021-02427-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2021] [Accepted: 06/13/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND The effectiveness and safety of non-surgical correction for congenital auricular deformities (CADs) remain unclear owing to a lack of high-level evidence. This systematic review and meta-analysis aimed to estimate the overall success and complication rates of the non-surgical correction for CAD. METHODS We searched PubMed, Medline, and Cochrane Library for eligible studies. The pooled success and complication rates of non-surgical correction were estimated using a random effects model. Subgroup analyses were performed to compare the success rates between patients treated with splints and molding systems, between those younger and older than 6-weeks, and among those with different types of CADs. RESULTS The review yielded 14 studies. The pooled success rate of non-surgical treatment was 93% (95% CI: 88%-97%). The success rates with splints and commercialized molding systems were 94% and 92%, respectively. The success rate was higher if non-surgical correction was initiated before age 6 weeks (96% vs. 82%). Prominent ears showed a lower success rate (85%) than other types of CADs (all > 90%). The pooled complication rate was 18% (95% CI: 10%-29%). Complications, including skin wound, irritation, and rash, were mild and easily treatable. CONCLUSION The non-surgical correction of CADs is highly effective and safe. Splints and molding systems offer similar effectiveness. Non-surgical correction is more beneficial if applied within 6 weeks of birth. Prominent ears have a lower, but still acceptable, success rate compared to other types of CAD. We recommend the early use of non-surgical correction to achieve favorable outcomes. LEVEL OF EVIDENCE III This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
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Affiliation(s)
- Huanhuan Wu
- Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, 33 Badachu Road, Beijing, 100144, China
| | - Zehao Niu
- Department of Plastic and Reconstructive Surgery, The First Medical Center, Chinese PLA General Hospital, 28 Fuxing Road, Beijing, 100853, China
| | - Guo Li
- Department of Plastic and Reconstructive Surgery, The First Medical Center, Chinese PLA General Hospital, 28 Fuxing Road, Beijing, 100853, China
| | - Yan Li
- Department of Plastic and Reconstructive Surgery, The First Medical Center, Chinese PLA General Hospital, 28 Fuxing Road, Beijing, 100853, China
| | - Bingqing Wang
- Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, 33 Badachu Road, Beijing, 100144, China
| | - Jing Qian
- Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, 33 Badachu Road, Beijing, 100144, China
| | - Yue Wang
- Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, 33 Badachu Road, Beijing, 100144, China
| | - Hanyi Jiang
- Graduate School of North, China University of Science and Technology, Tangshan, 063210, China
| | - Youbai Chen
- Department of Plastic and Reconstructive Surgery, The First Medical Center, Chinese PLA General Hospital, 28 Fuxing Road, Beijing, 100853, China.
| | - Yan Han
- Department of Plastic and Reconstructive Surgery, The First Medical Center, Chinese PLA General Hospital, 28 Fuxing Road, Beijing, 100853, China.
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Chen L, Li C, He A, Chen Y, Tong H, Fu Y, Zhang T. Using ear molding to correct auricular helix adhesion deformity. Front Pediatr 2022; 10:990629. [PMID: 36458143 PMCID: PMC9706092 DOI: 10.3389/fped.2022.990629] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Accepted: 10/21/2022] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVES This study examined the effectiveness of Byrd's EarWell system for the treatment of auricular helix adhesion. METHODS The newborns with helix adhesion were treated with ear molding. The photos of pinna were taken before, during, and after the treatment. The immediate and long-term outcomes, as well as the complications, were assessed by two independent plastic surgeons. STUDY DESIGN A retrospective study. Data on family history, neonatal weight, gestational age, delivery method, laterality, gender, age of initiating treatment, medical comorbidities, duration of treatment, and follow-up time were collected. STUDY SITE AND PERIOD From 2019 to 2021, infants treated with the EarWell System in the Eye and ENT Hospital of Fudan University were enrolled in this study. RESULTS A total of 46 newborns (66 ears) with helix adhesion were included. The average onset time of treatment was 4.57 ± 3.63 weeks. The average duration of treatment was 7.40 ± 2.05 weeks. 97.0% ears' (64/66) immediate results were excellent or good. During long-term follow-up, 95.5% ears achieved excellent or good outcomes. Age of initiation treatment significantly affected immediate (p = 0.001) and long-term (p = 0.004) outcomes. CONCLUSIONS EarWell System was an effective method to correct auricular helix adhesion. Using this approach, patients with helix adhesion could avoid surgeries. Age of initiation treatment was the predictor of successful correction.
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Affiliation(s)
- Lili Chen
- ENT institute, Eye & ENT Hospital, Fudan University, Shanghai, China.,Department of Facial Plastic and Reconstructive Surgery, Eye & ENT Hospital, Fudan University, Shanghai, China
| | - Chenlong Li
- ENT institute, Eye & ENT Hospital, Fudan University, Shanghai, China.,Department of Facial Plastic and Reconstructive Surgery, Eye & ENT Hospital, Fudan University, Shanghai, China
| | - Aijuan He
- ENT institute, Eye & ENT Hospital, Fudan University, Shanghai, China.,Department of Facial Plastic and Reconstructive Surgery, Eye & ENT Hospital, Fudan University, Shanghai, China
| | - Ying Chen
- ENT institute, Eye & ENT Hospital, Fudan University, Shanghai, China.,Department of Facial Plastic and Reconstructive Surgery, Eye & ENT Hospital, Fudan University, Shanghai, China
| | - Hua Tong
- ENT institute, Eye & ENT Hospital, Fudan University, Shanghai, China.,Department of Facial Plastic and Reconstructive Surgery, Eye & ENT Hospital, Fudan University, Shanghai, China
| | - Yaoyao Fu
- ENT institute, Eye & ENT Hospital, Fudan University, Shanghai, China.,Department of Facial Plastic and Reconstructive Surgery, Eye & ENT Hospital, Fudan University, Shanghai, China
| | - Tianyu Zhang
- ENT institute, Eye & ENT Hospital, Fudan University, Shanghai, China.,Department of Facial Plastic and Reconstructive Surgery, Eye & ENT Hospital, Fudan University, Shanghai, China.,NHC Key Laboratory of Hearing Medicine, Fudan University, Shanghai, China
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17
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Otoplasty through Ventral Skin Incision and Shaping of the Antihelix by Abrasion-A Retrospective Study. J Clin Med 2021; 10:jcm10163713. [PMID: 34442013 PMCID: PMC8397180 DOI: 10.3390/jcm10163713] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2021] [Revised: 08/12/2021] [Accepted: 08/13/2021] [Indexed: 11/18/2022] Open
Abstract
(1) Background: Protruding ears are the most common auricular malformation affecting approximately 5% of the population. One common factor leading to auricular protrusion is a deficiency or total absence of the antihelix. A technique first described by Gottfried Lemperle in 2003 attempts cartilage thinning, folding, and fixation by non-absorbable mattress sutures after ventral skin incision along the ventral helical rim. (2) Methods: Retrospective analysis of patient records was performed for otoplasties according to this technique, performed between 1985 and 2014 at Agaplesion Markus Hospital in Frankfurt, Germany. All recorded complications were examined. (3) Results: A total of 912 single otoplasties were performed according to this technique from 1985 to 2014. Overall complications included 26% minor complications not requiring further surgery and 11% major complications leading to revision surgery. Within those requiring revision surgery, the most common reason was recurrence of auricular protrusion (5%), followed by suture granulomas (5%) and hematomas (2%). (4) Conclusions: Lemperle’s otoplasty technique addresses the open thinning and shaping of the antihelix through a ventral incision along the helix to prevent irregularities and possible ridges. Results show a low complication rate comparable to data found in published studies. This technique is easy to perform, safe, and avoids often seen contour irregularities of the antihelix compared to techniques with a posterior approach.
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18
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Zhu Y, Zhou Y, Zhao Q, Ma Y, Lu Y. 3D Technique-Based Nonsurgical Correction of Deformational Congenital Auricular Deformities. ORL J Otorhinolaryngol Relat Spec 2021; 83:59-64. [PMID: 33440397 DOI: 10.1159/000509493] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2019] [Accepted: 06/15/2020] [Indexed: 11/19/2022]
Abstract
INTRODUCTION Congenital auricular deformity (CAD) is a common postpartum deformity, and nonsurgical correction of CAD has been recognized as a safe and effective approach. Three-dimensional (3D) technique has been used in surgical reconstruction of unilateral microtia; however, 3D technique used in nonsurgical correction for deformational CAD has not been reported. METHODS In this study, 12 CAD patients aged from 0.6 to 7 months with 16 deformational CAD were treated with 3D technique-based personalized nonsurgical correction (3D-NSC). Patients' CAD was photographed pre- and post-correction, and clinical outcome was evaluated as poor, fair, good, and excellent by comparing pre- and post-correction pictures. Different kinds of tests were used to analyze the data. RESULTS All patients got an improved auricle shape (10 excellent, 2 good, and 4 fair). Multivariate regression analysis showed that CAD type was significantly associated with correction outcome, sex and age were significantly associated with correction outcome for the 11 constructed types of CAD, and age was significantly associated with the correction outcome when we focused on the male constructed auricles. CONCLUSION 3D-NSC provided a significant nonsurgical clinical treatment for CAD patients, with younger patients getting better clinical outcomes with shorter correction time.
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Affiliation(s)
- Yifan Zhu
- International Joint Laboratory for Cell Medical Engineering of Henan Province, Huaihe Hospital of Henan University, Kaifeng, China.,Henan Engineering Laboratory for Translational Medicine of Infectious Diseases, Huaihe Hospital of Henan University, Kaifeng, China
| | - Yuemin Zhou
- International Joint Laboratory for Cell Medical Engineering of Henan Province, Huaihe Hospital of Henan University, Kaifeng, China.,Department of Plastic and Reconstructive Surgery, Huaihe Hospital of Henan University, Kaifeng, China
| | - Qiannan Zhao
- International Joint Laboratory for Cell Medical Engineering of Henan Province, Huaihe Hospital of Henan University, Kaifeng, China.,Department of Plastic and Reconstructive Surgery, Huaihe Hospital of Henan University, Kaifeng, China
| | - Yuanyuan Ma
- International Joint Laboratory for Cell Medical Engineering of Henan Province, Huaihe Hospital of Henan University, Kaifeng, China.,Department of Plastic and Reconstructive Surgery, Huaihe Hospital of Henan University, Kaifeng, China
| | - Yuquan Lu
- International Joint Laboratory for Cell Medical Engineering of Henan Province, Huaihe Hospital of Henan University, Kaifeng, China, .,College of Nursing and Health, Henan University, Kaifeng, China,
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Non-surgical Correction of Congenital Ear Anomalies: A Review of the Literature. PLASTIC AND RECONSTRUCTIVE SURGERY-GLOBAL OPEN 2020; 8:e3250. [PMID: 33299713 PMCID: PMC7722567 DOI: 10.1097/gox.0000000000003250] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2020] [Accepted: 09/14/2020] [Indexed: 12/02/2022]
Abstract
Congenital ear anomalies have been known to cause lasting psychosocial consequences for children. Congenital ear anomalies can generally be divided into malformations (chondro-cutaneous defect) and deformations (misshaped pinna). Operative techniques are the standard for correction at a minimal age of 5–7, exposing the children to teasing and heavy complications. Ear molding is a non-operative technique to treat ear anomalies at a younger age. Having been popularized since the 1980s, its use has increased over the past decades. However, uncertainties about its properties remain. Therefore, this review was conducted to look at what is known and what has been newly discovered in the last decade, comparing different treatment methods and materials. A literature search was performed on PubMed, and 16 articles, published in the last decade, were included. It was found that treatment initiated at an early age showed higher satisfactory outcome rates and a shorter duration of treatment. A shorter duration of treatment also led to higher satisfactory rates, which might be attributable to age at initiation, individual moldability, and treatment compliance. Complications were minor in all articles. Recurrence rate was low and mostly concerned prominent ears, which proved to be the most difficult to correct deformity as well. Malformations, however, were even more difficult to treat than deformations. Our analysis shows ear molding to be a successful treatment method for ear anomalies with a preference for early diagnosis and treatment.
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20
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Zhuang Q, Wei N, Zhou Q, Wang H, Wu Y, Chen Z, Yu D, Wang P, Shi H. Efficacy and Timing of Neonatal Ear Correction Molding. Aesthetic Plast Surg 2020; 44:872-878. [PMID: 31965228 DOI: 10.1007/s00266-019-01596-y] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2019] [Accepted: 12/19/2019] [Indexed: 11/26/2022]
Abstract
BACKGROUND AND AIM Given the incidence of congenital auricular anomalies varies racially, this study aimed to investigate the efficacy and timing of ear correction molding in infants with auricular anomalies. MATERIALS AND METHODS A total of 141 auricular anomalies of 100 infants less than 4 months of age were treated using the Earlimn molding system. Treatment outcomes were graded (three categories) in terms of auricular morphology. The efficacies and outcomes of modeling were evaluated in infants according to age and anomaly type. RESULTS The mean age at which correction was initiated was 35.13 days of life, and the average treatment duration was 17.81 days. Of all anomalies, 86% were corrected. Both deformations and certain malformations were satisfactorily corrected. The outcomes of children with conchal crura and mixed anomalies were relatively poor. Although no differences in treatment efficiency were evident among the three age groups, infants < 3 weeks old required shorter treatment courses than those > 6 weeks old. The only complications were mild skin ulcers. CONCLUSIONS Ear correction molding is remarkably effective for infants with auricular deformations/malformations. Molding efficacy depends on the type of anomaly. Initiation of molding at less than 6 weeks of age is essential to minimize treatment duration. LEVEL OF EVIDENCE IV This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.
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Affiliation(s)
- Qianger Zhuang
- Department of Otorhinolaryngology-Head and Neck Surgery, Wuxi Children's Hospital, Wuxi, Jiangsu, China
- Department of Otorhinolaryngology-Head and Neck Surgery, the Sixth People's Hospital affiliated to Shanghai Jiaotong University, 600 Yishan Road, Shanghai, 200233, China
| | - Ning Wei
- Department of Otorhinolaryngology-Head and Neck Surgery, Wuxi Children's Hospital, Wuxi, Jiangsu, China
| | - Qi Zhou
- Department of Otorhinolaryngology-Head and Neck Surgery, Wuxi Children's Hospital, Wuxi, Jiangsu, China
| | - Hui Wang
- Department of Otorhinolaryngology-Head and Neck Surgery, the Sixth People's Hospital affiliated to Shanghai Jiaotong University, 600 Yishan Road, Shanghai, 200233, China
| | - Yaqin Wu
- Department of Otorhinolaryngology-Head and Neck Surgery, the Sixth People's Hospital affiliated to Shanghai Jiaotong University, 600 Yishan Road, Shanghai, 200233, China
| | - Zhengnong Chen
- Department of Otorhinolaryngology-Head and Neck Surgery, the Sixth People's Hospital affiliated to Shanghai Jiaotong University, 600 Yishan Road, Shanghai, 200233, China.
| | - Dongzhen Yu
- Department of Otorhinolaryngology-Head and Neck Surgery, the Sixth People's Hospital affiliated to Shanghai Jiaotong University, 600 Yishan Road, Shanghai, 200233, China.
| | - Pengjun Wang
- Department of Otorhinolaryngology-Head and Neck Surgery, the Sixth People's Hospital affiliated to Shanghai Jiaotong University, 600 Yishan Road, Shanghai, 200233, China.
| | - Haibo Shi
- Department of Otorhinolaryngology-Head and Neck Surgery, the Sixth People's Hospital affiliated to Shanghai Jiaotong University, 600 Yishan Road, Shanghai, 200233, China
- Shanghai Key Laboratory of Sleep Disordered Breathing, Shanghai, China
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