[Non-invasive correction of congenital ear deformities with the EarWell Correction System: a prospective study]

Treatment of congenital auricle malformation with EarWell Ear Correction Kit: A meta-analysis

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.

Nonsurgical Treatment for Congenital Auricular Deformities: A Systematic Review and Meta-analysis

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 .

Non-surgical Correction of Congenital Ear Anomalies: A Review of the Literature

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.