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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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2
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van Cruchten C, Feijen MMW, Lazaâr S, Piatkowski A, van der Hulst RRWJ. The non-operative correction of ear anomalies in infants using the EarWell infant corrective system in the Netherlands. J Plast Reconstr Aesthet Surg 2024; 93:9-17. [PMID: 38603996 DOI: 10.1016/j.bjps.2024.03.002] [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: 01/14/2024] [Revised: 03/11/2024] [Accepted: 03/18/2024] [Indexed: 04/13/2024]
Abstract
BACKGROUND Congenital ear anomalies are regular but often overlooked occurrences. The golden standard of treatment has been to surgically correct these anomalies at a minimum age of 5 to 7 years. As of the last century, ear molding has developed to be a safe, reliable, and effective treatment method. Different treatment methods are still under investigation. This study aims to investigate the use of the EarWell Infant Corrective System in the Dutch population. METHODS Children aged 0-12 weeks were included in the Zuyderland Medical Center to be treated with the EarWell Infant Corrective System in case of ear deformations. Every 2 weeks, the system was replaced and correction was evaluated by both physician and parents. RESULTS Seventy-three participants were included, of whom 123 ears in total were treated. Age at initiation was 35.5 days on average; treatment lasted an average of 59 days. Parents and physicians both reported an amelioration of all ear anomalies after treatment, scoring the correction grade an 8.8. Overall satisfaction with the treatment method was 9 or higher for both groups. CONCLUSIONS The EarWell Infant Corrective System is a safe, reliable, and effective treatment method for the correction of ear anomalies in infants.
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Affiliation(s)
- Cas van Cruchten
- Department of Plastis, Reconstructive and Hand Surgery, Zuyderland Medical Centre, Dr. H. van der Hoffplein 1, 6162 BG Sittard-Geleen, Limburg, the Netherlands.
| | - Michelle M W Feijen
- Department of Plastis, Reconstructive and Hand Surgery, Zuyderland Medical Centre, Dr. H. van der Hoffplein 1, 6162 BG Sittard-Geleen, Limburg, the Netherlands
| | - Sherida Lazaâr
- Department of Plastis, Reconstructive and Hand Surgery, Zuyderland Medical Centre, Dr. H. van der Hoffplein 1, 6162 BG Sittard-Geleen, Limburg, the Netherlands
| | - Andrzej Piatkowski
- Department of Plastis, Reconstructive and Hand Surgery, Maastricht University Medical Centre, P. Debyelaan 25, 6229 HX Maastricht, Limburg, the Netherlands
| | - Rene R W J van der Hulst
- Department of Plastis, Reconstructive and Hand Surgery, Maastricht University Medical Centre, P. Debyelaan 25, 6229 HX Maastricht, Limburg, the Netherlands
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Hilewitz D, Olshinka A. Early Non-Surgical Treatment For Microtia Types 1 and 2. J Craniofac Surg 2024:00001665-990000000-01576. [PMID: 38743060 DOI: 10.1097/scs.0000000000010279] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2024] [Accepted: 04/04/2024] [Indexed: 05/16/2024] Open
Abstract
Esthetic concerns and psychosocial distress often accompany auricular deformities and malformations in both children and their parents. Approximately 30% of newborns are affected by auricular anomalies, with 15% to 20% resulting in permanent defects. While surgical intervention is typically considered the gold standard for malformations, a non-surgical approach, such as splinting, molding, or other non-invasive techniques, can effectively address deformations if promptly administered by a specialist. Microtia, classified into 4 types, presents challenges ranging from fundamental structural anomalies in types 1 and 2 to severe defects in type 3 and complete absence of the external ear in type 4 (anotia). This study introduces a novel non-invasive treatment modality for microtia types 1 and 2. The cohort consisted of 5 newborns treated for microtia types 1 or 2 between 2022 and 2023. Utilizing the EarWell system, treatment was initiated before 3 weeks of age (mean age: 2 weeks), with an average treatment duration of 6.6 weeks, supplemented by molding treatment as needed. Minor adverse effects, such as simple dermatitis, were observed in 2 patients. All parents expressed high satisfaction with the esthetic outcomes, with 60% reporting extreme satisfaction. The prompt initiation of the treatment protocol for microtia types 1 and 2 led to outstanding and timely outcomes in infants, enhancing the quality of life for both parents and their children. Early intervention for subsequent treatment may improve the condition and, in certain cases, serve as a satisfactory alternative for parents hesitant about further surgical intervention for their children.
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Affiliation(s)
| | - Asaf Olshinka
- Tel Aviv University School of Medicine, Tel Aviv
- Plastic Surgery & Burns Unit, Schneider Children's Medical Center of Israel, Petah Tikva, Israel
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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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Xu H, Ding S, Zhang F, Zhang Z, Chen X, Li M, Yang H, Han F, Liu H. The application of the strip-shaped cymba conchae orthosis in the nonsurgical correction of complex auricular deformity. J Otol 2024; 19:24-29. [PMID: 38313761 PMCID: PMC10837530 DOI: 10.1016/j.joto.2023.12.002] [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: 08/19/2023] [Revised: 11/16/2023] [Accepted: 12/05/2023] [Indexed: 02/06/2024] Open
Abstract
Objective This study aims to evaluate the efficacy and safety of using a strip-shaped cymba conchae orthosis for the nonsurgical correction of complex auricular deformities. Methods Clinical data were collected from 2020 to 2021 for 6 patients who underwent correction using a strip-shaped cymba conchae orthosis. The indications, corrective effects, and complications associated with use of the orthosis were analyzed. Results There were four indications for treatment: cryptotia with helix adhesion; cryptotia with grade I microtia; cryptotia with excessive helix thickness; and auricular deformity beyond the treatment time window (≥6 months). Excellent corrective effects were observed in all 6 patients. Complications occurred in one patient, who recovered after symptomatic treatment. Conclusion The use of a strip-shaped cymba conchae orthosis alone or combined with a U-shaped helix orthosis presents a feasible approach for correcting complex auricular deformities or deformities beyond the treatment time window in pediatric patients.
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Affiliation(s)
- Huijuan Xu
- Department of Otolaryngology Head and Neck Surgery, People's Hospital of Henan University, Henan Provincial People's Hospital, Zhengzhou, China
| | - Shaoguang Ding
- Department of Otolaryngology Head and Neck Surgery, Henan Provincial People's Hospital, People's Hospital of Zhengzhou University, People's Hospital of Henan University, Zhengzhou, China
| | - Fei Zhang
- Department of Otolaryngology Head and Neck Surgery, Henan Children's Hospital, Zhengzhou, China
| | - Zhifeng Zhang
- Department of Otolaryngology Head and Neck Surgery, The Third People's Hospital of Zhengzhou, Zhengzhou, China
| | - Xiangyu Chen
- Department of Otolaryngology Head and Neck Surgery, People's Hospital of Henan University, Henan Provincial People's Hospital, Zhengzhou, China
| | - Mingyang Li
- Department of Otolaryngology Head and Neck Surgery, Henan Provincial People's Hospital, People's Hospital of Zhengzhou University, People's Hospital of Henan University, Zhengzhou, China
| | | | - Fugen Han
- Department of Otolaryngology Head and Neck Surgery, Henan Children's Hospital, Zhengzhou, China
| | - Hongjian Liu
- Department of Otolaryngology Head and Neck Surgery, Henan Provincial People's Hospital, People's Hospital of Zhengzhou University, People's Hospital of Henan University, Zhengzhou, China
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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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Li J, Tan J, Yang D, Chen L. The advantages of domestic ear molding system in molding bilateral neonatal congenital auricular deformities. BMC Pediatr 2023; 23:101. [PMID: 36869317 PMCID: PMC9983205 DOI: 10.1186/s12887-023-03916-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2022] [Accepted: 02/16/2023] [Indexed: 03/05/2023] Open
Abstract
BACKGROUND There are different types of ear molding devices on the market. However, due to high cost, the wide application of the ear molding is hindered, especially for children with bilateral congenital auricular deformities (CAD). This study is designed to correct the bilateral CAD with the flexible use of Chinese domestic ear molding system. METHODS Newborns diagnosed with bilateral CAD were recruited in our hospital from September 2020 to October 2021. For each subject, one ear wore a set of domestic ear molding system, while the contralateral ear used only matching Retractor and Antihelix Former. Medical charts were reviewed to collect data on the types of CAD, the incidence of complications, the initiation and duration of treatment, as well as the satisfaction after treatment. Treatment outcomes were graded into three levels: excellent, good, and poor, according to the improvement of auricular morphology evaluated by both doctors and parents, respectively. RESULTS A total of 16 infants (32 ears) were treated with the Chinese domestic ear molding system, which contains 4 cases with Stahl's ear (8 ears), 5 cases with Helical rim deformity (10 ears), 3 cases with Cup ear (6 ears), 4 cases with Lop ear (8 ears). All infants accomplished the correction completely. Both parents and doctors were satisfied with the outcomes. No obvious complication was observed. CONCLUSIONS Ear molding is an effective nonsurgical treatment for CAD. Molding with Retractor and Antihelix Former is simple and effective. Domestic ear molding system can be flexibly used in correcting bilateral CAD. With this approach, infants with bilateral CAD will benefit more in the near future.
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Affiliation(s)
- Jie Li
- Department of Otorhinolaryngology, Fu Xing Hospital, Capital Medical University, No. 20 Fuxingmenwai Street, Xicheng District, Beijing, 100038, China.
| | - Junlong Tan
- Department of Otorhinolaryngology, Fu Xing Hospital, Capital Medical University, No. 20 Fuxingmenwai Street, Xicheng District, Beijing, 100038, China
| | - Denghua Yang
- Department of Otorhinolaryngology, Fu Xing Hospital, Capital Medical University, No. 20 Fuxingmenwai Street, Xicheng District, Beijing, 100038, China
| | - Liyan Chen
- Department of Otorhinolaryngology, Fu Xing Hospital, Capital Medical University, No. 20 Fuxingmenwai Street, Xicheng District, Beijing, 100038, China
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Abstract
BACKGROUND Ear molding is a noninvasive treatment that shows promising results for neonatal ear deformations. Little research has been reported evaluating 1-year outcomes or relapse after ear molding for ear malformations. METHODS One-year molding efficacy for constricted ear, a common malformation that affects the aesthetic appearance of the auricle, was assessed during a single-center, prospective study conducted over a 3-year period (from May of 2017 to April of 2020). Infants with constricted ears were recruited and treated with the EarWell Infant Ear Correction System. Constricted ear classification, age at treatment application, duration of treatment, complications, and parental satisfaction were analyzed. Photographic documentation of the ears was performed before treatment, at treatment termination, and 12 months after treatment to evaluate treatment efficacy and relapse. RESULTS Sixty patients with 91 constricted ears were recruited. The EarWell Infant Ear Correction System was initiated before 2 weeks of age for 75.0% of these patients. Successful correction was achieved in 85.8% of patients. Early molding initiation (before 14 days of age) resulted in a significantly higher success rate ( P = 0.017). Class 1 and class 2 deformities achieved better outcomes than class 3 deformities ( P = 0.001). Among the 91 auricles, 37 ears (40.7%) relapsed: 36.3% had mild relapse, 4.4% had moderate relapse, and 0% had severe relapse. The treatment duration for patients with relapse was shorter than for patients without relapse ( P = 0.035). CONCLUSION Early ear molding is an effective treatment for constricted ear. Sufficient molding duration and consolidation periods are crucial in maintaining treatment effects. CLINICAL QUESTION/LEVEL OF EVIDENCE Therapeutic, III.
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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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Analysis of the curative effect of a domestic ear orthosis system in the treatment of congenital auricle deformity. Am J Otolaryngol 2022; 43:103205. [PMID: 35279284 DOI: 10.1016/j.amjoto.2021.103205] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Revised: 07/21/2021] [Accepted: 09/05/2021] [Indexed: 11/23/2022]
Abstract
OBJECTIVE To evaluate the therapeutic effect and determinants of jingle ear orthosis in the correction of infant ear malformation and to evaluate its clinical application value. METHODS In this retrospective study, 156 patients with 233 ears who had used the beautiful ear orthosis system in Jiangxi Province in the last 3 years were included. The patients were grouped according to age at initial correction, sex, and type of deformity, and data on duration and age of orthotic use and complications were obtained. RESULTS We studied 156 paediatric cases with 233 ear deformities, 79 of which were single-ear deformities. In total, 77 cases had an ear shape deformity, and an implicit ear was the most common deformity. For a good therapeutic effect evaluation standard above 96.57%, the mean duration of follow-up was 1 month. The initial correction age was an important factor in the correction effect while gender had no obvious influence. The difference in the mean wearing time was not statistically significant (p = 0.233, p > 0.05). There was no statistically significant difference in the ratio of correcting effects between the 6 types of deformities that were excellent or good (p = 0.086, p > 0.05). CONCLUSIONS Domestic auricle orthosis is an effective nonsurgical treatment for ear malformation. The correction effect is related to the initial correction age. The younger the child is, the better the treatment effect is, and the shorter the treatment time is. Complications are common in older infants. Therefore, prompt non-surgical correction performed can improve the effective rate of treatment.
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Dinis J, Junn A, Long A, Phillips S, Reategui A, Kaplan A, Alperovich M. Non-Surgical Correction of Congenital Ear Anomalies: A Critical Assessment of Caretaker Burdens and Aesthetic Outcomes. Aesthetic Plast Surg 2022; 46:898-906. [PMID: 34608514 DOI: 10.1007/s00266-021-02610-y] [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: 06/27/2021] [Accepted: 09/19/2021] [Indexed: 11/30/2022]
Abstract
INTRODUCTION Congenital ear anomalies result from cartilage and skin compression in utero. They can be corrected in infancy before the cartilage hardens and loses its malleability. Caretaker burden of ear molding and its impact on esthetic outcomes has not been studied. METHODS Demographic and procedural variables were retrospectively collected for infants who underwent ear molding. Parents were surveyed regarding their experience, caretaker burden, and esthetic outcome. Outside physicians were provided with pre- and post-treatment photographs and asked to rate outcomes. A Likert scale was developed for responses and converted to a numeric score from 1 to 5 with 5 as the most desirable. RESULTS Seventy-four patients comprising 121 ears were included. Mean age at treatment was 20.1 ± 21.4 days with treatment duration of 21.1 ± 7.7 days. Parental participation in the survey was 70.1%. Questions that queried parents' experiences revealed a "very positive" experience with minor burden related to bathing and cleaning (Mean Likert Score 4.1, Range 1-5). Favorable parent-reported outcomes were obtained regarding anticipated social distress (4.28, 1-5), satisfaction with results (4.27, 1-5), and perception of final appearance (4.18, 1-5). Physician assessments of esthetic outcomes were slightly lower, but favorable between "somewhat effective" and "very effective" (3.46, 1-5). Earlier treatment trended favorably, but did not reach significance. Ear malformations had higher parent-reported satisfaction than ear deformations (4.75 ± 0.46 vs 4.21 ± 1.25, p = 0.025). CONCLUSION Despite the additional obligation for new parents, infant ear molding is rated low in terms of caretaker burden. Esthetic outcomes are excellent as assessed by parents and physicians. However, caretakers reported higher esthetic outcomes than physician evaluations. 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)
- Jacob Dinis
- Division of Plastic and Reconstructive Surgery, Department of Surgery, Yale University School of Medicine, 330 Cedar Street, Boardman Building, 3rd Floor, New Haven, CT, 06519, USA
| | - Alexandra Junn
- Division of Plastic and Reconstructive Surgery, Department of Surgery, Yale University School of Medicine, 330 Cedar Street, Boardman Building, 3rd Floor, New Haven, CT, 06519, USA
| | - Aaron Long
- Division of Plastic and Reconstructive Surgery, Department of Surgery, Yale University School of Medicine, 330 Cedar Street, Boardman Building, 3rd Floor, New Haven, CT, 06519, USA
| | - Sarah Phillips
- Division of Plastic and Reconstructive Surgery, Department of Surgery, Yale University School of Medicine, 330 Cedar Street, Boardman Building, 3rd Floor, New Haven, CT, 06519, USA
| | - Alvaro Reategui
- Division of Plastic and Reconstructive Surgery, Department of Surgery, Yale University School of Medicine, 330 Cedar Street, Boardman Building, 3rd Floor, New Haven, CT, 06519, USA
| | - Anna Kaplan
- Division of Plastic and Reconstructive Surgery, Department of Surgery, Yale University School of Medicine, 330 Cedar Street, Boardman Building, 3rd Floor, New Haven, CT, 06519, USA
| | - Michael Alperovich
- Division of Plastic and Reconstructive Surgery, Department of Surgery, Yale University School of Medicine, 330 Cedar Street, Boardman Building, 3rd Floor, New Haven, CT, 06519, USA.
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12
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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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Liu C, Wo P, Zhang J, Li J. Nonsurgical molding of congenital auricular deformities and analysis of the correction outcomes: A single-center, retrospective study in east China. Front Pediatr 2022; 10:1031575. [PMID: 36589152 PMCID: PMC9800832 DOI: 10.3389/fped.2022.1031575] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Accepted: 11/16/2022] [Indexed: 12/23/2022] Open
Abstract
OBJECTIVE Our research was carried out to provide a clinical reference for the application of nonsurgical therapy in newborns with congenital auricular deformities in east China. METHODS A retrospective study of consecutive newborns using noninvasive ear molding was conducted in Hangzhou in east China's Zhejiang Province. The demographic and clinical information and photographs of the ear before and after treatment were taken. The diagnosis of each auricular deformity was identified, and the treatment outcome was evaluated. RESULTS A total of 224 patients including 356 congenital ear anomalies received noninvasive ear molding. The median age of infants to initiate treatment was 39.5 days. The median treatment duration was 42.5 days. The median follow-up time was 137.0 days. The overall treatment effective rate of all infants with nonoperative ear molding was 92.1%, and mild skin irritation and ulceration occurred in 34 ear deformities (9.6%). It confirmed that the treatment efficiency was satisfactory and the complication rate was still acceptable despite the late initiation treatment of neonates in east China. Further analysis of treatment outcomes among three subgroups of infants (the ages to initiate the ear molding were respectively less than or equal to 28, 29-56, and more than 57 days) revealed that initiation treatment was significantly related to the treatment results and the earlier the initiation treatment, the higher the effective rate and the lower the complication incidence. CONCLUSION Our study hints that newborns in east China may have a longer period for correction. What is more, although our study affirmed a longer period for noninvasive molding, early diagnosis and treatment are still recommended to improve therapy efficiency and reduce treatment duration and complications.
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Affiliation(s)
- Chuanbo Liu
- Department of Plastic and Cosmetic Surgery, Affiliated Hangzhou First People's Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Peibin Wo
- Department of Plastic and Cosmetic Surgery, Affiliated Hangzhou First People's Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Jufang Zhang
- Department of Plastic and Cosmetic Surgery, Affiliated Hangzhou First People's Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Jinsheng Li
- Department of Plastic and Cosmetic Surgery, Affiliated Hangzhou First People's Hospital, Zhejiang University School of Medicine, Hangzhou, China
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The Outward Curved Concha, an Unfamiliar Congenital Auricular Deformation: A Novel Protocol for Nonsurgical Management. J Craniofac Surg 2021; 33:e392-e396. [PMID: 34690322 DOI: 10.1097/scs.0000000000008301] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
ABSTRACT Anomalies present in about 30% of newborn ears; 15% to 20% of them are permanent. Malformations can be treated solely surgically; however, deformations, when promptly diagnosed, can be treated with nonsurgical methods, such as splinting and molding. The deformity of an outward curved concha is not only an aesthetic issue, but may confer functional problems that impair hearing and hearing aid usage. The goal of this report was to present this unique anomaly and our novel noninvasive treatment protocol for its management. Our cohort comprised 10 newborns treated for outward curved concha during 2018 and 2019. The patients underwent nonsurgical treatment using the EarWell system. In some patients, the management was followed by molding and taping to achieve the best effect. Treatment for all the patients began before age 3 weeks (mean, 2 weeks). Treatment duration was 5.2 weeks, on average. Nine patients did not show any adverse effects. The majority of parents expressed satisfaction with the aesthetic result; 70% were extremely pleased. Early initiation of the treatment-protocol for outward curved concha deformation yielded excellent and timely results in the infants, without the necessity of an invasive procedure.
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15
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Abstract
Congenital ear abnormalities present an aesthetic and psychosocial concern for pediatric patients and their parents. Diagnosis of external ear deformities is based on clinical examination and is facilitated by an understanding of normal ear anatomy. Ear anomalies can be categorized as malformations or deformations. Malformations are characterized by absent anatomical structures of the ear (or absence of the ear itself), as exemplified by microtia and anotia. Ear deformations are characterized by ear anatomical landmarks that are present but are distorted or abnormal, with Stahl ear, constricted ear, and prominent ear being common presentations. Ear malformations will not improve with growth of the patient and uniformly require surgical intervention to recreate an anatomically typical ear. Although a small percentage of ear deformations can self-resolve, most patients with ear deformations will require nonsurgical or surgical reconstruction to achieve a normal or more aesthetic ear. In recent decades the use of nonsurgical ear splinting or molding has been recognized as a highly effective method in correcting a variety of congenital ear deformations when treatment is initiated in the first 8 weeks of life. The urgency in initiating nonsurgical treatment of ear deformations at an early age makes prompt recognition of these ear deformations essential because surgical correction remains the only viable reconstructive option in older infants and children.
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Affiliation(s)
- Sana L Bhatti
- Division of Plastic Surgery, Nicklaus Children's Hospital, Miami, FL.,Division of Plastic Surgery, Florida International University College of Medicine, Miami, FL
| | - Lauren T Daly
- Division of Plastic Surgery, University of Massachusetts, Worcester, MA
| | - Martha Mejia
- Division of Plastic Surgery, Nicklaus Children's Hospital, Miami, FL
| | - Chad Perlyn
- Division of Plastic Surgery, Nicklaus Children's Hospital, Miami, FL.,Division of Plastic Surgery, Florida International University College of Medicine, Miami, FL
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16
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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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Manji I, Durlacher K, Verchere C. Correction of neonatal auricular deformities with DuoDERM: A simple technique. Paediatr Child Health 2020; 26:270-273. [PMID: 34336053 DOI: 10.1093/pch/pxaa102] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2019] [Accepted: 06/22/2020] [Indexed: 11/15/2022] Open
Abstract
Ear moulding in neonates has been shown to successfully correct congenital auricular anomalies. There are several available moulding techniques. However, commercially available moulding devices (e.g., EarWell and Ear Buddy) can be costly, and their alternatives have limited customizability. We present a technique using cost-effective and customizable materials for moulding common anomalies (Stahl's ear, constricted ear, and prominent ear). DuoDERM Extra-thin, Steri-strips, and 3M Kind Removal Silicone tape are used to splint the ear in a preferred position. The DuoDERM is rolled into a putty, placed in the ear, and secured with tapes. This treatment is initiated in the clinic, with weekly splint changes carried out at home by caregivers, and intermittent follow-up appointments. DuoDERM moulding is a safe, inexpensive, highly customizable, and simple way to correct auricular deformities. Primary physicians/paediatricians should embed moulding into their practice, starting treatment as early as possible in the neonatal period.
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Affiliation(s)
- Inayah Manji
- Division of Pediatric Plastic Surgery, Department of Surgery, University of British Columbia, Vancouver, British Columbia.,Faculty of Medicine, University of British Columbia, Vancouver, British Columbia
| | - Kim Durlacher
- Department of Occupational Science & Occupational Therapy, University of British Columbia, Vancouver, British Columbia.,Occupational Therapy Department, British Columbia, Children's Hospital, Vancouver, British Columbia
| | - Cynthia Verchere
- Division of Pediatric Plastic Surgery, Department of Surgery, University of British Columbia, Vancouver, British Columbia.,Division of Plastic Surgery, Department of Surgery, British Columbia Children's Hospital, Vancouver, British Columbia
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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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19
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Ear Molding Therapy: Laypersons' Perceptions, Preferences, and Satisfaction with Treatment Outcome. PLASTIC AND RECONSTRUCTIVE SURGERY-GLOBAL OPEN 2020; 8:e2902. [PMID: 32802642 PMCID: PMC7413762 DOI: 10.1097/gox.0000000000002902] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2020] [Accepted: 04/15/2020] [Indexed: 11/25/2022]
Abstract
Supplemental Digital Content is available in the text. This study investigates laypersons’ perceptions of congenital ear deformities and preferences for treatment, particularly with ear molding therapy—an effective, noninvasive, yet time-sensitive treatment.
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20
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Nonoperative Molding of Congenital Ear Deformities: The Impact of Birth-Initiation Delay on Correction Outcome. J Craniofac Surg 2020; 31:1588-1592. [PMID: 32371707 DOI: 10.1097/scs.0000000000006473] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Ear molding can improve the majority congenital ear deformities when employed early after birth. However, the best time to initiate treatment remains debated. In describing one surgeon's experience over the past near decade, this study aims to highlight differences conferred by treatment timing. The authors hypothesize that auricular outcomes are superior when deformities are molded beginning in the first 3 weeks of life. A retrospective review (2010-2018) of 272 cases was performed to compare early initiation of molding (<3 weeks of birth) and delayed initiation (>3 weeks). The mean patient age was 20.4 days and the mean follow-up was 0.5 months. The overall treatment was approximately 31 days. The number of devices required was similar (2.3 versus 2.5) between early and delayed molding cases, but fall-outs (1.0 versus 0.7, P = 0.02) and replacements (0.9 versus 0.6, P = 0.004) were more common after delayed molding. Skin complications developed in 13.6% (37) of ears overall and did not differ by treatment timing. Follow-up surgery was reported in 2 (0.7%) ears. The 85% of families reported subjective satisfaction with the final outcome; satisfaction was significantly higher for early cases (97% versus 79%, P = 0.03). Ear molding of congenital ear deformities should begin within 3 weeks of birth. From our experience, setting realistic expectations helps limit discrepancies between expectation and outcome.
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Xiong H, Wang X, Li G, Xu J, Zhai J, Chen S, Lu Y, Chen Y, Zheng Y, Yang H. Comparison of 2 Ear Molding Systems for Nonsurgical Management of Newborn Auricular Deformities. EAR, NOSE & THROAT JOURNAL 2020; 100:652S-656S. [PMID: 32031003 DOI: 10.1177/0145561320901398] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Congenital auricular deformities are common diseases in newborn infants. We compared the efficacy of 2 ear molding systems in the nonsurgical management of newborn auricular deformities in Chinese infants. METHODS A total of 462 newborns with auricular deformities were treated with either the EarWell or the LiangEar ear molding systems. The posttreatment outcome was graded as excellent, fair, and poor. The differences in effectiveness between the 2 ear molding systems and factors that may affect the posttreatment outcome were analyzed. RESULTS Both ear molding systems showed substantial efficacy in the treatment of newborn auricular deformities. The effective rate was comparable between the EarWell and the LiangEar systems for 4 types of auricular deformities (cryptotia, prominent ear, helical rim abnormality, and cup ear), while the costs for the LiangEar systems were half as much as that for the EarWell systems. Multivariate regression analysis showed that earlier time points at treatment initiation, less severe auricular deformities, treatment duration, and breastfeeding were the most significant predictive factors for a better outcome. CONCLUSION Our findings demonstrate that using the EarWell and the LiangEar systems are both optimal nonsurgical approaches for treatment of most newborn auricular deformities.
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Affiliation(s)
- Hao Xiong
- Department of Otolaryngology, 56713Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China.,Institute of Hearing and Speech-Language Science, 26469Sun Yat-sen University, Guangzhou, China.,Department of Hearing and Speech Science, 517769Xinhua College, Sun Yat-sen University, Guangzhou, China
| | - Xiaoya Wang
- Department of Otolaryngology, Guangzhou Women and Children's Medical Center, Guangzhou, China
| | - Genghui Li
- Department of Hearing and Speech Science, 517769Xinhua College, Sun Yat-sen University, Guangzhou, China.,Department of Otolaryngology, Maoming People's Hospital, Maoming, China
| | - Jingjing Xu
- Department of Hearing and Speech Science, 517769Xinhua College, Sun Yat-sen University, Guangzhou, China
| | - Jinming Zhai
- 220741The Second Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Siyi Chen
- Department of Hearing and Speech Science, 517769Xinhua College, Sun Yat-sen University, Guangzhou, China
| | - Yuewen Lu
- Department of Hearing and Speech Science, 517769Xinhua College, Sun Yat-sen University, Guangzhou, China
| | - Yueling Chen
- Department of Hearing and Speech Science, 517769Xinhua College, Sun Yat-sen University, Guangzhou, China
| | - Yiqing Zheng
- Department of Otolaryngology, 56713Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China.,Institute of Hearing and Speech-Language Science, 26469Sun Yat-sen University, Guangzhou, China.,Department of Hearing and Speech Science, 517769Xinhua College, Sun Yat-sen University, Guangzhou, China
| | - Haidi Yang
- Department of Otolaryngology, 56713Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China.,Institute of Hearing and Speech-Language Science, 26469Sun Yat-sen University, Guangzhou, China.,Department of Hearing and Speech Science, 517769Xinhua College, Sun Yat-sen University, Guangzhou, China
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Wang D, Jiang H, Yang Q, Liu X, He L, Pan B, Lin L. Non-surgical correction of cryptotia and the analysis of treatment time and other influence factors. Int J Pediatr Otorhinolaryngol 2020; 129:109771. [PMID: 31731016 DOI: 10.1016/j.ijporl.2019.109771] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/26/2019] [Revised: 11/03/2019] [Accepted: 11/04/2019] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To explore correlations between post-treatment outcomes of non-surgical correction for cryptotia and treatment time and other influence factors. METHODS Forty-seven consecutive patients with 64 cryptotias were treated with the adjusted external stretching device and followed up over 12 months. A subjective evaluation scale was designed for patients to collect clinical data. Pretreatment and posttreatment evaluation were conducted by two blinded investigators. The correlations between influence factors and outcomes were explored through fractional polynomial method, multiple logistic regression, and robust linear regression methods. RESULTS Thirty-five patients with 49 cryptotias were included. Twenty-nine cryptotias (23 patients) have been successfully managed. Two of 17 unilateral cryptotias achieved nearly complete symmetry. The final optimal cutoff value for initiating treatment time is 6 months and for the duration of treatment per day is 5 h per day. Positive relationships between initiating treatment time >6 months and onset time, type II and onset time, initiating treatment time >6 months and effect stabilization time were observed. CONCLUSIONS Initiating treatment time <6 months and duration of treatment per day >5 h benefit for the posttreatment outcomes. Patients wearing the device under 6 months old would have earlier onset time and effect stabilization time. It is hard to achieve complete bilateral symmetry in unilateral patients. The adjustable devices can used for the auricles with different sizes and removed and equipped conveniently.
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Affiliation(s)
- Di Wang
- Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Haiyue Jiang
- Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Qinghua Yang
- Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Xia Liu
- Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Leren He
- Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Bo Pan
- Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Lin Lin
- Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
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Efficacy of Ear Molding in Infants using the EarWell Infant Correction System and Factors Affecting Outcome. Plast Reconstr Surg 2020; 144:648e-658e. [PMID: 31568305 DOI: 10.1097/prs.0000000000006057] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
BACKGROUND One-third of infants have ear anomalies, and less than one-third self-correct. Correction of ear deformities by molding exploits the plasticity of the auricular cartilage because of circulating maternal estrogen during infancy. In this study, the authors assess the efficacy of the EarWell Infant Correction System in the correction of ear deformities and determine the factors that affect its outcome. METHODS The authors conducted a single-center prospective study over a 3-year period. Consecutive full-term infants who underwent ear molding with the EarWell system were recruited. Primary outcome was successful correction of ear anomaly. Secondary outcomes included complications and maintenance of ear shape. Factors identified included type of anomaly, age at application, duration of application, and breastfeeding. RESULTS Sixty-seven patients with a total of 105 ears were recruited. The anomalies were classified into deformations (66.7 percent) and malformations (33.3 percent). The median age group at presentation was 0 to 7 days (67 percent). Average duration of application was 4.1 weeks. Successful correction was achieved in 86 percent of patients. Ear deformations achieved a significantly higher rate of successful outcome (98 percent) compared with malformations (64 percent) (p < 0.001). Skin complications were common (46 percent) and attributed to our tropical climate. Patients with complications were of a higher mean age (22.1 days) compared with patients with no complications (10.6 days) (p = 0.037). CONCLUSIONS The EarWell system is an effective nonsurgical option for the treatment of ear anomalies. The type of anomaly was the only predictor of successful correction, whereas age at application, duration of molding, and breastfeeding were not. Complications were more common in older infants. CLINICAL QUESTION/LEVEL OF EVIDENCE Therapeutic, IV.
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Anomalies congénitales de l’oreille externe : traitement néonatal par conformation. ANN CHIR PLAST ESTH 2019; 64:334-343. [DOI: 10.1016/j.anplas.2018.06.011] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2018] [Accepted: 06/19/2018] [Indexed: 11/17/2022]
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25
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Abstract
The incidence of congenital ear deformities has been documented to be as high as 58% of all newborns. Unfortunately, the majority of these deformations do not spontaneously self-correct, leaving the child with a permanent deformity that can only be corrected through surgery. With the evolving simplicity of ear molding that can be done in the office, this can obviate the need for unnecessary surgery that comes with its own set of complications and a higher cost. Early detection and early treatment is key for successful ear molding. The purpose of this article is to review the types of deformational ear deformities and the most up-to-date literature on ear molding, increase awareness to this topic, and ultimately increase patient and parental satisfaction with their overall care.
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Affiliation(s)
- Catherine S Chang
- 1 Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
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26
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Abstract
The known classifications for microtia have been cumbersome and difficult to apply in daily consultation. The lack of a progressive surgical behavior according to each degree of affection also contributes to confusion and in a lower success rate in clinical application. The authors propose a progressive surgical classification that takes into consideration the principal anatomical defect and the corresponding correction with modern techniques, having eliminated from previous classifications, those elements that are now considered deformations of the ear, capable of conservative treatment in early stages of life.
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Lennon C, Chinnadurai S. Nonsurgical Management of Congenital Auricular Anomalies. Facial Plast Surg Clin North Am 2018; 26:1-8. [DOI: 10.1016/j.fsc.2017.09.001] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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28
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Zhao H, Lin G, Seong YH, Shi J, Xu J, Huang W. Anthropometric research of congenital auricular deformities for newborns. J Matern Fetal Neonatal Med 2017; 32:1176-1183. [PMID: 29219007 DOI: 10.1080/14767058.2017.1402877] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Hui Zhao
- Department of Human Anatomy, School of Basic Medical Sciences, Southern Medical University, Guangzhou, China
| | - Guanfeng Lin
- Teaching and Scientific Research Center, School of Laboratory Medicine and Biotechnology, Southern Medical University, Guangzhou, China
| | | | - Jin Shi
- Laboratory of Neurosurgery, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Jing Xu
- Department of Human Anatomy, School of Basic Medical Sciences, Southern Medical University, Guangzhou, China
| | - Wenhua Huang
- Department of Human Anatomy, School of Basic Medical Sciences, Southern Medical University, Guangzhou, China
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29
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A Morphometric Study of the Newborn Ear and an Analysis of Factors Related to Congenital Auricular Deformities. Plast Reconstr Surg 2017; 140:147-155. [DOI: 10.1097/prs.0000000000003443] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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30
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Classification of Newborn Ear Malformations and their Treatment with the EarWell Infant Ear Correction System. Plast Reconstr Surg 2017; 139:681-691. [DOI: 10.1097/prs.0000000000003150] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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31
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Chang CS, Bartlett SP. A Simplified Nonsurgical Method for the Correction of Neonatal Deformational Auricular Anomalies. Clin Pediatr (Phila) 2017; 56:132-139. [PMID: 27075023 DOI: 10.1177/0009922816641368] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Despite reported success of early nonsurgical splinting of congenital ear deformities, the technique has not been widely utilized due to difficulty with application and positional maintenance of these devices. Delay in treatment can result in unnecessary surgery for the child later in life. In response to this need, we developed a simplified system consisting of Velcro, conformers, and polysiloxane gel that can be applied in 3 steps. Before and after photos after application of the device were graded by a plastic surgeon independent of the study. A total of 33 ear deformities were treated. In all, 92.3% of ears achieved significant improvement and normalization of their ears after therapy. This device allows for a more straightforward and individualized application than current products available. Our hope is that practitioners involved early in the infant's care will utilize this technology resulting in improved outcomes and avoiding unnecessary surgery.
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Kim JH, Sheen YH, Kim KE, Heo JS, Jeon JH, Chung SH. Treatment of Auricular Deformities with the EarWell System in Three Newborns. NEONATAL MEDICINE 2017. [DOI: 10.5385/nm.2017.24.3.129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
Affiliation(s)
- Ji Hee Kim
- Department of Pediatrics, CHA Gangnam Medical Center, CHA University School of Medicine, Seoul, Korea
| | - Youn Ho Sheen
- Department of Pediatrics, CHA Gangnam Medical Center, CHA University School of Medicine, Seoul, Korea
| | - Ki Eun Kim
- Department of Pediatrics, CHA Gangnam Medical Center, CHA University School of Medicine, Seoul, Korea
| | - Ju Sun Heo
- Department of Pediatrics, CHA Gangnam Medical Center, CHA University School of Medicine, Seoul, Korea
| | - Ji Hyun Jeon
- Department of Pediatrics, CHA Gangnam Medical Center, CHA University School of Medicine, Seoul, Korea
| | - Sung Hoon Chung
- Department of Pediatrics, Kyung Hee University Hospital at Gangdong, Kyung Hee University School of Medicine, Seoul, Korea
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Anstadt EE, Johns DN, Kwok ACM, Siddiqi F, Gociman B. Neonatal Ear Molding: Timing and Technique. Pediatrics 2016; 137:e20152831. [PMID: 26908661 DOI: 10.1542/peds.2015-2831] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/15/2015] [Indexed: 11/24/2022] Open
Abstract
The incidence of auricular deformities is believed to be ∼11.5 per 10,000 births, excluding children with microtia. Although not life-threatening, auricular deformities can cause undue distress for patients and their families. Although surgical procedures have traditionally been used to reconstruct congenital auricular deformities, ear molding has been gaining acceptance as an efficacious, noninvasive alternative for the treatment of newborns with ear deformations. We present the successful correction of bilateral Stahl's ear deformity in a newborn through a straightforward, nonsurgical method implemented on the first day of life. The aim of this report is to make pediatric practitioners aware of an effective and simple molding technique appropriate for correction of congenital auricular anomalies. In addition, it stresses the importance of very early initiation of ear cartilage molding for achieving the desired outcome.
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Affiliation(s)
| | - Dana Nicole Johns
- Division of Plastic and Reconstructive Surgery, University of Utah, Salt Lake City, Utah
| | - Alvin Chi-Ming Kwok
- Division of Plastic and Reconstructive Surgery, University of Utah, Salt Lake City, Utah
| | - Faizi Siddiqi
- Division of Plastic and Reconstructive Surgery, University of Utah, Salt Lake City, Utah
| | - Barbu Gociman
- Division of Plastic and Reconstructive Surgery, University of Utah, Salt Lake City, Utah
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A Simple Method of Neonatal Ear Molding for Treatment of Stahl Ear Deformity. J Craniofac Surg 2015; 26:e802-3. [DOI: 10.1097/scs.0000000000002275] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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Affiliation(s)
- Shaun Mehta
- Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Andres Gantous
- Division of Facial Plastic and Reconstructive Surgery, Department of Otolaryngology–Head & Neck Surgery, University of Toronto, Toronto, Ontario, Canada
- Division of Otolaryngology–Head & Neck Surgery, Department of Surgery, St Joseph’s Health Centre, Toronto, Ontario, Canada
- Department of Otolaryngology–Head & Neck Surgery, St Michael’s Hospital, Toronto, Ontario, Canada
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Klatt ME, Ratnapalan S. Earlobe anomalies in children. Clin Pediatr (Phila) 2014; 53:823-5. [PMID: 24065738 DOI: 10.1177/0009922813504028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Fraser L, Starritt N, Melia L, Kubba H. Development of a screening service for neonatal ear deformity using neonatal hearing screeners and an information leaflet. Int J Pediatr Otorhinolaryngol 2013; 77:538-43. [PMID: 23411133 DOI: 10.1016/j.ijporl.2012.12.033] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2012] [Revised: 12/15/2012] [Accepted: 12/21/2012] [Indexed: 11/29/2022]
Abstract
OBJECTIVES Early splinting of neonatal ear deformities has been proven to be successful but the opportunity to splint is frequently missed due to lack of awareness amongst healthcare personnel. We aimed to develop a regional screening service using neonatal hearing screeners and an information leaflet to allow for the early detection and treatment of such children. METHODS We created an information leaflet that was distributed by hearing screeners to all parents in Greater Glasgow at the time of the child's neonatal hearing assessment, with a contact number allowing parents to self refer. All neonates referred were seen at a dedicated clinic within a week and suitability for splints determined. We aimed to assess acceptability of the service, splinting result as rated by parents and otolaryngologist and also costs involved. RESULTS Over a 15 month period, 13,403 leaflets were distributed. 88 babies were referred (0.7%) and 54 were found suitable for splinting. 78% of parents rated the efficacy of splints as either excellent or very good and 96% said they would recommend the service to a friend. Median age at first review was 4 days. We found a weak but statistically significant correlation between age at first review and the surgeon rated outcome from splinting (Spearman's rho=-0.321, p=0.038), with those babies commencing treatment early generally having a better splinting result. We also found that age at first review correlated with duration of splinting required (Spearman's rho=0.357, p=0.008), with younger babies generally requiring shorter splinting times. Cost analysis revealed a saving of £482.76 per child when comparing splint treatment to potential later corrective ear surgery costs. CONCLUSIONS Our screening service is both acceptable to parents and efficient in allowing for early correction of ear deformity in the majority of cases. By detecting treatable children early, we propose that the introduction of routine screening and splinting on a wider basis will avoid the psychological burden of ear deformity in childhood and also avoid the need for later corrective surgery.
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Affiliation(s)
- Lyndsay Fraser
- Department of Otolaryngology, Royal Hospital for Sick Children, Dalnair Street, Glasgow G3 8SJ, United Kingdom.
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van Wijk MP, Breugem CC, Kon M. A prospective study on non-surgical correction of protruding ears: the importance of early treatment. J Plast Reconstr Aesthet Surg 2011; 65:54-60. [PMID: 21903493 DOI: 10.1016/j.bjps.2011.08.021] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2011] [Revised: 08/06/2011] [Accepted: 08/09/2011] [Indexed: 10/17/2022]
Abstract
OBJECTIVES Splinting is an elegant method to correct ear deformities in the newborn. However evidence is lacking on the relation between age and efficacy and duration of the treatment. We prospectively studied these questions on protruding ears in 132 babies. METHODS A splint in the scaphal hollow was used in combination with tape (Earbuddies(®)). Treatment continued until the desired shape persisted. Results were judged from photographs and mastoid-helical distance was measured. RESULTS In 132 babies 209 ears were treated. Twenty-four patients had no follow-up, 27 stopped therapy for skin irritation and fixation problems. In the remaining patients results were good in 28%, fair in 36%, poor in 36%. Efficacy deteriorates with age; with fair or good results in 66.7% if therapy started before the sixth week. Older children needed to be splinted longer. The anti-helical fold was easier corrected than a deep concha (correction in 69.8% versus 26.8%). CONCLUSIONS Considering splinting therapy for protruding ears, a reasonable chance of success can only be offered to parents of children up to six weeks of age. It is favorable if the deformity is mainly due to a flat antihelix.
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Affiliation(s)
- M P van Wijk
- Dutch Center of Ear Reconstruction, Division of Pediatric Plastic Surgery KE.04.140.0, Wilhelmina Children's Hospital University Medical Center Utrecht, P.O. Box 85090, 3508 AB Utrecht, The Netherlands.
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The Use of a Retroauricular Fascioperichondrial Flap in the Recreation of the Antihelical Fold in Prominent Ear Surgery. Ann Plast Surg 2009; 63:536-40. [PMID: 19806040 DOI: 10.1097/sap.0b013e318195bfdd] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Non-surgical correction of congenital deformities of the auricle: A systematic review of the literature. J Plast Reconstr Aesthet Surg 2009; 62:727-36. [DOI: 10.1016/j.bjps.2009.01.020] [Citation(s) in RCA: 59] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2008] [Revised: 01/05/2009] [Accepted: 01/08/2009] [Indexed: 11/24/2022]
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Miralles G, Rodríguez-Urcelay P. A useful dressing for ear surgery. EUROPEAN JOURNAL OF PLASTIC SURGERY 2008. [DOI: 10.1007/s00238-008-0231-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Vaiude PN, Anthony ET, Syed M, Ilyas S. A case report on the remodelling technique for the earlobe using a soft splint. J Plast Reconstr Aesthet Surg 2008; 61:451-4. [DOI: 10.1016/j.bjps.2006.03.046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2005] [Revised: 02/22/2006] [Accepted: 03/04/2006] [Indexed: 11/30/2022]
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Al-Zahrani K, Al-Humsi T, Hassanain J, Al-Qattan MM. The prevalence of Stahl's ear deformity in Saudi Arabia. J Plast Reconstr Aesthet Surg 2007; 60:335-6. [PMID: 17293301 DOI: 10.1016/j.bjps.2006.04.016] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2006] [Revised: 04/07/2006] [Accepted: 04/20/2006] [Indexed: 10/24/2022]
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Abstract
Postpartum splinting can completely correct congenital ear deformities and obviate the need for later surgery
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Affiliation(s)
- Andrew J Lindford
- Department of Plastic and Reconstructive Surgery, Queen Victoria Hospital, East Grinstead RH19 3DZ
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Bader D, Grun M, Riskin-Mashiah S, Grunfeld A, Kugleman A, Kogelman A, Chistyakov I, Merlob P. Auricular mild errors of morphogenesis: epidemiological analysis, local correlations and clinical significance. ACTA ACUST UNITED AC 2004; 47:225-34. [PMID: 15337467 DOI: 10.1016/j.anngen.2004.02.007] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2003] [Accepted: 02/04/2004] [Indexed: 11/22/2022]
Abstract
BACKGROUND The mild errors or morphogenesis (MEMs) are well known and accepted markers of alterations in embryonic development with predictive value in identification of major malformations, specific genetic syndromes, metabolic and psychiatric disease and childhood malignancy. OBJECTIVE The goal of this study was to assess the contribution of auricular MEMs as part of total MEMs in an effort to study the factors influencing the different potential informative value of different types of MEMs and their variability with perinatal factors. METHOD Three thousand one hundred and seven consecutive born neonates were screened for auricular and non-auricular MEMs, inregistered concomitantly with major malformations and postural defects. The study was accomplished by our specially designed computerized program in a relatively large nonhomogeneous ethnic population, in the metropolitan area of Haifa, Israel. RESULTS The general prevalence of auricular MEMs was 43.1%; the most frequent pathogenetic type was the postural one. Significantly higher rates of auricular MEMs were associated with male sex, small- and large-for-gestational age, IVF pregnancy, triplet pregnancy, maternal diabetes and parental consanguinity. CONCLUSION We conclude that the presence, number, and association or concomitance of auricular MEMs in the same neonate may have important clinical, diagnostic, pathogenetic, screening, and therapeutic value.
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Affiliation(s)
- David Bader
- Department of Neonatology, Bnei Zion Medical Center, 47, Golomb Street, Haifa 31048, Israel.
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