One-Year Outcomes of Ear Molding for Infants with Constricted Ear

A new corrective method for the Tanzer's group IIB constricted ear: Helical expansion using V-Y advancement flap combined with concha cartilage graft

BACKGROUND

The complexity of a constricted ear shape renders the aim of establishing a uniform surgical method unattainable, thus posing an ongoing challenge in its correction. The Tanzer's group IIB constricted ear is characterized by a prominent downward folding, an underdeveloped antihelix, and the absence of sacpha. The present study used a V-Y advancement flap combined with concha cartilage for the repair of Tanzer's group IIB constricted ear.

METHOD

A total of 16 patients diagnosed with type IIB ear constriction from September 2016 to September 2022 were enrolled in this retrospective study. The correction procedure for the constricted ear involved the utilization of a V-Y advancement flap combined with concha cartilage graft. The auricle shape data of the patients, their visual analog scale (VAS) satisfaction scores, and aesthetic outcomes scale (AOS) aesthetic scores were examined preoperatively and 12 months post-operatively.

RESULT

The mean duration of follow-up in this study was 18 months. The post-operative measurements of ear length, ear width, bilateral differences in ear length, and bilateral differences in ear width exhibited significant improvement compared to the preoperative values. The mean preoperative AOS score was 1.12 ± 0.34, and the mean post-operative AOS score increased to 3.81 ± 0.40. The preoperative VAS satisfaction score was 2.31 ± 0.70, whereas the post-operative VAS score significantly increased to 8.00 ± 0.89. The follow-up period did not present any cases of flap necrosis, hematoma, infection, or wound dehiscence.

CONCLUSION

The combination of V-Y advancement flap and concha cartilage transplantation for the correction of Tanzer's group IIB constricted ear can achieve a natural and aesthetically pleasing auricle shape, resulting in high patient satisfaction.

Efficiency of ear molding for treating constricted ears of different severity

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.

Ear Molding in Children-Timing, Technique, and Follow-up: A Systematic Review

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.

Analysis of the effect and influencing factors of EarWell auricle orthosis in the treatment of congenital auricle deformity in children

OBJECTIVE

To observe the efficacy of EarWell ear orthosis in treating children with different types of ear deformities.

METHODS

We selected 80 children aged <6 weeks with ear deformities (110 ears: 15, 30, 21, 25, and 19 ears with prominent ear, lop ear, cup ear, cryptotia, and helical rim deformity, respectively). Differences in effectiveness rate, treatment time, and incidence of complications among children with different types of auricular deformities were compared. Recurrence rates at 1 and 3 months after the treatment were compared.

RESULTS

The overall success rate was 92.73 %, and the treatment effectiveness rate did not differ significantly among the children with different types of auricular malformations (P > 0.05). The correction time of the helical rim deformity was the shortest, and the correction times of the prominent and cup ears were significantly longer than those of the other groups (P < 0.05). The incidence of complications associated with helical rim deformity and lop ear was lower, and the incidence of prominent and cup ear complications was significantly higher than that in the other groups (P < 0.05). The recurrence rate in children with prominent and cup ears was higher at 1 and 3 months after correction, and children with a lop ear and cryptotia showed no recurrence at 1 and 3 months after treatment, which correlated with the correction time, incidence of complications, and recurrence rate (P < 0.05) CONCLUSION: The EarWell auricle orthosis is an effective treatment in children with auricular morphological malformations. Correction time, complication rate, and recurrence rate were related to the malformation type.

Seminars in Plastic Surgery: Pediatric Ear Anomalies and Reconstruction

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.

Correction of Mild-to-Moderate Constricted Ear Abnormality Using Mustardé Suture, Cartilage Onlay Graft, and Transposition Flap: A Case Report

Constricted ear has a prevalence of 5.2 to 10% among ear abnormalities, and various surgical methods are suggested for treatment. We introduce a case of a constricted ear treated with a simple method using a novel concept cartilage graft and transposition flap, along with the well-known Mustardé suture, which is used for pediatric patients with mild to moderate constricted ears of Tanzer classification type IIA. A 10-year-old female patient visited the hospital complaining of an abnormality in the congenital right ear. Surgical approach was planned under the diagnosis of Tanzer classification type IIA constricted right ear. Posterior helix onlay graft and perichondrocutaneous transposition flap using excessive helical cartilage were performed along with the Mustardé suture. In the immediate postoperative period, ear contour was improved, and it was well-maintained without recurrence until 6 months' follow-up. In conclusion, the combination of Mustardé suture, and cartilage onlay graft and perichondrocutaneous transposition flap in the mild to moderate constricted ear would be a useful surgical option, producing aesthetically good results in a simple and effective method.