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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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2
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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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Lin Y, Ronde EM, Butt HA, van Etten-Jamaludin F, Breugem CC. Objective evaluation of nonsurgical treatment of prominent ears: A systematic review. JPRAS Open 2023; 38:14-24. [PMID: 37694192 PMCID: PMC10491642 DOI: 10.1016/j.jpra.2023.07.002] [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: 06/16/2023] [Accepted: 07/09/2023] [Indexed: 09/12/2023] Open
Abstract
Background The prominent ear is a type of congenital ear deformity that can be corrected by a variety of nonsurgical treatments, such as splinting and the taping method. However, there is no objective evaluation method that is universally accepted. The aim of this review is to evaluate objective measurement methods that are used in the available literature to analyze nonsurgical treatment of prominent ears. Methods A systematic review was performed in the MEDLINE and Embase databases in December 2022 and updated on April 2023 according to Preferred Reporting Items for Systematics and Meta-Analyses (PRISMA) guideline. Any study using objective measurements (continuous variables such as distance and angle) to evaluate the effect of nonsurgical treatment of prominent ears was included. The Joanna Briggs Institute (JBI) critical appraisal for case series was used for quality assessment. Results A total of 286 studies were screened for eligibility, of which five articles were eligible for inclusion. All of the included studies were case series. The helix mastoid distance (HMD) is the most commonly used parameter to measure treatment outcome. Pinna and cartilage stiffness, length, and width were also used, but without clear statistical relevance. HMD was classified into grading groups (i.e. good, moderate, and poor) to evaluate the treatment's effect. Conclusion Based on the included studies, objective measurements are rarely used, and when used, they are largely heterogeneous. Although HMD was the most frequent measurement used, all studies used different definitions for the measurement and grouped subsequent outcomes differently. Automated algorithms, based on three-dimensional imaging, could be used for object measurements in the nonsurgical treatment of prominent ears.
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Affiliation(s)
- Yangyang Lin
- Department of Plastic, Reconstructive and Hand Surgery, Amsterdam UMC, Amsterdam Medical Centre, Amsterdam, The Netherlands
| | - Elsa M. Ronde
- Department of Plastic, Reconstructive and Hand Surgery, Amsterdam UMC, Amsterdam Medical Centre, Amsterdam, The Netherlands
| | - Hashir A. Butt
- Bachelor of Science in Medicine, Amsterdam UMC, location AMC, University of Amsterdam, The Netherlands
| | - F.S. van Etten-Jamaludin
- Amsterdam UMC, University of Amsterdam, Research Support, Medical Library Academic Medical Center, Amsterdam, the Netherlands
| | - Corstiaan C. Breugem
- Department of Plastic, Reconstructive and Hand Surgery, Amsterdam UMC, Amsterdam Medical Centre, Amsterdam, The Netherlands
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Schonauer F, Pezone G, Cavaliere A, D'Andrea F. Comparative study of pre- and postauricular flaps for external auditory canal defect reconstruction. JPRAS Open 2023; 37:121-129. [PMID: 37554519 PMCID: PMC10404484 DOI: 10.1016/j.jpra.2023.06.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Accepted: 06/18/2023] [Indexed: 08/10/2023] Open
Abstract
BACKGROUND Malignancies involving the external auditory canal deserve critical evaluation due to this area's aesthetic and functional importance. Flaps can be very useful for the restoration of the external auditory canal. A variety of flaps available for the surgical treatment of external acoustic meatus defects exist, depending on the precise location and size. OBJECTIVES Our study aimed to compare aesthetic and functional results in the postoncological reconstruction of external auditory canal defects using a preauricular flap and postauricular revolving door flap. METHODS Sixteen patients treated at our plastic surgery unit for defects involving the external auditory canal between January 2014 and December 2020 were included in the study. All defects were the result of a primary or secondary skin cancer excision. Patients were divided into two groups, one receiving the preauricular flap technique and the other the postauricular revolving door flap technique. RESULTS Three separate visual analog scales reported excellent scores for the two procedures, though the postauricular revolving door flap had slightly better results. Both preauricular flap and postauricular revolving door flap reconstructive techniques showed good options for external auditory canal reconstruction in postexcision skin cancer patients. From an aesthetic point of view, the revolving door flap appeared to be a more elegant surgical approach in this type of reconstruction because the scar was hidden in the postauricular sulcus. CONCLUSIONS Reconstruction with a postauricular revolving door flap allowed for a more natural movement with no external pedicle. EVIDENCE-BASED MEDICINE EBM LEVEL IV.
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Affiliation(s)
- Fabrizio Schonauer
- Unit of Plastic Surgery, University Federico II, Naples, Italy, Via Sergio Pansini, 5 - 80131 Napoli
| | - Giuseppe Pezone
- Unit of Plastic Surgery, University Federico II, Naples, Italy, Via Sergio Pansini, 5 - 80131 Napoli
| | - Annachiara Cavaliere
- Unit of Plastic Surgery, University Federico II, Naples, Italy, Via Sergio Pansini, 5 - 80131 Napoli
| | - Francesco D'Andrea
- Unit of Plastic Surgery, University Federico II, Naples, Italy, Via Sergio Pansini, 5 - 80131 Napoli
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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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8
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Schonauer F, Pezone G, Pensato R, D'Andrea F. Stahl's ear deformities treated with auricular splinting. J Plast Reconstr Aesthet Surg 2020; 74:1101-1160. [PMID: 33214120 DOI: 10.1016/j.bjps.2020.10.081] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2020] [Revised: 08/30/2020] [Accepted: 10/22/2020] [Indexed: 10/23/2022]
Affiliation(s)
| | - Giuseppe Pezone
- Plastic Surgery Unit, Universita degli Studi di Napoli Federico II Scuola di Medicina e Chirurgia, 80131 Napoli, NA, Italy
| | - Rosita Pensato
- Plastic Surgery Unit, Universita degli Studi della Campania Luigi Vanvitelli Scuola di Medicina e Chirurgia, 80131 Napoli, NA, Italy
| | - Francesco D'Andrea
- Prof, Plastic Surgery Unit, Universita degli Studi di Napoli Federico II Scuola di Medicina e Chirurgia, 80131 Napoli, NA, Italy
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9
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Liu YCC, Kini S, Barton G, Pham T, Marcet-Gonzalez J, Novak B. Implementation of auricular malformation screenings in the newborn population. Int J Pediatr Otorhinolaryngol 2020; 133:109999. [PMID: 32224391 DOI: 10.1016/j.ijporl.2020.109999] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/20/2019] [Revised: 03/08/2020] [Accepted: 03/09/2020] [Indexed: 11/25/2022]
Abstract
BACKGROUND AND OBJECTIVE Research has shown that it is important to initiate ear molding early for children with auricular malformations in order to achieve the best results. Currently our institute relies on the traditional primary care physician (PCP) referral system, which does not recognize the time sensitivity of the visit in patients with auricular malformations. The purpose of the current research is to implement a new screening protocol for identifying auricular malformations in the newborn population and thus expedite the clinic visit and necessary intervention. METHODS The hearing screen technicians (HSTs) were trained to identify some of the most common auricular malformations. A picture guide of 11 types of auricular malformations were given to the HSTs to use as a reference. At the time of the newborn hearing screen, the HSTs examined the pinnas of each baby. When an auricular malformation was identified, the auricular malformation team was immediately alerted and a bedside consultation with ENT occurred. RESULTS Comparison was made of the referral rate between pre- and post-implementation of the protocol which showed an increased rate of identification (five referrals in the 12-month period pre-implementation versus eighteen referrals in the 15-month period post-implementation). CONCLUSION We successfully implemented an auricular malformation screening protocol that was linked to newborn hearing screenings. The frequency of identification has increased with the implementation of the new screening protocol and has resulted in earlier initial ENT consultations for ear molding with the goal of improving patient satisfaction and results.
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Affiliation(s)
- Yi-Chun Carol Liu
- Baylor College of Medicine, Department of Otolaryngology - Head and Neck Surgery, One Baylor Plaza Suite NA-102, Houston, TX, 77030, USA; Texas Children's Hospital, Department of Pediatric Otolaryngology, 6701 Fannin St, Suite 640, Houston, TX, 77030, USA.
| | - Sameer Kini
- Baylor College of Medicine, Department of Otolaryngology - Head and Neck Surgery, One Baylor Plaza Suite NA-102, Houston, TX, 77030, USA.
| | - Geran Barton
- Texas Children's Hospital, Department of Surgery, 6621 Fannin Street, Suite B320, Houston, TX, 77030, USA
| | - Tien Pham
- Texas Children's Hospital, Department of Surgery, 6621 Fannin Street, Suite B320, Houston, TX, 77030, USA
| | - Jessie Marcet-Gonzalez
- Texas Children's Hospital, Department of Surgery, 6621 Fannin Street, Suite B320, Houston, TX, 77030, USA
| | - Barbra Novak
- Texas Children's Hospital, Department of Audiology, 6701 Fannin Street, MC 520.30, Houston, TX, 77030, USA
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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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11
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Schultz K, Guillen D, Maricevich RS. Newborn Ear Deformities: Early Recognition and Novel Nonoperative Techniques. Semin Plast Surg 2017; 31:141-145. [PMID: 28798548 DOI: 10.1055/s-0037-1603958] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Congenital auricular anomalies are common sources of aesthetic concern and psychosocial distress for both children and their parents. Only one-third of these anomalies self-correct, leaving a large need for acceptable corrective methods. Otoplasty is often the standard treatment; however, newer nonsurgical methods, including splinting and molding in the neonatal period, have shown favorable results without the complications of surgical intervention and with the advantage of early intervention. These treatment options have not yet been widely adopted in Western countries due to delayed diagnosis of auricular deformities and confusion regarding treatment indications and technique.
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Affiliation(s)
- Kelly Schultz
- Division of Plastic Surgery, Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, Texas
| | - Diana Guillen
- Division of Plastic Surgery, Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, Texas
| | - Renata S Maricevich
- Division of Plastic Surgery, Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, Texas
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12
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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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13
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Mohammadi AA, Imani MT, Kardeh S, Karami MM, Kherad M. Non-surgical Management of Congenital Auricular Deformities. World J Plast Surg 2016; 5:139-47. [PMID: 27579269 PMCID: PMC5003949] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Unlike congenital auricular malformations which are identified by underdevelopment of dermal and cartilaginous tissues, deformed ears are less sever congenital anomalies characterized only by a misshaped pinna structure and can be improved with acceptable cosmetic results and minimal cost through ear molding if treated in early neonatal period. In this study, authors present the first report of using splinting techniques for treatment of deformational auricular anomalies in Iranian children. METHODS Our case load consisted of a series of 29 patients (Male=16, Female=13) who were referred to Plastic Surgery Unit of Shiraz University of Medical Sciences from September 2011 to December 2014. Children aged more than 6 moths were excluded. Twenty-nine children affected by various deformities including prominent ears (n=11), lop ears (n=8) and constricted ears (n=10) were treated by splintage as a nonsurgical technique. The mean time of treatment was 13.33±2 weeks. RESULTS Eight (27.6%) patients did not complete the treatment. Splinting resulted in excellent or satisfactory results in 12 (57.14%) of treated cases. No improvement was observed at the end of the molding treatment in 9 patients. No complication was observed during the treatment in any of the patients. CONCLUSION The nonsurgical molding can be used as an effective approach for achieving natural outcomes and correcting cosmetic abnormalities. Rate of satisfaction is dependent on type of deformity, the neonatal age in which treatment started and also parents' adherence to treatment methods and principals. Concerning the low rate of complications and high satisfactory results the method can be used instead of surgery in appropriate cases.
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Affiliation(s)
- Ali Akbar Mohammadi
- Shiraz Burn Research Center, Division of Plastic and Reconstructive Surgery, Department of Surgery, Shiraz University of Medical Sciences, Shiraz, Iran;,Corresponding Author: Ali Akbar Mohammadi, MD; Shiraz Burn Research Center, Division of Plastic and Reconstructive Surgery, Department of Surgery, Shiraz University of Medical Sciences, Shiraz, Iran, Tel: +98-711-8219640, Fax: +98-711-8217090, E-mail:
| | - Mohammad Taghi Imani
- Shiraz Burn Research Center, Division of Plastic and Reconstructive Surgery, Department of Surgery, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Sina Kardeh
- Shiraz Burn Research Center, Division of Plastic and Reconstructive Surgery, Department of Surgery, Shiraz University of Medical Sciences, Shiraz, Iran;,Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mehrab Mohammad Karami
- Shiraz Burn Research Center, Division of Plastic and Reconstructive Surgery, Department of Surgery, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Masoomeh Kherad
- Shiraz Burn Research Center, Division of Plastic and Reconstructive Surgery, Department of Surgery, Shiraz University of Medical Sciences, Shiraz, Iran
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15
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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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16
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Petersson RS, Recker CA, Martin JRK, Driscoll CLW, Friedman O. Identification of congenital auricular deformities during newborn hearing screening allows for non-surgical correction: a Mayo Clinic pilot study. Int J Pediatr Otorhinolaryngol 2012; 76:1406-12. [PMID: 22770593 DOI: 10.1016/j.ijporl.2012.06.011] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2012] [Revised: 06/10/2012] [Accepted: 06/14/2012] [Indexed: 10/28/2022]
Abstract
OBJECTIVE To introduce a Mayo Clinic pilot study in which newborn hearing screeners are trained to identify congenital auricular deformities, allowing for non-surgical correction with a simple splint initiated in the immediate neonatal period. METHODS Newborn hearing screeners received education on evaluation of congenital auricular deformities. Ten infants with 19 affected ears amenable to treatment with a simple splint were enrolled between June 15 and December 10, 2009. Splinting was initiated prior to the infant's discharge from the hospital. RESULTS Congenital auricular deformities amenable to correction with splinting included cup ear, Stahl's ear, and prominent ear. All ears were assessed by physical examination and photographic documentation prior to splinting and at follow-up visits. All exhibited improvement from the original deformity after 1-4 weeks of splinting. There were no instances of skin irritation or breakdown. CONCLUSION Splinting therapy of congenital auricular deformities is very effective when initiated within the first 3 days of life while cartilage is quite malleable. Newborn hearing screening is performed within 24-48 h of birth and is an ideal opportunity to identify auricular deformities. This pilot study shows that early identification of auricular deformities by properly educated newborn hearing screeners is feasible, allowing for successful initiation of splinting therapy.
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Affiliation(s)
- Rajanya S Petersson
- Department of Otolaryngology - Head and Neck Surgery, Virginia Commonwealth University, Richmond, VA, USA.
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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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Schonauer F, Scarcella A, Mataro I, Umbaldo A, Molea G. Collodion baby associated with congenital auricular anomalies: Postpartum splinting of a rare congenital auricular deformity. J Plast Reconstr Aesthet Surg 2010; 63:e155-6. [DOI: 10.1016/j.bjps.2009.01.054] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2008] [Revised: 01/18/2009] [Accepted: 01/29/2009] [Indexed: 10/21/2022]
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Schonauer F, La Rusca I, Molea G. Non-surgical correction of deformational auricular anomalies. J Plast Reconstr Aesthet Surg 2009; 62:876-83. [DOI: 10.1016/j.bjps.2007.11.072] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2007] [Accepted: 11/07/2007] [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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Epidemiology and risk factors for microtia in Colombia. ACTA OTORRINOLARINGOLOGICA ESPANOLA 2009. [DOI: 10.1016/s2173-5735(09)70113-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Bibliography. Current world literature. Head and neck reconstruction. Curr Opin Otolaryngol Head Neck Surg 2008; 16:394-7. [PMID: 18626261 DOI: 10.1097/moo.0b013e32830c1edc] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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