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Ghafari A, Alaniz L, Vu C, Ibarra A, Vallurupalli M, Willens S, Cordero J, J Pfaff M. External ear malformations and cardiac and renal anomalies: A systematic review and meta-analysis. PLoS One 2024; 19:e0309692. [PMID: 39298400 DOI: 10.1371/journal.pone.0309692] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2024] [Accepted: 08/17/2024] [Indexed: 09/21/2024] Open
Abstract
CONTEXT External Ear Malformations (EEM) continue to be a common malformation seen in the pediatric patient population. This study aims to further elucidate the correlation between EEM and cardiac and renal anomalies. OBJECTIVE A systematic review and meta-analysis to study the incidence of cardiac and renal anomalies associated with syndromic and isolated (EEM). DATA SOURCES The literature search spanned multiple databases, including Google Scholar, PubMed, Scopus, Web of Science, and MEDLINE. STUDY SELECTION Studies must be focused on EEM and cardiac and/or renal anomalies. Only articles written in English were included. DATA EXTRACTION General study characteristics, number of EEM patients, number of cardiac and renal anomalies and whether cases were syndromic were extracted from the studies. RESULTS Of 1,058 initial studies, 33 were included for meta-analyses. Mean JBI score for all included studies was 92.06%, indicating acceptable study quality. Interrater reliability was high, with a Cohen kappa score for all studies of 0.94. The resulting pooled prevalence of cardiac abnormalities was 20% [95% CI:13-28%], while renal abnormalities were 13% [95% CI: 7-20%]. The most common anomalies were VSD (3.725%) and renal agenesis (2.04%). The presence of syndrome data across studies was not a significant modifier of prevalence rates. LIMITATIONS Primary limitation is due to heterogeneity in individual study methodology and reporting standards. CONCLUSIONS These results highlight a higher prevalence of cardiac-related conditions than renal anomalies in patients with both syndromic and non-syndromic EEM in the included studies, underscoring the need for thorough clinical evaluations.
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Affiliation(s)
- Arman Ghafari
- University of California Irvine, School of Medicine, Irvine, CA, United States of America
| | - Leonardo Alaniz
- University of California Irvine, School of Medicine, Irvine, CA, United States of America
| | - Cindy Vu
- University of California Irvine, School of Medicine, Irvine, CA, United States of America
| | - Alejandra Ibarra
- University of California Irvine, School of Medicine, Irvine, CA, United States of America
| | - Medha Vallurupalli
- Keck School of Medicine of USC, Los Angeles, CA, United States of America
| | - Sierra Willens
- Stanford University School of Medicine, Palo Alto, CA, United States of America
- Department of Plastic Surgery, University of California Irvine Medical Center, Orange, CA, United States of America
| | - Justin Cordero
- University of California Riverside, School of Medicine, Riverside, CA, United States of America
| | - Miles J Pfaff
- University of California Irvine, School of Medicine, Irvine, CA, United States of America
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Şimşekcan E, Sarıay B, Turcan D. Cervical Chondrocutaneous Branchial Remnants: A Rare Congenital Anomaly of the Neck. A Case Series, Literature Review, and Associated Anomalies. Facial Plast Surg 2024; 40:505-513. [PMID: 37607572 DOI: 10.1055/a-2158-1529] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/24/2023] Open
Abstract
Cervical chondrocutaneous branchial remnants (CCBRs) are rare anomalies found in the neck. These remnants can be easily misdiagnosed due to their low incidence, and they are often associated with other anomalies. Previous studies have reported an association with other anomalies in up to 76% of cases. In this article, the authors present a case series of two patients with bilateral CCBRs and investigate the associated anomalies through a literature review. Patients diagnosed with CCBRs who presented with cervical masses were included. Records were reviewed to investigate factors such as sex, location of the CCBRs, associated anomalies, timing of operations, and cartilage pathology. A surgical excision technique was employed, and the study also included a literature review focusing on reports related to CCBRs and associated anomalies. Two patients, a 3-year-old boy and a 17-year-old adolescent girl, with bilateral CCBRs underwent surgical excision. Patient demographics, prevalence, and characteristics of associated anomalies in CCBR cases were documented in the literature review. This case series presented two successful surgical excisions of CCBRs without complications or recurrence at 1 year of follow-up. The study emphasized the importance of thorough evaluation and assessment for associated anomalies in various body systems due to the potential co-occurrence of CCBRs with other anomalies.
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Affiliation(s)
- Efe Şimşekcan
- Department of Plastic, Reconstructive and Aesthetic Surgery, 25 Aralık Devlet Hastanesi, Gaziantep, Türkiye
| | - Büşra Sarıay
- Department Of Radiology, Abdulkadir Yüksel Devlet Hastanesi, Gaziantep, Türkiye
| | - Didem Turcan
- Department of Pathology, 25 Aralık Devlet Hastanesi, Gaziantep, Türkiye
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Wang SX, Streit A. Shared features in ear and kidney development - implications for oto-renal syndromes. Dis Model Mech 2024; 17:dmm050447. [PMID: 38353121 PMCID: PMC10886756 DOI: 10.1242/dmm.050447] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/16/2024] Open
Abstract
The association between ear and kidney anomalies has long been recognized. However, little is known about the underlying mechanisms. In the last two decades, embryonic development of the inner ear and kidney has been studied extensively. Here, we describe the developmental pathways shared between both organs with particular emphasis on the genes that regulate signalling cross talk and the specification of progenitor cells and specialised cell types. We relate this to the clinical features of oto-renal syndromes and explore links to developmental mechanisms.
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Affiliation(s)
- Scarlet Xiaoyan Wang
- Centre for Craniofacial and Regenerative Biology, King's College London, London SE1 9RT, UK
| | - Andrea Streit
- Centre for Craniofacial and Regenerative Biology, King's College London, London SE1 9RT, UK
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Fernández M, Fuentes A, López C, Ramírez MT, Funes R, Garib C, Hinojosa MP, Sorrentino G, Struque C, Sotomayor M, Meza MJ. MITOS EN EL CUIDADO DEL RECIÉN NACIDO, BÚSQUEDA DE EVIDENCIA. REVISTA MÉDICA CLÍNICA LAS CONDES 2021. [DOI: 10.1016/j.rmclc.2021.10.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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A Single Institutional Review of Periauricular Vestiges and Renal Anomalies: The Role of Screening Renal Ultrasonography. J Craniofac Surg 2021; 33:835-837. [PMID: 34334743 DOI: 10.1097/scs.0000000000008050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
ABSTRACT Children with minor ear malformations including periauricular vestiges often undergo renal ultrasonography (RUS) to exclude renal anomalies associated with genetic conditions. The aim of this study is to assess the association between isolated periauricular vestiges and renal anomalies and delineate the indication for RUS in screening for renal anomalies. This is a retrospective review of infants who underwent surgical consultation for periauricular vestige excision to probe a possible relationship with renal anomalies. Patients with an isolated vestige were compared to patients presenting with additional clinical findings suggestive of a possible genetic disorder. A total of 150 infants underwent periauricular vestige excision; 47 were referred for RUS, 23 with no additional clinical findings, and 24 with periauricular vestiges in addition to other suspicious clinical and/or developmental findings. Of these 47 patients, 10 had renal anomalies: 4 (17.4%) with an isolated periauricular vestige had minor anomalies and 6 (25.0%) with a vestige plus suspicious clinical signs had 5 minor anomalies and one major anomaly. The odds of a patient with an isolated periauricular vestige having positive RUS findings were not significantly different than a patient with additional clinical findings having positive RUS findings (P = 0.72).The incidence of renal anomalies in infants with an isolated periauricular vestige was similar to that in patients with associated clinical signs suggestive of a possible genetic disorder. This was higher than the background population rate. Although most anomalies in patients with isolated ear findings were minor, our results suggest routine screening RUS should be considered.
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Rehfuss A, Bourgeois T, Thompson B, Sebastião YV, Wood RJ, Jayanthi VR, Fuchs ME. Baseline Renal Volumes in Children Born With Cloacal Anomalies. Urology 2020; 148:250-253. [PMID: 32827534 DOI: 10.1016/j.urology.2020.08.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2020] [Revised: 07/17/2020] [Accepted: 08/09/2020] [Indexed: 11/18/2022]
Abstract
OBJECTIVE To better understand why children born with cloacal anomalies are at a high risk of renal insufficiency, this study aims to determine baseline renal volume in children with cloacal anomalies compared to controls. We hypothesized children with cloacal anomalies would be born with less renal volume. METHODS An IRB approved database of children with cloacal anomalies was reviewed. Controls were female patients with 2-vessel umbilical cord or preauricular tags who underwent screening renal ultrasound. Children were included if they had a renal ultrasound in the first 3 months of life. Cloacal exstrophy, horseshoe and cross-fused ectopic kidneys were excluded. Total and individual kidney volumes were compared between the 2 groups. RESULTS The study cohort consisted of 109 patients, 46 (42.2%) cloaca patients and 63 (57.8%) controls. In unadjusted analyses, average total renal volume for cloaca and control patients was 22.4 cm3 vs 25.5 cm3 respectively (P = .1006), and there was no significant difference when adjusting for age (P = .3915). The estimated difference in renal unit volume between cloaca patients without solitary kidneys and controls was -1.6 cm3 (95%C.I.: -3.6, 0.4; P = .1201), and there was no significant difference when adjusting for age (P = .4725). The age-adjusted difference in renal unit volume between cloaca patients with solitary kidney and controls was 1.8 cm3 (95%CI: -1.1, 4.8; P = .2148). CONCLUSIONS Children with cloacal anomalies have similar baseline renal volumes as children without cloacal anomalies. Therefore, the increased risk of renal insufficiency in this patient population appears to be due to renal injury postnatally.
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Affiliation(s)
- Alexandra Rehfuss
- Department of Urology, Nationwide Children's Hospital, Columbus, OH.
| | - Tran Bourgeois
- Center for Surgical Outcomes Research, The Abigail Wexner Research Institute at Nationwide Children's Hospital, Columbus, OH
| | - Benjamin Thompson
- Department of Radiology, Nationwide Children's Hospital, Columbus, OH
| | - Yuri V Sebastião
- Center for Surgical Outcomes Research, The Abigail Wexner Research Institute at Nationwide Children's Hospital, Columbus, OH
| | - Richard J Wood
- Department of Pediatric Colorectal and Pelvic Reconstructive Surgery, Nationwide Children's Hospital, Columbus, OH
| | | | - Molly E Fuchs
- Department of Urology, Nationwide Children's Hospital, Columbus, OH
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Subbarayan E, Chittoria R. Innovative Usage of Accessory Auricles as Full-thickness Skin Graft. J Cutan Aesthet Surg 2018; 10:150-152. [PMID: 29403186 PMCID: PMC5782439 DOI: 10.4103/jcas.jcas_70_17] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Accessory auricles are relatively rare malformations arising from the first branchial arch which contains skin, fat and cartilage. The treatment is usually surgical removal for the cosmetic purpose. We are sharing our experience of utilising the accessory auricle skin as full thickness graft for post.burn reconstruction of the fingers contracture of a child. Even though this type of association is rare, it is an innovative idea following Sir Harold Gilles' principle 'Never throw anything away'.
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Affiliation(s)
- Elankumar Subbarayan
- Department of Plastic Surgery, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
| | - Ravikumar Chittoria
- Department of Plastic Surgery, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
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Rubio O, Galera V, Alonso MC. Morphological variability of the earlobe in a Spanish population sample. HOMO-JOURNAL OF COMPARATIVE HUMAN BIOLOGY 2017; 68:222-235. [PMID: 28416164 DOI: 10.1016/j.jchb.2017.03.007] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/26/2016] [Accepted: 01/03/2017] [Indexed: 11/16/2022]
Abstract
This article shows the morphological variability of the earlobe in a Spanish population of European origin. The frequencies of four lobe characteristics (attachment, contour, modeling, and size) and their degree of expression were studied. The relationship among the characteristics and the differences involving sex and laterality were also considered. The least frequent morphology, and of main use in solving forensic cases, was the very small size with triangle-pulled contour into the skin and crossed-discontinuous modeling. The most frequent morphology, and most clinically useful, was the medium-sized lobe with free-arched contour and eminent or cross-continuous modeling. The characteristics were all symmetric. Size and modeling showed sexual dimorphism. Some characteristics were associated with each other: attachment with contour and modeling and the contour with modeling and size. The least frequent peculiarities were sharp lobe and virgule. The literature is scarce on this matter, practically non-existent for some characteristics, especially modeling and peculiarities. For the first time, the associations of the ear characteristics were analyzed, and this information could be applied to forensic identification.
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Affiliation(s)
- O Rubio
- University Institute of Research in Police Sciences (IUICP), Faculty of Law, Alcalá University, Libreros, 27, Ground Floor, 28802 Alcalá de Henares, Madrid, Spain; Department of Life Science, Alcalá University, 28871 Alcalá de Henares, Madrid, Spain.
| | - V Galera
- University Institute of Research in Police Sciences (IUICP), Faculty of Law, Alcalá University, Libreros, 27, Ground Floor, 28802 Alcalá de Henares, Madrid, Spain; Department of Life Science, Alcalá University, 28871 Alcalá de Henares, Madrid, Spain
| | - M C Alonso
- University Institute of Research in Police Sciences (IUICP), Faculty of Law, Alcalá University, Libreros, 27, Ground Floor, 28802 Alcalá de Henares, Madrid, Spain; Department of Physics and Mathematics, Alcalá University, 28871 Alcalá de Henares, Madrid, Spain
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Klockars T, Kajosaari L. Cervical Chondrocutaneous Branchial Remnants. Cleft Palate Craniofac J 2017; 54:223-226. [DOI: 10.1597/15-019] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Objective Cervical chondrocutaneous branchial remnants are rare malformations usually found in the lower neck. As high as 76% of patients have been reported to have associated anomalies. We review the literature and report a case series of seven patients with cervical cartilaginous remnants. Design A retrospective case series of seven patients identified from the electronic hospital records. Results Seven patients with cervical chondrocutaneous branchial remnants were identified (six boys and one girl). Only one of the patients had associated anomalies. Conclusions A review of the literature revealed no evidence for sinuses or cysts related to cervical chondrocutaneous branchial remnants. Operative treatment can be postponed to a suitable and safe age. There is marked variation in the reported prevalence of associated anomalies, ranging from 11% to 76%.
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Affiliation(s)
- Tuomas Klockars
- Department of Otorhinolaryngology–Head and Neck Surgery, Helsinki University Central Hospital and University of Helsinki, Helsinki, Finland
| | - Lauri Kajosaari
- Department of Otorhinolaryngology–Head and Neck Surgery, Helsinki University Central Hospital and University of Helsinki, Helsinki, Finland
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10
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Karabulut YY, Şenel E, Karabulut HH, Dölek Y. Three different clinical faces of the same histopathological entity: hair follicle nevus, trichofolliculoma and accessory tragus. An Bras Dermatol 2016; 90:519-22. [PMID: 26375221 PMCID: PMC4560541 DOI: 10.1590/abd1806-4841.20153785] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Hair follicle nevus is a rare, congenital hamartoma with follicular differentiation characterized histologically by numerous, tiny, mature hair follicles. Trichofolliculoma, the histopathological features of which are quite similar to those of hair follicle nevus, is also a hamartoma that differs from hair follicle. Accessory tragus is a relatively common, benign congenital abnormality of the external ear with an incidence rate of 1 to 10 per 1,000 live births. OBJECTIVE This study seeks to assess the discriminatory value of currently available, histological criteria in the differential diagnosis of hair follicle nevus, accessory tragi and trichofolliculoma. METHODS Twenty-one patients comprising 9 cases of hair follicle nevus, 8 accessory tragi patients and 4 trichofolliculoma cases, were recruited to perform the study. RESULTS There were 10 males and 11 females in the study group. No significant difference was observed between the three study groups in terms of age, gender or histopathological parameters such as density of hair follicles, subcutaneous fat score and presence of connective tissue framework. Cartilaginous component was seen in 8 cases that were diagnosed as accessory tragi, while central cyst and radiating hair follicles were seen in 4 cases which were diagnosed as trichofolliculoma. CONCLUSION The results of our study showed that diagnostic discrimination of these diseases could be made only with the clinicopathologic correlation because of their clinical and histopathological similarities.
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Abstract
This paper focuses on the diagnosis and management of developmental anomalies of the skin that may be seen early in life. Common locations include the head, nose, preauricular area of the face, neck, and spine. Those that occur in or near the midline can be more serious because of possible intracranial connections. Radiologic imaging of the areas of involvement is often important; computed tomography (CT) scans can delineate bony defects; whereas, magnetic resonance imaging (MRI) more clearly defines intracranial connections. Occult spinal dysraphism can be suspected when certain cutaneous signs are present.
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Affiliation(s)
- Jane Sanders Bellet
- Departments of Dermatology and Pediatrics, Duke University Medical Center, Durham, NC, USA.
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Poujade O, Pecastaing A, Ducarme G, Luton D. Prenatal diagnosis of an isolated skin tumor of the chin. ULTRASOUND IN OBSTETRICS & GYNECOLOGY : THE OFFICIAL JOURNAL OF THE INTERNATIONAL SOCIETY OF ULTRASOUND IN OBSTETRICS AND GYNECOLOGY 2010; 35:373-374. [PMID: 20127757 DOI: 10.1002/uog.7571] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
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Roth DAE, Hildesheimer M, Bardenstein S, Goidel D, Reichman B, Maayan-Metzger A, Kuint J. Preauricular skin tags and ear pits are associated with permanent hearing impairment in newborns. Pediatrics 2008; 122:e884-90. [PMID: 18829787 DOI: 10.1542/peds.2008-0606] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVES Our goals were to (1) study the prevalence of hearing impairment in a large cohort of infants with preauricular skin tags or ear pits and compare it with that among all other newborns participating in our universal newborn hearing screening program during the same period and (2) evaluate the effectiveness of transient evoked otoacoustic emissions as a hearing-screening tool in this population. PATIENTS AND METHODS During the study period of 7.5 years, 68484 infants were screened for hearing impairment, of whom 637 (0.93%) had preauricular skin tags and/or ear pits. The population was divided into 3 groups: (1) a low-risk group for hearing impairment; (2) a high-risk group for hearing impairment; and (3) a very high-risk group for hearing impairment. The screening results and audiological follow-up for these infants were examined retrospectively. RESULTS A significantly higher prevalence of permanent hearing impairment was found among infants with preauricular skin tags or ear pits (8 of 1000), compared with infants without tags or pits (1.5 of 1000). In the low-risk group, the prevalence was 3.4 of 1000, compared with 0.5 of 1000 in infants with and without preauricular tags or pits, respectively. In the high-risk group, the prevalence was 77 of 1000, compared with 20 of 1000 in infants with and without preauricular tags or pits, respectively. The odds ratio for hearing impairment associated with preauricular skin tags and/or ear pits after adjusting for level of risk group was 4.9. All infants diagnosed with permanent hearing impairment, with the exception of 1 with late-onset impairment, were detected by in-hospital transient-evoked otoacoustic emissions screening. CONCLUSIONS Infants with preauricular skin tags or ear pits are at increased risk for permanent hearing impairment. Transient-evoked otoacoustic emissions were found to be an effective hearing-screening tool in this population.
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Isolated preauricular pits and tags: is it necessary to investigate renal abnormalities and hearing impairment? Eur Arch Otorhinolaryngol 2008; 265:1057-60. [PMID: 18253743 DOI: 10.1007/s00405-008-0595-y] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2007] [Accepted: 01/21/2008] [Indexed: 10/22/2022]
Abstract
We investigated the incidence and co-existence of hearing impairment and renal abnormalities in healthy children with preauricular tags and pits. Study population consists of 13,740 primary school children from routine health check. Thirty-five children with preauricular tags and pits were noted. Control group consisted of 91 patients without pits and tags, who underwent renal ultrasound and were scheduled to pediatric outpatient clinic. Urinalysis, renal ultrasound, otoacoustic emission were performed in both the groups. The prevalence of renal abnormality (1/36; 2.7%) and hearing impairment (1/36; 2.7%) in patients with preauricular tags and pits was similar to that of control group (3/91; 3.2% and 4/91; 4.3%) (P = 0.87, P = 0.64, respectively). According to our results, it is not necessary to investigate hearing or urinary abnormality in patients with preauricular tag or pit, unless there is an association of a syndrome or family history of hearing or renal impairment.
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Kameswaran M, Kumar RSA, Murali S, Raghunandhan S, Karthikeyan K. Cochlear implantation in branchio-oto-renal syndrome - A surgical challenge. Indian J Otolaryngol Head Neck Surg 2007; 59:280-3. [PMID: 23120453 PMCID: PMC3452117 DOI: 10.1007/s12070-007-0081-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Branchio-oto-renal syndrome (Melnick-Fraser Syndrome) is a rare Autosomal Dominant disorder characterized by the syndromic association of branchial cysts or fistulae along with external, middle & inner malformations and renal anomalies. Incomplete penetrance and variable expressivity are common with the phenotypic variation ranging from mild to severe forms & consisting of various eye, ear, oral and craniofacial abnormalities. Mutations in the EYA1 gene on chromosomal site 8q13.3 are identified as the primary cause of BOR syndrome. We present a 3year old child with BOR syndrome, who came to us with bilateral low set, malformed ears & profound cochlear hearing loss along with bilateral branchial fistulae & unilateral renal agenesis. This child underwent successful cochlear implantation recently. The clinical presentation, pre-operative investigations, intra-operative findings & post-op habilitation status are presented with special highlights on the unique facial nerve course along with middle and inner ear anomalies which posed a surgical challenge during cochlear implantation.
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Affiliation(s)
- Mohan Kameswaran
- Madras ENT Research Foundation, No.1, 1st Cross street, Off 2nd Main Road, Raja Annamalaipuram, Chennai, 600 028 Tamil Nadu India
| | - R. S. Anand Kumar
- Madras ENT Research Foundation, No.1, 1st Cross street, Off 2nd Main Road, Raja Annamalaipuram, Chennai, 600 028 Tamil Nadu India
| | - Sathiya Murali
- Madras ENT Research Foundation, No.1, 1st Cross street, Off 2nd Main Road, Raja Annamalaipuram, Chennai, 600 028 Tamil Nadu India
| | - S. Raghunandhan
- Madras ENT Research Foundation, No.1, 1st Cross street, Off 2nd Main Road, Raja Annamalaipuram, Chennai, 600 028 Tamil Nadu India
| | - K. Karthikeyan
- Madras ENT Research Foundation, No.1, 1st Cross street, Off 2nd Main Road, Raja Annamalaipuram, Chennai, 600 028 Tamil Nadu India
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Lizama M, Cavagnaro F, Arau R, Navarrete O, Fontanaz AM, García CJ. Association of isolated preauricular tags and nephrourological anomalies: case-control study. Pediatr Nephrol 2007; 22:658-60. [PMID: 17216250 DOI: 10.1007/s00467-006-0395-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2006] [Revised: 10/23/2006] [Accepted: 10/25/2006] [Indexed: 10/23/2022]
Abstract
Isolated preauricular tags (IPT) are considered minor malformations whereas nephrourological anomalies (NUA) are considered major malformations. Their incidences fluctuate between 5 and 10 per 1,000 and 1-3 per 100 live births, respectively. There is contradictory evidence regarding the incidence of NUA in infants with IPT. The objective of this study is to determine if there is a clinical association between IPT and NUA. A case-control study was made in a Pediatric hospital in Santiago, Chile, with infants born between April 2000 and April 2005, considering as cases those with IPT, and controls those infants born following the cases, paired by sex and without IPT. All subjects had a complete physical examination and a renal ultrasound to assess for the presence of congenital anomalies and NUA, respectively. One hundred cases and an equal number of controls were included. There were 41 females in each group. In the case group, two infants presented renal anomalies in the RUS: one left hydronephrosis and one case of left kidney agenesis. In the control group, two infants with anomaly were found: one with a left ureterocele and one case of bilateral duplex kidney. The observed incidence of NUA was similar in both groups to that reported in the literature for the general population. No significant statistical difference was found in the incidence of these abnormalities between patients who presented with IPT and those who did not. From our study, we suggest that RUS is not necessary in the routine evaluation of infants with IPT.
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Affiliation(s)
- Macarena Lizama
- Department of Pediatrics, Escuela de Medicina, Pontificia Universidad Católica de Chile, Lira 85, 5th Floor, Santiago, Chile.
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Lesesky EB, Cunningham BB, Makkar HS. Pediatric surgical pearls: minimizing complications. SEMINARS IN CUTANEOUS MEDICINE AND SURGERY 2007; 26:54-64. [PMID: 17349564 DOI: 10.1016/j.sder.2006.12.007] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Performing dermatologic surgery in infants and children presents unique challenges. A thorough understanding of both pediatric developmental milestones and their unique surgical circumstances is essential to providing optimal dermatologic care of the pediatric patient. In this work, we combine the authors' experiences with data from the literature to provide pediatric dermatologic procedural pearls.
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Affiliation(s)
- Erin B Lesesky
- Division of Pediatric and Adolescent Dermatology, Rady Children's Hospital and Health Center, San Diego, CA 92123, USA.
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Deshpande SA, Watson H. Renal ultrasonography not required in babies with isolated minor ear anomalies. Arch Dis Child Fetal Neonatal Ed 2006; 91:F29-30. [PMID: 16223753 PMCID: PMC2672645 DOI: 10.1136/adc.2005.083329] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
AIM To determine whether infants with isolated minor anomalies of the external ear are at increased risk of renal malformations. METHODS Consecutive infants with isolated minor anomalies of the external ear (preauricular skin tags, preauricular sinuses, ear pits, and misshapen pinnae) were offered renal ultrasonography by experienced sonographers over a 41 month period. The prevalence of renal anomalies in such infants was compared with that detected on routine fetal scanning during the same period. RESULTS Ninety six of 13 136 liveborn infants (7.3/1000, 95% confidence interval (CI) 5.9 to 8.9) were noted to have isolated minor ear anomalies on routine neonatal examination, with preauricular skin tags being the most common (85%). Ninety one (95%) infants underwent renal sonography at a mean (SD) age of 40 (19.6) days. Only one infant (1.1%, 95% CI 0.03 to 5.9) had transient unilateral pyelectasia. During the same period, non-syndromic renal anomalies were found in 0.64% (95% CI 0.52 to 0.73) of infants, a prevalence no different from that of infants with minor ear anomalies (p = 0.44). CONCLUSIONS Routine renal imaging is not warranted in infants with such minor external ear anomalies unless accompanied by other systemic malformations.
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Affiliation(s)
- S A Deshpande
- Royal Shrewsbury Hospital, Mytton Oak Road, Shrewsbury SY3 8XQ, UK.
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19
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Abstract
There are many developmental abnormalities that may appear in the neonate and in infants when critical steps in embryogenesis fail. These steps are often not fatal but can lead to significant morbidity for those patients affected. A logical approach is needed in addressing both the diagnostic and therapeutic issues that arise when caring for these patients, as various lesions will warrant an observational approach, and others may require imaging studies or definitive surgical intervention. Additionally, there are other "lumps and bumps" that are seen in the neonatal and infantile age groups that include malignancies and cutaneous neoplasms with associated systemic sequelae.
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Affiliation(s)
- Davis Farvolden
- University of Massachusetts Medical School, Worcester, MA, USA
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Izzedine H, Tankere F, Launay-Vacher V, Deray G. Ear and kidney syndromes: molecular versus clinical approach. Kidney Int 2004; 65:369-85. [PMID: 14717907 DOI: 10.1111/j.1523-1755.2004.00390.x] [Citation(s) in RCA: 36] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
The association between ear and kidney anomalies is not usually due to an insult to the embryo. In recent years, many essential development control genes that coordinate the assembly and function of kidney and ear have been discovered through the generation of animal mutants and have increased our understanding of the mechanisms of human oto-renal diseases. Here, we describe ear and kidney clinical syndromes and their molecular expression.
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Affiliation(s)
- Hassane Izzedine
- Department of Nephrology, Pitié Salpétrière Hospital, Paris, France.
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21
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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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23
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Grun M, Merlob P, Grunfeld A, Abend M, Chystiakov I, Riskin-Mashiah S, Bader D. Auricular mild errors of morphogenesis: epidemiological study with application of a targeted computer program. ANNALES DE GENETIQUE 2002; 45:207-12. [PMID: 12668169 DOI: 10.1016/s0003-3995(02)01143-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Mild errors of morphogenesis (MEMs) are findings of great importance in multiple fields because of their predictive value in identification of major malformations, specific genetic syndromes, mental retardation and childhood malignancy. In order to evaluate the contribution of auricular MEMs, we constructed a computerized program, especially designed for the recording of auricular MEMs in connection with nonauricular MEMs, personal data, family, pregnancy and birth history, presence of major malformation and postural defects. The program is easy to use and delivers, at request, immediate information regarding prevalence of each auricular MEM and percentage associations between all variables. In the period from January 1, 1999 to December 31, 1999, we screened 3107 consecutively born neonates and recorded auricular and nonauricular MEMs, detected by surface examination. The general prevalence of auricular MEMs was 43.2% and the most frequent MEMs and their associates were of postural-type. This computerized program offers many advantages for the study of ear MEMs.
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Affiliation(s)
- Marta Grun
- Department of Neonatology, Bnei Zion Medical Center and Rappaport Faculty of Medicine, Israel Institute of Technology-Technion, Haifa, Israel
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Kugelman A, Tubi A, Bader D, Chemo M, Dabbah H. Pre-auricular tags and pits in the newborn: the role of renal ultrasonography. J Pediatr 2002; 141:388-91. [PMID: 12219060 DOI: 10.1067/mpd.2002.126600] [Citation(s) in RCA: 39] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
OBJECTIVE To determine the role of renal ultrasonography in the evaluation of healthy newborn infants with isolated pre-auricular tags and pits. STUDY DESIGN During the 4 years of prospective study, 108 of 17,286 infants were born with isolated pre-auricular tags or pits (6.2 per 1000 live births): 92 were assessed for urinary tract abnormalities by performing renal ultrasonography at 1 to 3 months of age. The study group was compared with a control group of 95 consecutive healthy infants without pre-auricular tags or pits born during the same period who underwent renal ultrasonography on the second day of life. RESULTS The study and control groups were comparable in birth weight, gestational age, and sex ratio. Renal ultrasonography was abnormal only in 2 infants with pre-auricular tags (2.2%); both had mild left pyelectasis. The prevalence did not differ significantly from that in the control group, in which 3 infants had mild pyelectasis (3.1%, P = 1.0) and 1 infant had a renal calculus. The prevalence of renal abnormalities in infants with isolated pre-auricular tags or pits in our study (2.2%) was also comparable to the prevalence in the general population (all abnormalities 0.2%-8.1%; significant abnormalities 0.2%-1.4%). CONCLUSIONS We conclude that renal ultrasonography is not indicated in the routine evaluation of the newborn infant with isolated pre-auricular tags or pits.
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Affiliation(s)
- Amir Kugelman
- Department of Neonatology, Bnai-Zion Medical Center, B. Rappaport School of Medicine, Technion-Israel Institute of Technology, Haifa, Israel
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Abstract
Normal ears come in a wide variety of sizes and shapes, likely because of the impact of racial and familial characteristics (phenotypes), the complexity of the embryologic development (malformations), and the potential for intrauterine factors such as oligohydramnios or intrauterine compression to produce distinct physical characteristics in normally formed tissues (deformations). This article will provide an overview of the embryologic origins of the external ear. Relevant terminology used to describe the ear will be reviewed, along with objective guidelines for the assessment of ear size, shape, and position. Clinical implications of abnormal findings will be discussed along with recommendations for referral and follow-up.
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Affiliation(s)
- Lynn Spilman
- NICU, Children's Hospital, Albany Medical Center, 43 New Scotland Ave, Albany, NY 12208, USA.
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Jira H, Ameur A, Kasmaoui E, Ghadouane M, Alami M, Abbar M. [Pathologic horseshoe kidney. Report of 13 cases]. ANNALES D'UROLOGIE 2002; 36:22-5. [PMID: 11859571 DOI: 10.1016/s0003-4401(01)00067-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
The authors report a series of 13 horseshoe kidneys observed over a 22-year period. All patients are men with a mean age of 39 years (20-65 years). The clinical features were dominated by abdomino-lumbar pain (nine cases). The horseshoe kidney was associated with renal stones in nine cases, uretero-pelvic junction syndrome in five cases and pyonephrosis in one case. The specific anatomic and surgical features of this rare malformation are emphasized and the therapeutic features of each uropathy associated with horseshoe kidney are discussed.
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Affiliation(s)
- H Jira
- Service d'urologie, hôpital militaire d'instruction Mohamed V, Rabat, Maroc
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