[Therapeutic effect analysis of non-invasive ear moldings on correcting congenital auricular deformity in 435 ears].

Objective:To evaluate the therapeutic effect of non-invasive ear moldings on correcting congenital auricular deformity of infants. Methods:A total of 435 ears with congenital auricular deformity were treated in the department of Otorhinolaryngology of Chengdu Women and Children's Central Hospital from December 2019 to July 2023. The infants were divided into 3 groups according to the initial treatment age, i. e. , 0-30 days（group A, n=106, 175 ears）, 31-90 days（group B, n=124, 202 ears） and ≥91 days（group C, n=37, 58 ears）. All infants were corrected with Chinese ear moldings. The efficacy, complication rate and treatment duration were compared among the three groups, and the treatments of different types of auricle deformity was analyzed. Results:Through comparison of three groups, the results showed that the markedly effective and cured rate of group A was the highest, and group C was the lowest. The difference was statistically significant（P=0.008）. Specially, there was a significant decrease of after 5 months in Group C. There was no significant difference in the complication rate among the three groups（P=0.232）, and the occurrence of complications has no significant impact on treatment. Group C has the longest treatment duration and group A has the shortest. The difference was statistically significant（P<0.001）. Conclusion:Congenital auricle deformity should be early detected and intervened. The younger the age of children, the better efficacy and shorter treatment duration can be acquired. Children under 5 months still will receive a good treatment. Nevertheless, for children older than 5 months, corrective treatment may also be considered. The efficacy for malformations was significantly lower than that of deformations. The number of cases, efficacy and complication rate for different types of deformations were significantly different.

Drug-associated congenital anomalies of the external ear identified in the United States food and drug administration adverse event reporting system database.

Congenital anomalies of the external ear can have a significant impact on a child's development and quality of life. While genetic factors play a crucial role in the etiology of these anomalies, environmental factors such as drug exposure during pregnancy may also contribute to their occurrence. This study aims to investigate the association between drug exposure and congenital anomalies of the external ear using data from an adverse drug reaction report database. Using OpenVigil 2.1, we queried the FAERS database to retrieve adverse event reports from the first quarter of 2004 to the first quarter of 2024. To identify relevant cases, we used Medical Dictionary for Regulatory Activities terms focusing on congenital anomalies of the external ear. Drug generic names were sourced from the DrugBank database. To assess safety signals and rank drugs by their signal strength, we conducted a disproportionality analysis, generating reporting odds ratios (ROR) and proportional reporting ratios (PRR). A total of 20,754,281 AE reports were identified in the FAERS database from Q1 2004 to Q1 2024, of which 1763 were related to congenital anomalies of the external ear. Valproic acid (122 cases) was associated with the most cases, followed by mycophenolate mofetil (105 cases) and lamotrigine (65 cases). According to the disproportionality analysis, the top five drugs with the highest ROR and PRR were primidone (ROR: 397.05, 95% CI 147.21, 1070.9; PRR: 388.71, 95% CI 145.89, 1035.7), valproic acid (ROR: 239.46, 95% CI 123.75, 463.37; PRR: 236.42, 95% CI 123.82, 451.43), tapazole (ROR: 198.35, 95% CI 63.49, 619.67; PRR: 196.25, 95% CI 62.97, 611.67), nevirapine (ROR: 138.24, 95% CI 82.9, 230.51; PRR: 137.23, 95% CI 82.44, 228.44), and sebivo (ROR: 117.1, 95% CI 48.51, 282.67; PRR: 116.37, 95% CI 48.17, 281.12). This study identified several drugs significantly associated with congenital anomalies of the external ear in the FAERS database using disproportionality analysis. The findings can help healthcare professionals better recognize and manage drug-induced congenital anomalies of the external ear, particularly when prescribing high-risk medications. Further research is needed to elucidate the mechanisms underlying these associations and develop strategies for preventing and mitigating drug-induced congenital anomalies of the external ear.

Comparative performance of video-otoscopy and CT in the diagnosis of external ear disease in cats.

OBJECTIVES: The aim of the study was to compare CT with video-otoscopy for detecting external ear canal masses in cats and to describe CT features of feline external ear disease. METHODS: This retrospective study evaluated the external ear canals of cats that underwent both CT and video-otoscopy. Two blinded observers reviewed the CT scans and their findings were compared with video-otoscopy results evaluated by one blinded observer. RESULTS: Of the 32 examined ears, 13 had an external ear canal mass detected by both CT and video-otoscopy. No false positives were identified. All 19 ears without masses were correctly identified as true negatives, resulting in perfect agreement for mass detection (kappa = 1.000). On histopathology, 9/13 masses were diagnosed as polyps, 1/13 masses was diagnosed as carcinoma, 2/13 did not undergo histopathology and 1/13 masses seen on video-otoscopy was diagnosed as otitis externa with granulomatous tissue formation. Of the 16 cats examined, 12 had a mass in the external ear canal diagnosed by video-otoscopy: six domestic shorthairs, five Maine Coons and one Oriental Shorthair cat. Of these cats, 11 had a unilateral mass and one had a bilateral mass. There was very low agreement between CT and video-otoscopy for ear canal wall enhancement and erythema (kappa = 0.033), as well as for ear canal thickening and stenosis (weighted kappa = 0.056). There was no significant difference between chronic and non-chronic clinical signs in terms of the presence of ear canal wall mineralisation (P = 0.223). CONCLUSIONS AND RELEVANCE: There is high agreement between video-otoscopy and CT in detecting external ear canal masses in cats. However, there is very low agreement between CT and video-otoscopy for ear canal wall enhancement, erythema, thickening and stenosis. The presence of external ear canal mineralisation did not correlate with the chronicity of clinical signs.

Clinical and molecular cytogenetic findings of cat eye syndrome and a 2-year-old patient with congenital aural atresia and hearing loss.

BACKGROUND: Cat eye syndrome (CES) is a rare congenital disease frequently caused by a partial tetrasomy of the proximal long (q) arm of chromosome 22, due to a small supernumerary marker chromosome (sSMC). CES patients show remarkable phenotypic variability. Despite the progress of molecular cytogenetic technology, the cause of phenotypic variability and the genotype-phenotype correlations remain unknown. METHODS: We analyzed clinical and genetic data of a new patient with CES together with 27 previously reported ones with a confirmed genomic gain in the PubMed database between 2012 and 2023. RESULTS: We reported a boy with CES carrying a 22q11.1-q11.21 duplication of 1.76 Mb tetrasomy (16888900_18644241, hg19) who presented currently rare or unreported clinical findings such as congenital aural atresia, hearing loss, PLSVC, and IVC. The results of the whole exome sequencing (WES) showed a heterozygous mutation of the GJB2 gene (NM_004004.6: exon2: c.109G > A). In addition, the results of our literature review showed that the presence of a classical sSMC was the most frequent cytogenetic abnormality in CES (82%). 63% of cases were in a homogenous state and 37% of cases were in a mosaic state. 72% of cases had a 1-2 Mb duplication. In the majority of CES patients the breakpoints in chromosome 22 are localized to a 50 kb region (18610000_18660000 bp). The CES critical region (CESCR) may be further delimited to a 0.3 Mb region (17799398_18111588 bp). Within this region CECR2, SLC25A18, ATP6V1E1, and BCL2L13 are strong candidate genes for causing the main CES phenotype. The ear anomalies are the most frequent features in CES patients (89%) and hearing loss was present in 36% of CES patients. CONCLUSIONS: The phenotypic features in CES are highly variable. Our findings expand the symptom spectrum of CES and lay the foundation for better delineating the clinical phenotype, molecular cytogenetic features associated with CES and genotype-phenotype correlations. We recommend performing WES to rule out the involvement of other genetic factors in the patient's phenotype. In addition, our findings also highlight the need for genetic counseling and recurrence risk assessment.

Lentigo Maligna and Lentigo Maligna Melanoma of the External Ear: Clinical and Dermoscopic Features of 19 Patients.

External ear lentigo maligna/lentigo melanoma (LM/LMM) represents approximately 1%-4% of all primary cutaneous melanomas. Over the past 20 years, dermoscopy has proven highly effective in early detection of LM/LMM, with recent studies identifying perifollicular linear projections (PLP) as a specific diagnostic criterion for early LM. However, in clinical practice, LM and LMM turn out to be very difficult to distinguish based on dermoscopic findings. Therefore, our retrospective monocentric study aimed to investigate dermoscopic characteristics, as well as the epidemiological and clinical data of 19 patients diagnosed with the external ear (EE) LM/LMM at the Oncologic Dermatology Unit in Bologna. Dermoscopic images were obtained using the FotoFinder Medicam 800HD, and specific criteria validated by the International Dermoscopy Society (IDS) for atypical pigmented facial lesions were assessed. Fisher's exact test was primarily used for statistical comparisons. As results, most of the patients were male (74%) with an average age (± SD) at diagnosis of 69.8 (± 15.1) years old. LMM appeared more commonly observed in elderly patients as compared to LM (mean 71.6 vs. 66.7, p = 0.514), presenting as pigmented macule (89.5%) of the ear lobule (23.9%). A statistically significant difference (p = 0.01) of tumour' diameter between LMM and LM was reported with the first resulting more than twice the size of the latter. Concerning dermoscopic findings, asymmetric pigmented follicles, obliteration of the follicular openings and grey circles were more frequently observed in LMM compared to LM (63.2% vs. 31.6%; 63.2% vs. 26.3%; 47.4% vs. 15.8%, respectively).

Auricular deformity correction with simultaneous reconstruction of the conchal bowl using autologous ear cartilage for "flat ear": A novel surgical technique.

BACKGROUNDS: "Flat ear" is a subtype of Grade II conchal-type microtia characterized by severely underdeveloped conchal bowl. Traditional surgical techniques often rely on autologous costal cartilage, which poses several risks and complications. This study aimed to introduce a novel surgical technique using autologous ear cartilage in auricular deformity correction surgery with simultaneous conchal bowl reconstruction for "flat ear." METHODS: A total of 19 patients were involved in this single-center, retrospective cohort study. All patients underwent the described surgical technique. Data were collected preoperatively, immediately after the surgery, and at the last follow-up, including auricular length, width, perimeter, and conchal bowl depth. Patient satisfaction was assessed using the Visual Analog Scale (VAS). RESULTS: The study included 12 males and 7 females, with an average age of 10.67 ± 3.86 years. Postoperative results showed significant improvements in auricular measurements, with the affected ear achieving near symmetry with the normal ear. The mean conchal bowl depth was restored from a preoperative 4.33 ± 1.78 mm to 17.32 ± 1.28 mm postoperatively. VAS scores for patient satisfaction increased significantly from 1.44 ± 0.92 preoperatively to 7.72 ± 1.49 postoperatively, with stability observed at the last follow-up. CONCLUSION: The novel technique offers a promising alternative to traditional costal cartilage-based auricular deformity correction surgery, providing excellent aesthetic outcomes and high patient satisfaction. This approach may expand treatment options for patients with "flat ear" and related auricular deformities, with reduced invasiveness and potential for future auditory rehabilitation.

External ear malformations and cardiac and renal anomalies: A systematic review and meta-analysis.

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.

Mirror Ear: A Rare Case of Polyotia.

Polyotia is an anomaly of the external auricle in which the accessory auricle is large enough to closely resemble an additional pinna rather than a skin remnant and cartilage. Polyotia, also known as mirror ear or accessory ear, is a type of ear anomaly in the tragus area, but the term refers to substantial anomalies which resemble an accessory ear, unlike a pre-auricular tag. It is an extremely rare condition and to date, less than 30 cases of polyotia have been reported according to a review of the literature. A variety of theories has been proposed for development of such abnormal external auricle. We report two cases of polyotia which presented to Dhulikhel Hospital ENT OPD that was successfully corrected surgically. An 8-year-old boy and a 14-year-old boy presented with a large accessory anomalous auricle on left and right ear respectively. The accessory auricle was composed of an elastic cartilaginous component covered with skin and was positioned anteriorly to the original auricle in both the cases. The anomaly was not as large as the patient's external auricle, rather it mirrored the external auricle. On the opposite ear both the cases presented with preauricular skin tag. Surgical correction was done by dissecting the skin free from the duplicated cartilage via an incision along the free edge of the helix the duplicated cartilage was contoured to fill the pre-tragal hollow and the tragus reconstructed with a free cartilage graft.

Blastic plasmacytoid dendritic cell neoplasm: a rare external ear lesion presenting with leukaemia.

Blastic plasmacytoid dendritic cell neoplasm (BPDCN) is a rare and aggressive haematological malignancy, typically characterised by cutaneous lesions and bone marrow involvement. We present a unique case of a woman in her 70s, initially seen for a spontaneous swelling on her left external ear resembling a haematoma, which recurred after initial treatment, triggering further evaluation.Diagnostic challenges arose as the patient displayed positive markers for Myeloperoxidase (MPO) (p-ANCA), suggesting vasculitis. Dermatology considered various differential diagnoses, but imaging and tests ruled out significant pathology. Steroid treatment led to improvement, but coincided with a surge in white cell count (WCC), prompting an urgent haematological review.Subsequent investigations, including a punch biopsy of the external ear and a bone marrow biopsy revealed BPDCN concurrent with chronic myelomonocytic leukaemia. This case highlights the challenging diagnostic journey, emphasising the need for multidisciplinary collaboration and the potential for unique BPDCN presentations, expanding our understanding of this malignancy.

[Auricular and periauricular pathologies in the ENT department of Sylvanus Olympio Teaching Hospital in Lome (Togo)]. / Pathologies auriculaires et périauriculaires au service d'ORL du Centre hospitalier universitaire Sylvanus Olympio de Lomé (Togo).

Objective: The aim of this study is to describe the epidemiological aspects, clinical features and principles of management of different types of auricular and peri-auricular pathologies. Patients and Methods: This is a 5-year retrospective descriptive study (from May 1, 2018 to April 30, 2023) of the records of patients who consulted for a functional or cosmetic complaint relating to the auricle or periauricular region in the ENT and cervico-facial surgery department of the Centre hospitalier universitaire Sylvanus Olympio. Results: A total of 159 cases over 5 years, i.e. an annual frequency of 31 cases, met the study criteria. The mean age of the patients was 22.2 years. Children and students accounted for 24.5% and 23.9% of cases respectively. Auricular pathologies accounted for 64.8% of cases and peri-auricular pathologies for 36.2%.Tumors and trauma accounted for 33.3% and 29.6% of cases respectively, and congenital pathologies were found in 29.9% of cases. Among traumatic lesions, intentional assault and battery was the cause in 21.3%, followed by road accidents in 17.2%. The right ear was affected in 48% and the lobule in 40.4%. Keloids accounted for 17.6% of all cases, and 53% of tumors and pseudotumors. The left ear was involved in 50% of cases. Piercing was the cause of keloids in 10.7% of cases. Conclusion: Auricular and peri-auricular pathologies were dominated by benign tumors, trauma and congenital pathologies, and involved young subjects. Management is based on the type of lesion, with functional and aesthetic considerations in mind.

Single-stage reconstruction of severe question mark ear with the absence of large portions of the lobule using affected cartilage graft and 3 flaps.

BACKGROUND: Question mark ear (QME) is a congenital abnormality characterized by a prominent curve within the helix that resembles a question mark. Several surgical reconstruction techniques have been proposed to treat this deformity. In this study, we aimed to evaluate the cosmetic outcomes of a new cartilage and postauricular flap surgical reconstruction technique for patients diagnosed with severe QME. METHOD: From 2017 to 2023, 33 patients with severe QMEs were treated with a new reconstruction surgical technique at the Plastic Surgery Hospital of Peking Union Medical College. The perimeter, width, length, and auriculocephalic angles of both ears were measured and compared to assess the symmetry. The patient's satisfaction with the surgical outcomes and incidence of post-operative complications were also evaluated. The average follow-up duration was 15.48 months. RESULTS: The auricular perimeter, width, and length changed significantly after surgery. The dimensions of the left and right ear did not vary significantly in patients with unilateral or bilateral severe QME after surgery and at the end of the 1-year follow-up. Most patients (87.88%) or carers were satisfied with the cosmetic outcomes after surgery. All patients underwent suture removal 14 days after surgery and exhibited excellent wound healing without any complications such as hematoma, infection, and flap necrosis. CONCLUSION: Our new surgical reconstruction technique for severe QME resulted in good cosmetic outcomes, high patient satisfaction, fast recovery, and no post-operative complications.

[Exploration of technique for preservation of external-middle ear structure in surgery of jugular foramen paraganglioma （appended 2 case reports）].

Objective:To investigate the feasibility and effect of the modified surgery of the classic infratemporal fossa type A approach for the surgical treatment of jugular foramen paraganglioma with preservation of the external and middle ear structures. Methods:The medical data of 2 patients with jugular foraminal paraganglioma treated by sublabyrinthic-transmastoid approach were retrospectively analyzed. The clinical feature, degree of tumor resection, postoperative facial nerve function and hearing retention, and the incidence of postoperative complications were evaluated. Results:Two patients were both female, and were pathologically confirmed as paraganglioma. The tumor of case 1 was staged as C2De1, and case 2 as C1De1. Tumors were completely resected in both patients. Case 1 suffered infection after surgery, with residual tympanic membrane perforation and mixed deafness. Case 2 developed mild facial paralysis（grade Ⅱ） after surgery, and recovered after symptomatic treatment. There was no tumor residue or recurrence during half a year of follow-up. Conclusion:Surgical treatment of certain paragangliomas in the jugular foramen with a combined sublabyrinthic-transmastoid and upper neck approach might achieve both complete resection of the tumor and preserving the structure and function of the outer-middle ear. This procedure is suitable for paragangliomas restricted in the jugular foramen area, with no or limited involvement of the internal carotid artery（C1 or C2）, and with no or mild hearing loss.

Auricular spoon-shaped crus malformation including variants: Clinical features and a novel surgical approach.

BACKGROUND: Certain auricular malformations are uncommon and lack generally accepted diagnostic names. This study investigates an uncommon complex auricular malformation known as auricular spoon-shaped crus malformation providing a detailed description of its external characteristics. Additionally, an effective surgical approach is proposed. METHODS: Between 1991 and 2023, 12 auricles in 11 patients with auricular spoon-shaped crus malformation including variants were surgically treated at our center. Patient medical records and photographic data were retrospectively reviewed. RESULTS: Each auricle exhibited 2 to 4 major structural deformities within the 5 areas of the superior crus, inferior crus, and stem of the antihelix, helical crus, and earlobe. These deformities resulted in depression between the antihelix and antitragus, vertical shortening, horizontal elongation of the auricle, and/or drooping of the ear. Three patients displayed a low positioning of the malformed ear, and 8 patients exhibited mild to moderate hemifacial microsomia. In corrections we conducted earlier, we utilized various methods with variable aesthetic outcomes. Recently, an improved corrective method we implemented yielded consistently promising aesthetic results. We have confidence that adopting the surgical approach we suggest can lead to promising aesthetic results when addressing this malformation. Furthermore, we hope that the presented malformation will be recognized as a primary auricular malformation by auricular surgeons in the future.

Clinical and social success in epithetic ear rehabilitation - Retrospectively evaluating the long-term survival of auricular implants.

PURPOSE: The aim of this study was to evaluate existing staging recommendations for peri-implantitis and its applicability for auricular bone anchoring. MATERIALS AND METHODS: In this cross-sectional study, 44 patients treated with 47 ear epitheses and 128 implants were analyzed over 191.6 months (mean). Peri-implant sulcus depth, sulcus fluid flow rate, and peri-implant skin reaction, as well as cleaning habits and patients' quality of life, were analyzed. Mixed effect linear and mixed effect ordered logistic regression models were used. RESULTS: Two of the 128 implants were lost (1.6 %). A total of 14.5 % of all patients presented light erythemas, 19.4 % showed stage 2, 4.8 % stage 3, and 12.9 % an acute infection according to Holgers. A correlation between skin reaction and sulcus fluid flow rate was observed, when grouping patients with acute signs of inflammation. Concerning patient satisfaction, 58.1 % of the patients were highly satisfied with their epitheses, 39.5 % very satisfied, and one patient was just satisfied. Younger age correlated with lower satisfaction rates. CONCLUSION: Implant-retained auricular epitheses are a safe, highly sufficient and satisfying way of extending ear reconstruction. Sulcus depth and skin reaction are quick and valuable assessment tools in auricular implants, but skin reaction alone was clinically insufficient to predict peri-implant pocket inflammation.

One-Year Results of Ear Reconstruction with 3D Printed Implants.

PURPOSE: External ear reconstruction has been a challenging subject for plastic surgeons for decades. Popular methods using autologous costal cartilage or polyethylene still have their drawbacks. With the advance of three-dimensional (3D) printing technique, bioscaffold engineering using synthetic polymer draws attention as an alternative. This is a clinical trial of ear reconstruction using 3D printed scaffold, presented with clinical results after 1 year. MATERIALS AND METHODS: From 2021 to 2022, five adult patients with unilateral microtia underwent two-staged total ear reconstruction using 3D printed implants. For each patient, a patient-specific 3D printed scaffold was designed and produced with polycaprolactone (PCL) based on computed tomography images, using fused deposition modeling. Computed tomography scan was obtained preoperatively, within 2 weeks following the surgery and after 1 year, to compare the volume of the normal side and the reconstructed ear. At 1-year visit, clinical photo was taken for scoring by two surgeons and patients themselves. RESULTS: All five patients had completely healed reconstructed ear at 1-year follow-up. On average, the volume of reconstructed ear was 161.54% of that of the normal side ear. In a range of 0 to 10, objective assessors gave scores 3 to 6, whereas patients gave scores 8 to 10. CONCLUSION: External ear reconstruction using 3D printed PCL implant showed durable, safe results reflected by excellent volume restoration and patient satisfaction at 1 year postoperatively. Further clinical follow-up with more cases and refinement of scaffold with advancing bioprinting technique is anticipated. The study's plan and results have been registered with the Clinical Research Information Service (CRIS No. 3-2019-0306) and the Ministry of Food and Drug Safety (MFDS No. 1182).

The pixie ear: How to prevent and correct it-a review of the literature.

As the life expectancy of the population continues to increase, more facial-rejuvenating procedures are sought. As the number of facelift procedures increases, it is mandatory to acknowledge, and most importantly prevent, any possible associated complications. One of the complications after rhytidectomy, and a sign of facelift, is the so-called "pixie ear deformity" or "bat ear." This is regarded as a telltale sign of a facelift procedure and appears to be identified in 5% of earlobe inset cases. The ear's location is a crucial hallmark of an aesthetically pleasing face, not only by itself but also in relation with other aesthetic units. When performing a facelift procedure, tension vectors of the rhytidectomy flap could cause alterations in ear's position and appearance: the ear loses its great mobility and becomes more fixed in its acquired position, resulting in a "stuck-on" appearance. The auricle is displaced following an anteroinferior direction, with the otobasion inferius (the most caudal anterior attachment of the earlobe to the cheek) being dislocated from its original more posterior and upper position to a new more anterior and caudal location. The displacement of the auricle is usually accompanied by distortion of the earlobe rotating forward and becoming more anterior than the rest of the ear. In recent decades, many techniques and procedures have been described to prevent and correct the pixie ear; in this review, we aim to analyze and describe them comprehensively.

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.

[Management of patients with complex ear deformities]. / Prise en charge des patients présentant des déformations complexes du pavillon de l'oreille.

Complex ear reconstruction requires specialized multidisciplinary care. Most patients present with microtia, often associated with hearing disorders. The management of these disorders is a priority, and reconstruction of the external ear remains optional. Nowadays, auricular reconstruction is based on the subcutaneous implantation of either autologous cartilage or an allogeneic implant. Autologous reconstruction requires highly specialized surgical expertise and involves harvesting rib cartilage but carries a lower risk of exposure compared to allogeneic implants. Both techniques yield good results with a high success rate and have a positive impact on the social functioning and daily life of patients.

La reconstruction complexe du pavillon auriculaire nécessite une prise en charge multidisciplinaire spécialisée. La majorité des patients nécessitant ce geste présentent une microtie, souvent associée à des troubles de l'audition. La prise en charge de ceux-ci est prioritaire et la reconstruction du pavillon reste facultative. Aujourd'hui, la reconstruction du pavillon se base sur l'implantation sous-cutanée d'une maquette de cartilage autologue ou d'un implant allogène. La reconstruction autologue demande une expertise chirurgicale hautement spécialisée et nécessite un prélèvement de cartilage costal mais présente un risque d'exposition inférieur par rapport à l'implant allogène. Les deux techniques permettent d'atteindre de bons résultats avec un taux de réussite élevé et un effet positif sur le fonctionnement social et le quotidien des patients.

Selecting Flap Transfer Methods to Repair Helix Soft Tissue Defect Based on the Direction of Long Axis.

BACKGROUND: The posterior auricular flap has long been favored for repairing skin defects on the ear's surface. However, achieving optimal esthetic outcomes in ear reconstruction requires a flexible approach to flap transfer methods. While bipedicle advancement flaps are commonly used for body wound coverage, they are rarely used in auricular defect repair. OBJECTIVE: To propose a modified flap transfer approach based on the orientation of the auricular defect's long axis and assess the postoperative esthetic outcomes. METHODS: The authors reported 12 patients treated using 2 distinct flap transfer techniques. Mild to moderate helix soft tissue defects remained after excision of the masses. A direct island flap was created for patients with longitudinal defects to cover the defect. For patients with transverse defects, a combination of bipedicle and island flaps was used for repair. Scar quality and esthetic outcomes were assessed at least 6 months postsurgery using the Scar Cosmesis Assessment and Rating scale. RESULTS: All patients experienced no serious complications and achieved excellent cosmetic results. Patients undergoing combined flap transfer exhibited relatively more favorable esthetic outcomes. CONCLUSION: The authors propose a novel concept for repairing helix soft tissue defects by designing local flaps based on the direction of the defect's long axis. For repairing helix soft tissue defects with a long axis parallel to the auricular edge, the combined utilization of bipedicle advancement flap and island rotation flap transfer should be consideration more.

Effect of External Ear Deformity on Hearing in Wrestlers.

PURPOSE: Cauliflower ear in wrestlers can lead to hearing impairment. This study primarily aims to assess the hearing of wrestlers with bilateral cauliflower ears and determine their external ear canal (EEC) resonance frequencies. Our second aim is to evaluate their hearing quality, speech, and spatial perception. METHOD: This study included 28 male wrestlers aged 18-35 years with bilateral cauliflower ears, as well as 27 male participants in the control group with no wrestling history. The participants' hearing thresholds were determined across the frequency range of 125-16000 Hz for air-conduction and 500-4000 Hz for bone conduction. EEC resonance frequencies were measured. Additionally, all participants completed the Turkish version of the Speech, Spatial, and Qualities of Hearing Scale (SSQ) questionnaire. RESULTS: Wrestlers with cauliflower ears exhibited significantly higher hearing thresholds, particularly at frequencies above 4000 Hz (p < .05). Analysis of EEC resonance showed a shift to higher frequencies in the second resonance peak of the right ear (p < .001) and the first resonance peak of the left ear (p = .045). SSQ scores revealed that wrestlers had higher spatial perception (p = .046), hearing quality (p = .004), and general scores (p = .042) in comparison to the control group. CONCLUSIONS: Blunt traumas in wrestlers, leading to cauliflower ear, can result in hearing loss. Moreover, deformities in the external ear affect the resonance frequencies of the EEC. Therefore, it is crucial to advocate for the use of ear protection equipment among wrestlers. When fitting hearing aids, attention should be given to changes in the EEC resonance frequency.