Assuntos
Insuficiência Adrenal/diagnóstico , Calcinose/diagnóstico , Cartilagem da Orelha/patologia , Deformidades Adquiridas da Orelha/diagnóstico , Insuficiência Adrenal/complicações , Insuficiência Adrenal/tratamento farmacológico , Idoso , Calcinose/tratamento farmacológico , Calcinose/etiologia , Cartilagem da Orelha/diagnóstico por imagem , Cartilagem da Orelha/efeitos dos fármacos , Deformidades Adquiridas da Orelha/tratamento farmacológico , Deformidades Adquiridas da Orelha/etiologia , Glucocorticoides/uso terapêutico , Terapia de Reposição Hormonal , Humanos , Imageamento por Ressonância Magnética , Masculino , Tomografia Computadorizada por Raios XRESUMO
OBJECTIVES: The post-traumatic ear deformity, known today as cauliflower ear, has been described since antiquity. It has long been associated with pugilistic sports (wrestling, boxing) as well as among the mentally ill. The aim of this study is to present the various terms used since antiquity to describe these traumatic deformations of the auricle and to trace the origin of the modern moniker "cauliflower ear." METHODS: Historical study, only based on original documentation accessed through personal libraries and universities repositories, completed with online sources and etymological dictionaries. RESULTS: We were able to identify no fewer than 39 names for the deformity. The term cauliflower ear is of relatively recent origin. It was coined in the first decade of the 20th century, initially in the popular press and subsequently adopted by the medical profession. CONCLUSION: Ironically, the deformity has only superficial resemblance to a cauliflower. The vegetable, which is part of the cabbage family, has a symmetrical and highly ordered fractal geometry with well-circumscribed excrescences. Cauliflower ear, by contrast, notably lacks symmetry and its rounded protuberances flow into one another. Although somewhat a misnomer, the term is deeply rooted in both popular and medical culture. LEVEL OF EVIDENCE: N/A Laryngoscope, 131:E1315-E1321, 2021.
Assuntos
Traumatismos em Atletas/complicações , Pavilhão Auricular/anormalidades , Pavilhão Auricular/lesões , Deformidades Adquiridas da Orelha/etiologia , Pavilhão Auricular/irrigação sanguínea , Pavilhão Auricular/patologia , Deformidades Adquiridas da Orelha/diagnóstico , Deformidades Adquiridas da Orelha/história , Deformidades Adquiridas da Orelha/patologia , Otopatias/etiologia , Otopatias/história , Otopatias/patologia , Hematoma/complicações , História do Século XVIII , História do Século XIX , História do Século XX , História Antiga , História Medieval , Humanos , Esportes/tendências , Terminologia como AssuntoRESUMO
Loss of facial organs in an individual may be due to congenital anomalies or acquired causes. The missing parts of the face like ear, eyes and nose are considered as maxillofacial defects that can be rehabilitated by a prosthesis and/or cosmetic surgeries. This frontier of science has developed into a more reliable and predictable process due to the ever-increasing development of materials and equipments used in this procedure. The fabrication of an ear prosthesis is considered by many prosthetists to be one of the most difficult replacements in maxillofacial reconstruction. The severe undercuts and pronounced convolutions of the ear present a challenge in simulating a naturally proportioned prosthesis. Proper assessment of the disfigured facial organs and a feasible approach to rehabilitating them has for long been the target of clinical maxillofacial prosthodontics. This report describes a simple and engrossing technique to rehabilitate a patient with a partial auricular defect in the most aesthetic and economical manner using medical-grade room temperature vulcanising silicone.
Assuntos
Deformidades Adquiridas da Orelha , Orelha Externa , Próteses e Implantes , Desenho de Prótese/métodos , Ajuste de Prótese/métodos , Deformidades Adquiridas da Orelha/diagnóstico , Deformidades Adquiridas da Orelha/psicologia , Deformidades Adquiridas da Orelha/reabilitação , Orelha Externa/lesões , Orelha Externa/patologia , Estética , Feminino , Humanos , Pessoa de Meia-Idade , Satisfação do Paciente , Silicones/uso terapêutico , Resultado do TratamentoAssuntos
Deformidades Adquiridas da Orelha/diagnóstico , Policondrite Recidivante/diagnóstico , Adulto , Diagnóstico Diferencial , Pavilhão Auricular/patologia , Deformidades Adquiridas da Orelha/etiologia , Deformidades Adquiridas da Orelha/patologia , Feminino , Humanos , Policondrite Recidivante/complicações , Policondrite Recidivante/patologiaRESUMO
The terminology Cauliflower ear refers to the appearance of external ear, sequelae to underlying primary inflammation/infection. Trauma and secondary infection or perichondritis being the most common cause of cauliflower ear, this article describes a case of unilateral cauliflower ear due to multibacillary leprosy. This case shows the importance of skin smears and the histopathological identification and classification of leprosy patients with unusual lesions.
Assuntos
Deformidades Adquiridas da Orelha/diagnóstico , Deformidades Adquiridas da Orelha/patologia , Orelha Externa/patologia , Hanseníase Multibacilar/diagnóstico , Hanseníase Multibacilar/patologia , Humanos , Masculino , Pessoa de Meia-Idade , Pele/patologiaRESUMO
Otoplasty for the correction of protruding ears is characterized by various techniques and a common and popular cosmetic procedure. For the surgeon, whether beginner or advanced, it is essential to understand the principles and master techniques for standard auricular deformities before applying further sophisticated methods, because a lot of complications and failures are caused by wrong indication and incorrect surgical techniques. The different surgical steps are best learned from teaching models. Therefore, we developed two different silicone models of protruding ears with moderate auricular deformities: one with conchal hyperplasia for the training of conchal resection, and one without antihelix for creating an antihelical fold by suturing technique, based on computed tomography scans of patients. The silicone ear models were evaluated during four standardized surgery courses for residents in otorhinolaryngology by 91 participants using specially designed questionnaires. Nearly all participants rated the training on the auricular models as very helpful (n = 51) or good (n = 31); the scores for the different techniques and properties of the models ranged from 2.0 to 2.6 in a range from 1 (very good) to 4 (inadequate). The good results demonstrate the possibility for learning different surgical otoplasty techniques with this newly designed teaching tool.
Assuntos
Pavilhão Auricular , Deformidades Adquiridas da Orelha , Procedimentos Cirúrgicos Otológicos , Procedimentos de Cirurgia Plástica , Cirurgia Plástica/educação , Materiais de Ensino/normas , Competência Clínica , Pavilhão Auricular/anormalidades , Pavilhão Auricular/diagnóstico por imagem , Pavilhão Auricular/cirurgia , Deformidades Adquiridas da Orelha/diagnóstico , Deformidades Adquiridas da Orelha/cirurgia , Feminino , Humanos , Masculino , Procedimentos Cirúrgicos Otológicos/educação , Procedimentos Cirúrgicos Otológicos/métodos , Procedimentos de Cirurgia Plástica/educação , Procedimentos de Cirurgia Plástica/métodos , Técnicas de Sutura , Ensino , Tomografia Computadorizada por Raios X/métodosRESUMO
OBJECTIVES/HYPOTHESIS: To demonstrate the dosimetry effect of electromechanical reshaping (EMR) on cartilage shape change, structural integrity, cellular viability, and remodeling of grafts in an in vivo long-term animal model. STUDY DESIGN: Animal study. METHODS: A subperichondrial cartilaginous defect was created within the base of the pinna of 31 New Zealand white rabbits. Autologous costal cartilage grafts were electromechanically reshaped to resemble the rabbit auricular base framework and mechanically secured into the pinna base defect. Forty-nine costal cartilage specimens (four control and 45 experimental) successfully underwent EMR using a paired set of voltage-time combinations and survived for 6 or 12 weeks. Shape change was measured, and specimens were analyzed using digital imaging, tissue histology, and confocal microscopy with LIVE-DEAD viability assays. RESULTS: Shape change was proportional to charge transfer in all experimental specimens (P < .01) and increased with voltage. All experimental specimens contoured to the auricular base. Focal cartilage degeneration and fibrosis was observed where needle electrodes were inserted, ranging from 2.2 to 3.9 mm. The response to injury increased with increasing charge transfer and survival duration. CONCLUSIONS: EMR results in appropriate shape change in cartilage grafts with chondrocyte injury highly localized. These studies suggest that elements of auricular reconstruction may be feasible using EMR. Extended survival periods and further optimization of voltage-time pairs are necessary to evaluate the long-term effects and shape-change potential of EMR. LEVELS OF EVIDENCE: NA.
Assuntos
Cartilagem/transplante , Pavilhão Auricular/cirurgia , Deformidades Adquiridas da Orelha/cirurgia , Eletrocirurgia/métodos , Procedimentos Cirúrgicos Otológicos/métodos , Procedimentos de Cirurgia Plástica/métodos , Animais , Modelos Animais de Doenças , Pavilhão Auricular/patologia , Deformidades Adquiridas da Orelha/diagnóstico , Seguimentos , Microscopia Confocal , Coelhos , Fatores de TempoAssuntos
Pavilhão Auricular/cirurgia , Deformidades Adquiridas da Orelha/cirurgia , Próteses e Implantes , Implantação de Prótese/métodos , Carcinoma de Células Escamosas/patologia , Carcinoma de Células Escamosas/cirurgia , Pavilhão Auricular/patologia , Deformidades Adquiridas da Orelha/diagnóstico , Estética , Seguimentos , Neoplasias de Cabeça e Pescoço/patologia , Neoplasias de Cabeça e Pescoço/cirurgia , Humanos , Masculino , Pessoa de Meia-Idade , Invasividade Neoplásica/patologia , Desenho de Prótese , Procedimentos de Cirurgia Plástica/métodos , Resultado do TratamentoRESUMO
In this study, we evaluated clinical results and health-related quality of life in our otoplasty patients in whom we used cartilage resection method (CRM) and suturing method (SM). A total of 132 ears of 77 patients (36 males, 41 females; mean age 14.6 ± 6.4) between January 2006 and February 2013 were included in this study. Patients were divided into two groups according to the type of surgery performed: Group 1 was the cartilage resection group (CRG) and Group 2 was the suturing group (SG). CRM was performed on 64 ears of 37 patients (unilateral in 10 cases and bilateral in 27 cases), and SM was performed on 68 ears of 40 patients (unilateral in 12 cases and bilateral in 28 cases). The parameters of the groups, including operation time, measurements of the auriculocephalic distances, complication rates, postoperative satisfaction rates, and health-related quality of life were compared. Mean operation time was 53.7 ± 7.8 min in the CRG and 44.9 ± 4.2 min in the SG (P ≤ 0.05). Mean postoperative auriculocephalic measurements were similar in both groups. The complications were more frequent in the CRG (10/37 patients, 27.02 %) than in the SG (3/40 patients, 7.54 %) with statistically significant difference (P < 0.05). Three months after the surgery, visual analog scale increased from 25 (preoperatively) to 70 in the CRG and from 30 to 90 in the SG, with a statistically significant difference (P < 0.05). Patients' health-related quality of life showed a statistically significant increase after the operation in both groups (P < 0.05). CRM and SM are effective treatment methods with high success rates for patients with prominent ears. In the selected cases, SM seems to represent a better option for otoplasty than CRM because clinical results, cosmetic outcomes, patient satisfaction, and health-related quality of life scores were better than CRM.
Assuntos
Deformidades Adquiridas da Orelha , Orelha Externa , Procedimentos Cirúrgicos Otológicos , Procedimentos de Cirurgia Plástica , Qualidade de Vida , Adolescente , Cartilagem/cirurgia , Criança , Deformidades Adquiridas da Orelha/diagnóstico , Deformidades Adquiridas da Orelha/psicologia , Deformidades Adquiridas da Orelha/cirurgia , Orelha Externa/patologia , Orelha Externa/cirurgia , Feminino , Humanos , Masculino , Duração da Cirurgia , Procedimentos Cirúrgicos Otológicos/efeitos adversos , Procedimentos Cirúrgicos Otológicos/métodos , Procedimentos Cirúrgicos Otológicos/psicologia , Satisfação do Paciente , Complicações Pós-Operatórias/diagnóstico , Procedimentos de Cirurgia Plástica/efeitos adversos , Procedimentos de Cirurgia Plástica/métodos , Procedimentos de Cirurgia Plástica/psicologia , Técnicas de Sutura , Resultado do Tratamento , Adulto JovemRESUMO
Our objectives were to review all reported staging systems of tympanic membrane (TM) retraction pockets (RP) and to report their reliability and utility to our daily clinical practice in terms of follow-up and decision making in the management of RP. We aim to propose a new management algorithm of TMRPs. We conducted a thorough research on Ovid Medline, Pubmed and Cochrane databases for English and French languages studies published between 1963 and 2012 on the retraction pocket. Studies were excluded if it were a short comments, photo clinical cases, experimental studies or round table articles. Cholesteatoma was not included in keywords, since it is considered as an advanced pathological entity with different staging and management approaches. We included 60 of 756 articles that met our inclusion criteria. Sadé and Berco proposed the first staging system of RP in 1976, while the last one was described by Borgstein et al. in 2007. From 1976 to 2007, 12 different staging systems have been described for tympanic membrane retractions. There are three broad categories of TMRPs: localized retractions of the pars tensa, generalized retractions of the pars tensa (atelectasis) and retraction of the pars flaccida. Most of the described staging systems are useful for following up the evolution of retractions over time. However, no consensus was found concerning the decision making in its management. In conclusion, proper management of TMRPs requires a reproducible, easily applicable staging system with low inter- and intra-observer variability. We propose a management algorithm that considers the functional handicap of the patient rather than the topographic description of the TM.
Assuntos
Deformidades Adquiridas da Orelha/diagnóstico , Membrana Timpânica/patologia , Deformidades Adquiridas da Orelha/cirurgia , Humanos , Membrana Timpânica/cirurgiaRESUMO
Physical diagnosis is considered to be a cornerstone in clinical medicine. Examination of the ears is frequently forgotten although, in many clinical situations, it may help: in gout (tophi), lupus, congenital anomalies, trauma and in local malignancies. We may add another physical-acquired sign: the Frank's sign in which a diagonal notch in the ear lobe is found in patients with coronary heart disease.
Assuntos
Doença das Coronárias/diagnóstico , Deformidades Adquiridas da Orelha/diagnóstico , Orelha Externa , HumanosRESUMO
Cauliflower ear (CE) is caused by repeated direct trauma to the external ear. Surgical correction of an established CE is one of the most challenging problems in ear reconstruction. However, no reports have clarified the dissection of an established CE in detail. In this report, the dissection of a CE is described based on macroscopic, microscopic and imaging features.
Assuntos
Deformidades Adquiridas da Orelha/cirurgia , Adulto , Deformidades Adquiridas da Orelha/diagnóstico , Deformidades Adquiridas da Orelha/etiologia , Futebol Americano/lesões , Humanos , Imageamento por Ressonância Magnética , Masculino , Tomografia Computadorizada por Raios XRESUMO
Objetivo: As manifestações artério-venosas (MAV) são anomalias congênitas resultantes do desenvolvimento anômalo dos vasos sanguíneos. Estas podem ser de alto ou baixo fluxo, dependendo do vaso nutridor de lesão. Ao considerar MAVs de orelha, no entanto, algumas características particulares estimulam abordagem cirúrgica. Durante a fase de crescimento, obstrução do meato acústico externo, sangramentos, ulceração ou dor podem coexistir com deformidades anatômica e transtornos psicológicos. Após a fase de crescimento pode haver estabilização, e as deformidades anatômicas cartilaginosas podem ocorrer em decorrência de deficiência de desenvolvimento por alteração na vascularização do local, por efeito de massa tumoral com compressão direta na cartilagem provocando desde deformidades leves até erosões e destruição do arcabouço cartilaginoso. Serão relatados quatro casos de MAV de orelha e suas diferentes opções terapêuticas. Relato de casos: Caso 1 - OBS, 33 anos, sexo masculino, MAV extensa de orelha com episódios freqüentes de ulceração e sangramentos, tendo sido submetido a dois procedimentos de escleroterapia sem sucesso. Submetido a embolização local no dia anterior à cirurgia, com opção cirúrgica de exérese de toda MAV com preservação cutânea da parte posterior à orelha e lóbulo e todo arcabouço cartilaginoso. Para reconstrução foi feito um retalho em "cambalhota" da fáscia temporal para propiciar leito viável para então proceder à enxertia cutânea com pele parcial de face anterior de coxa. Caso 2 - CA, 22 anos, sexo masculino, MAV de orelha com comprometimento parcial de orelha com destruição de cartilagem. Procedimento cirúrgico realizado incluiu ressecção parcial e reconstrução com Medpor. Caso 3 - JV, 8 anos, sexo masculino, MAV de pólo superior de orelha. Procedimento cirúrgico realizado incluiu ressecção local com fechamento local primário com princípio cirúrgico em "estrela"...
Assuntos
Humanos , Deformidades Adquiridas da Orelha/cirurgia , Deformidades Adquiridas da Orelha/diagnóstico , Orelha/anormalidades , Orelha/cirurgiaRESUMO
The diagonal earlobe crease is a sign theorically related to coronary artery disease. The purpose of this study was to prove the usefulness of this sign. A total of 104 patients were examined (ages 30 to 80) grouped by age and sex. Forty nine of them were diagnosed of having coronary artery disease by coronary angiography (a 70% obstruction of one of the major arteries), and/or myocardial perfusion imaging with Thallium 201 (fixed defects). The control group included 55 patients (asymptomatic with normal electrocardiogram). Data here obtained included sensitivity (61.2%), specificity (78 2%), positive predictive value (71.4%) and negative predictive value (69.3%). We found a significant relation between the presence of the diagonal earlobe crease and coronary artery disease. We consider it a sign that could prove useful in clinical practice, mainly among patients aged between 30 and 60.
Assuntos
Doença da Artéria Coronariana/diagnóstico , Deformidades Adquiridas da Orelha/diagnóstico , Orelha Externa/anatomia & histologia , Adulto , Distribuição por Idade , Idoso , Idoso de 80 Anos ou mais , Doença da Artéria Coronariana/etiologia , Métodos Epidemiológicos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Distribuição por Sexo , Fatores SexuaisRESUMO
El surco diagonal es un signo encontrado en el lóbulo de la oreja, que estaría relacionado con la enfermedad arterial coronaria. Nuestro objetivo fue estudiar la utilidad del signo. Se examinaron 104 pacientes (entre 30 y 80 años) clasificados por sexo y edad. Cuarenta y nueve tenían enfermedad arterial coronaria diagnosticada por coronariografía (obstrucción > del 70% en una de las grandes arterias) y/o gamagrafía de perfusión miocárdica con Talio 201 (defecto fijo). El grupo control estuvo compuesto por 55 pacientes (asintomáticos, con electrocardiograma normal). Los datos obtenidos fueron sensibilidad (61.2%), especificidad (78.2%), valor predictivo positivo de (71.4%) y valor predictivo negativo (69.3%.). Observamos una relación significativa entre la presencia de surco diagonal y enfermedad arterial coronaria. Consideramos que este signo podría resultar de utilidad en la práctica clínica, fundamentalmente para los pacientes entre 30 y 60 años.
The diagonal earlobe crease is a sign theorically related to coronary artery disease. The purpose of this study was to prove the usefulness of this sign. A total of 104 patients were examined (ages 30 to 80) grouped by age and sex. Forty nine of them were diagnosed of having coronary artery disease by coronary angiography (a 70% obstruction of one of the major arteries), and/or myocardial perfusion imaging with Thallium 201 (fixed defects). The control group included 55 patients (asymptomatic with normal electrocardiogram). Data here obtained included sensitivity (61.2%), specificity (78.2%), positive predictive value (71.4%) and negative predictive value (69.3%). We found a significant relation between the presence of the diagonal earlobe crease and coronary artery disease. We consider it a sign that could prove useful in clinical practice, mainly among patients aged between 30 and 60.
Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Idoso de 80 Anos ou mais , Doença da Artéria Coronariana/diagnóstico , Deformidades Adquiridas da Orelha/diagnóstico , Orelha Externa/anatomia & histologia , Distribuição por Idade , Biomarcadores/análise , Doença da Artéria Coronariana/etiologia , Dislipidemias/diagnóstico , Eletrocardiografia , Métodos Epidemiológicos , Hipertensão/diagnóstico , Obesidade/complicações , Distribuição por Sexo , Fatores Sexuais , Fumar/efeitos adversosRESUMO
Introdução: orelha em abano afeta aproximadamente 5 da população geral. Existem mais de 200 pro- cedimentos descritos para tratamento desta deformidade. Há três vias principais para a realização da otoplastia moderna: raspagem, excisão e fixação da cartilagem auricular. Objetivos: sistematização de técnicas cirúrgicas, correspondente ao local com alteração, com ênfase aos métodos de fixação, como forma de tratamento, dentro de um ambiente hospitalar universitário. Métodos: Estu- do prospectivo, com 51 pacientes submetidos à otoplastia por fixação, utilizando fios inabsorvíveis, de abril de 2004 a novembro de 2006, no Serviço de Cirurgia Plástica do Hospital Universitário Cajuru da PUC - PR. Resultados: Ponto de Furnas foi aplicado em todos os pacientes, com média unilateral de 1,34. O número médio de pontos de Mustardé foi de 2,21 unilateral. Em 54 dos pacientes houve confecção de pontos da fossa triangu - lar da fáscia temporal, para correção do pólo superior. Dentre as intercorrências pós-operatórias apresentaram-sese 5 complicações: 3 recidivas (3), 1 abscesso (1) e 1 hematoma (1). Discussão: utilizados métodos de fi- xação pela possibilidade de correção durante o ato e também pela fácil reprodutibilidade do procedimento, apresentando taxas de recidivas condizentes com a lite- ratura. Conclusões: confecção de pontos com moldagem da cartilagem auricular é um procedimento de fácil execução, reproduzível e relativamente livre de grandes complicações.
Prominent ears affect nearly 5 of general population. There are more than 200 procedures described for the treatment of these deformities. The 3 major techniques for the modern otoplasty are cartilage scarification, excision and fixation. Objective: systematization of the surgical techniques, correlating with the auricular deformity and the type of fixation method in an university hospital. Methods: retrospective study of 51 patients whounder went otoplasty with the fixation technique using unabsorbable suture between April 2004 and November 2006 in the plastic surgery unit of the Cajuru Hospital - Catholic University of Parana. Results: furnas sutures were applied in all patients, with an unilateral average of 1,34 sutures. The unilateral average of Mustardé sutures were 2,21. In 54 of the patients were done sutures between the triangular fossa and temporal fascia for the correction of the superior pole. There were 5 complications: 3 recurrences (3), 1 abscess (1) and 1 hematoma (1). Conclusions: moulding the cartilage auricular with the fixation sutures is an easy procedure, reproducible and relatively free of complications.