Due to the variety in the shape of dysmorphic cartilage, tragus reconstruction is one of the most challenging goals in otoplasty. The authors describe a method to reconstruct a prominent tragus in a simple way suitable for accounting for the size, shape, and location of the remaining ear. We present a case of tragus deformity in an 11-year-old female patient after a previous excision of pretragal skin tags. There was a small remnant of the deeply located dystopic cartilage in a horizontal orientation. The dystopic cartilage was used to reconstruct the tragus using a chondrocutaneous transposition flap. Only a small portion of the pre-existing cartilage was used to create a chondrocutaneous transposition flap that supplemented the portion of cartilage during tragus reconstruction. The result was a new tragus that showed acceptable improvement in shape, location, and projection. Patients with a small portion of pre-existing cartilage near the tragal wall may benefit from the use of this method for tragus reconstruction.
Cartilage ; Child ; Congenital Abnormalities ; Ear ; Ear, External ; Female ; Humans ; Methods ; Skin ; Surgical Flaps

OBJECTIVE: To present our experience with ear splint therapy for babies with ear deformities, and thereby demonstrate that this therapy is an effective and safe intervention without significant complications. METHODS: This was a retrospective study of 54 babies (35 boys and 19 girls; 80 ears; age ≤3 months) with ear deformities who had received ear splint therapy at the Center for Torticollis, Department of Physical Medicine and Rehabilitation, Ajou University Hospital between December 2014 and February 2016. Before the initiation of ear splint therapy, ear deformities were classified with reference to the standard terminology. We compared the severity of ear deformity before and after ear splint therapy by using the physician's ratings. We also compared the physician's ratings and the caregiver's ratings on completion of ear splint therapy. RESULTS: Among these 54 babies, 41 children (58 ears, 72.5%) completed the ear splint therapy. The mean age at initiation of therapy was 52.91±18.26 days and the treatment duration was 44.27±32.06 days. Satyr ear, forward-facing ear lobe, Darwinian notch, overfolded ear, and cupped ear were the five most common ear deformities. At the completion of therapy, the final physician's ratings of ear deformities were significantly improved compared to the initial ratings (8.28±1.44 vs. 2.51±0.92; p<0.001). There was no significant difference between the physician's ratings and the caregiver's ratings at the completion of ear splint therapy (8.28±1.44 vs. 8.0±1.61; p=0.297). CONCLUSION: We demonstrated that ear splint therapy significantly improved ear deformities in babies, as measured by quantitative rating scales. Ear splint therapy is an effective and safe intervention for babies with ear deformities.
Child ; Congenital Abnormalities* ; Ear Auricle ; Ear* ; Ear, External ; Female ; Humans ; Infant ; Physical and Rehabilitation Medicine ; Retrospective Studies ; Splints* ; Torticollis ; Weights and Measures

OBJECTIVETo explore the curative effect of Z-plasty without skin grafting for correction of cryptotia.

METHODSTwenty-five cases (29 ears) with cryototia were corrected by Z-plasty without skin grafting in our department from June 2009 to January 2014. A Z-shaped incision with one arm on the back of antihelix and the other arm on the edge of hair was made on the back of ear and scalp. The adhesion on the back of antihelix cartilage was dissected and the cartilage framework was lifted and re-positioned. The postauricular flap was transferred to cover the wound on the back of antihelix. The other flap was transferred to cover the remnant wound and correct the malformation of cryptotia.

RESULTSAll the patients were followed up from 6 months to 1 year with stable and symmetric appearance.

CONCLUSIONSThe shape of auricle is natural after operation without skin grafting. It is a simple and ideal method for the treatment of cryptotia.

Ear Cartilage ; abnormalities ; surgery ; Ear, External ; abnormalities ; surgery ; Humans ; Skin Transplantation

OBJECTIVETo carry out genetic analysis for two patients affected with congenital heart disease, developmental delay with or without cleft palate.

METHODSCytogenetic and molecular genetic methods including karyotyping, fluorescence in situ hybridization (FISH), multiplex ligation-dependent probe amplification (MLPA) and single nucleotide polymorphisms array (SNP-array) were employed to detect potential mutations. For parents of both patients, MLPA was used to analyze whether they were carrier of the deletion.

RESULTSFor neither patient, no abnormality was detected upon karyotype analysis. However, FISH analysis has indicated the presence of 22q11.2 deletion. SNP-array analysis has confirmed that both patients have carried a 2.5 Mb deletion in the 22q11.2 region. MLPA analysis suggested none of the parents has carried the same deletion.

CONCLUSIONAlthough the phenotypes of our patients were not identical, they were both diagnosed as 22q11.2 deletion syndrome by multiple methods. The deletions in both cases were de novo in nature. Precise delineation of the genotype can facilitate better understanding of the patients' phenotype.

Abnormalities, Multiple ; genetics ; pathology ; Child, Preschool ; Chromosome Deletion ; Chromosomes, Human, Pair 22 ; genetics ; DiGeorge Syndrome ; genetics ; pathology ; Ear, External ; abnormalities ; Genotype ; Humans ; In Situ Hybridization, Fluorescence ; Infant ; Karyotyping ; Male ; Microarray Analysis ; methods ; Phenotype ; Polymorphism, Single Nucleotide ; Syndrome

OBJECTIVE: This research focuses on the psychologic status of children patients with congenital malformation of external and middle ear by Achenbach's Child Behavior Checklist (CBCL) in order to explore the degree of the influence. METHOD: The 66 patients of 4-16 years old were assessed psychologic status with CBCL filled in by their parents according to their performance in half a year. Then calculated the detection rate of behav ioral disorders of these patients. Collected all patients' general information and Marx's grade of malformed ears. Then analyzed the relationship between the detection rate and these factors. RESULT: The detection rate of behavioral disorders of 4-16 years old patients, 21.21%, which is higher than that of Chinese norm. The Marx's grade and parents' mental stress relate with the behavioral disorders. In Logistic regression analysis, the value of Cox & Snell coefficient of the regression model is 0. 153. The detection rate of behavioral disorders in grade III patients (36.4%) is greater than that of grade II (4.3%), P = 0.004. CONCLUSION Congenital malformation of external and middle ear has an absolute influence on the patients' psychologic status, but its effect is only about 15% parts of the multitudinous influential factors. And grade III patients carry a high-risk for behavioral disorders.
Adolescent ; Child ; Child Behavior Disorders ; epidemiology ; Child, Preschool ; Ear, External ; abnormalities ; Ear, Middle ; abnormalities ; Female ; Humans ; Male ; Psychology, Child

OBJECTIVETo explore the clinical effect of the method by using an expanded post-auricular skin flap combined with autologous rib cartilage framework for correction of concha-type microtia.

METHODSThe operation were performed in three stages. The expander was implanted under post-auricular skin at the first stage and expanded skin flap was formed. At the second stage, the expander was taken out and the expanded skin flap was transferred with autologous rib cartilage framework and skin graft for correction of microtia. At the third stage, the reconstructed ear was revised and new concha was formed.

RESULTSFrom August 2008 to August 2011, 108 cases with 113 concha-type microtia were corrected by this method. All patients healed primarily and were followed up for 6 months to 3 years. The reconstructed ears had a good appearance and position, and were symmetric to ear on the healthy sides.

CONCLUSIONSUsing expanded post-auricular skin flap combined with autologous rib cartilage framework is a reliable method for concha-type microtia.

Adolescent ; Adult ; Cartilage ; transplantation ; Child ; Child, Preschool ; Ear, External ; abnormalities ; Female ; Humans ; Male ; Reconstructive Surgical Procedures ; methods ; Ribs ; Skin Transplantation ; methods ; Surgical Flaps ; Tissue Expansion ; methods ; Transplantation, Autologous ; Treatment Outcome ; Young Adult

OBJECTIVETo explore the therapeutic effect of the temporal rotation flap combined with cartilage plasty for cryptotia correction.

METHODSFrom January 2009 to June 2012, 8 cases with cryptotia (10 ears) were treated. After complete dissection of the cartilage adhesion, the cartilage was reshaped by suture to restore its appearance. Then the temporal triangular rotation flap was transferred to cover the wound.

RESULTSNo hematoma, infection or flap necrosis happened. The follow-up period ranged from 3 months to 1 year, with an average of (6.88 +/- 2.85) months. The ear appearance kept stable with no recurrence and inconspicuous scar. Satisfactory result was achieved.

CONCLUSIONTemporal rotation flap combined with cartilage plasty is a good option for correction of mild or moderate cryptotia.

Adolescent ; Child ; Ear Cartilage ; surgery ; Ear, External ; abnormalities ; Female ; Humans ; Male ; Reconstructive Surgical Procedures ; methods ; Rotation ; Skin Transplantation ; Surgical Flaps

OBJECTIVETo investigate the therapeutic effect of crescent flap with skin-grafting for the correction of cryptotia.

METHODSBetween the helix and scalp, we designed a crescent flap with the pedicle above the helix. Another affiliated triangular flap was formed below the crescent flap. Skin-grafting was performed after the transposition of two flaps.

RESULTSFrom Jan. 2008 to Mar. 2013, 16 cases with cryptotia (19 ears) were treated by this method. The ears were re-positioned to normal location with auriculocephalic sulcus. No vascular crisis was happened. The patients were followed-up for 3 months to 2 years with satisfactory result and no recurrence.

CONCLUSIONSThis method of crescent flap with skin-grafting is suitable for cryptotia at any grade. It is designed brilliantly with no inconspicuous scar.

Adolescent ; Adult ; Child ; Child, Preschool ; Ear, External ; abnormalities ; surgery ; Female ; Humans ; Male ; Reconstructive Surgical Procedures ; methods ; Skin Transplantation ; methods ; Surgical Flaps ; Young Adult

Congenital malformations of the external and middle ear is the common reason of pediatric hearing impairment and cosmic problem. The treatment composes of auricular plastic surgery and auditory reconstruction surgery. The use of BAHA, vibrant sound-bridge and tissue engineering materials can significantly improve the treatment outcomes.
Contraindications ; Ear, External ; abnormalities ; surgery ; Ear, Middle ; abnormalities ; surgery ; Hearing Aids ; Humans ; Infant, Newborn ; Reconstructive Surgical Procedures ; Treatment Outcome

Congenital malformation of external and middle ear is a common disease in ENT department, and the incidence of this disease is second only to cleft lip and palate in the whole congenital malformations of the head and face. The external and middle ear malformations may occur separately, or as an important ear symptom of the systemic syndrome. We systematically review and analysis the genetic research progress of congenital malformation of external and middle ear, which would be helpful to understand the mechanism of external and middle ear development, and to provide clues for the further discovery of new virulence genes.
Chromosome Aberrations ; Ear, External ; abnormalities ; Ear, Middle ; abnormalities ; Genes ; Humans