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Kumar C Pradeep, Shahid M A Mohammed, Mandavia Anisha
A natural appearing ear with appropriate projection from the head remains a great challenge in the reconstruction of the ear. Surgical and prosthetic means have been addressed in the management of patients with microtia, with each carrying its own merits and demerits. Lack of adequate projection of the ear and adhesion of tissues are some common complications of reconstructive surgery that can adversely affect the treatment outcome. This article describes a technique for the fabrication of a postsurgical stent to prevent adhesion of the surgically reconstructed ear to the underlying tissues...
October 17, 2016: Journal of Prosthetic Dentistry
Minyan Zhang, Xiaochen Tian, Jun Shi, Huxian Liu, Ning Liu, Zhengjun Cui
OBJECTIVE: This study aims to observe the efficacies of microsurgical technique combined with the Zhuang's skin soft tissue expander in treating Hunter type III congenital microtia. METHODS: Fifty-eight patients (61 ears) were enrolled from 2003 to 2012; the skin tissue expander was embedded subepidermally in the first stage via the intrahairline longitudinal incision in the postauricular mastoid area, the diseased-side rib cartilage was then taken for preparing the ear bracket in the second stage, and the tragus was surgically reconstructed in the third stage...
October 17, 2016: Annals of Plastic Surgery
Norio Fukuda, Hirotaka Asato, Kohei Umekawa, Goro Takada, Takeshi Kan, Shoichi Sasaki
BACKGROUND: Adhesion occurs as a part of the wound healing process, but it sometimes compromises patients' daily activities. The authors were looking for materials and methods that could prevent adhesion, and noticed that the costal cartilage has possibility. The anti-adhesive property of the costal cartilage was examined histologically. METHODS: Thirty-five patients with microtia who provided consent for participating in this study were enrolled between April 2008 and March 2015...
October 14, 2016: Journal of Plastic Surgery and Hand Surgery
Emmy Verheij, Henricus G X M Thomeer, Frank A Pameijer, Vedat Topsakal
Van Maldergem syndrome (VMS) is a very rare syndrome that was first described in 1992. The main features of this syndrome comprise intellectual disability, blepharo-naso-facial malformation, and hand anomalies. Almost all nine described patients have been shown to be affected by conductive hearing impairment attributed to microtia, and atresia of the outer ear canal. Here, we present a VMS patient with congenital malformations of the middle ear as the main reason for severe conductive bilateral hearing impairment...
October 14, 2016: American Journal of Medical Genetics. Part A
Randall A Bly, Amit D Bhrany, Craig S Murakami, Kathleen C Y Sie
Microtia reconstruction is a challenging endeavor that has seen significant technique evolution. It is important to educate patients and their families to determine the best hearing rehabilitation and ear reconstructive options. Microtia is often associated with aural atresia, hearing loss, and craniofacial syndromes. Optimal care is provided by multiple disciplines, including a reconstructive surgeon, an otologic surgeon, an audiologist, and a craniofacial pediatrician. Microtia management includes observation, prosthetic ear, autologous cartilage reconstruction, or alloplastic implant placement...
November 2016: Facial Plastic Surgery Clinics of North America
Keguang Chen, Huiying Lyu, Lin Yang, Tianyu Zhang, Peidong Dai
OBJECTIVES: An aberrant subarcuate artery (SAA) and its related canal are infrequent and asymptomatic. The presence of this variation may cause untoward hemorrhages, if accidentally nicked. Therefore, it is important for otologists to be aware of this entity, and its relative anatomy, to avoid any unexpected complication. We present a case of a 7-year-old girl who presented with right-sided microtia with membranous atresia. METHODS: High-resolution computed tomographic scan and three-dimensional reconstruction of the temporal bone showed bilateral enlarged SAA...
October 7, 2016: ORL; Journal for Oto-rhino-laryngology and its related Specialties
Vânia Henriques, Rafaela Teles, Ana Sousa, Roberto Estevão, Jorge Rodrigues, Alexandra Gomes, Francisco Silva, Ângelo Fernandes, Fausto Fernandes
Congenital middle ear malformations are rare. Most part of them are usually associated with other malformations, such as aural atresia, microtia, and dysmorphic craniofacial features. A clinical case of a 24-year-old male with a right-sided conductive hearing loss since his childhood, without craniofacial malformation, is presented. He was proposed for exploratory tympanotomy under the suspicious diagnosis of otosclerosis. The surgery revealed an abnormal location of stapes' superstructure, which was attached to the promontory and had an isolated and mobile osseous footplate in the oval window...
2016: Case Reports in Otolaryngology
Melita D Irving, Boyan I Dimitrov, Marja Wessels, Muriel Holder-Espinasse, David Chitayat, Michael A Simpson
Acrofacial dysostosis syndrome of Rodriguez is characterized by severe mandibular underdevelopment, upper limb phocomelia with absent fingers, absent fibulae, cleft palate, microtia, and abnormal pulmonary function. First reported in three siblings it was assumed to be an autosomal recessive condition. However, subsequent publication reported a further five simplex occurrences and a living patient with a heterozygous mutation in the SF3B4 gene. Exome sequencing was performed on four fetuses with this disorder, including one of the originally described affected siblings...
September 19, 2016: American Journal of Medical Genetics. Part A
Antonio Perez-Aytes, Purificacion Marin-Reina, Virginia Boso, Ana Ledo, John C Carey, Maximo Vento
Mycophenolate mofetil (MMF) is probably the most common employed immunosuppressant drug in recipients of solid organ transplant and in many autoimmune diseases. In vitro studies, a significant number of single clinical observations and a recent study from a group of different European teratogen information services, have provided very consistent data supporting the existence of a specific MMF embryopathy. The typical malformative pattern of MMF embryopathy includes external ear anomalies ranging from hypoplastic pinna (microtia) to complete absence of pinna (anotia); cleft lip, with or without cleft palate, and ocular anomalies as iris or chorioretinal coloboma and anophthalmia/microphthalmia...
September 14, 2016: European Journal of Medical Genetics
Shane Zim, Janet Lee, Brian Rubinstein, Craig Senders
OBJECTIVE:   The objective of this study was to determine whether patients with isolated microtia or aural atresia have an increased prevalence of renal or cervical vertebral anomalies. DESIGN:   The study design was a retrospective medical record review. SETTING:   The setting was the following four distinct institutions: an urban tertiary care children's hospital, two urban academic medical centers, and a staff-model health maintenance organization...
September 15, 2016: Cleft Palate-craniofacial Journal
Peng Zhu, Suijun Chen
CONCLUSIONS: The use of the 3D template model in microtia surgery leads to satisfactory results, for its contribution to the engraving and localization of the microtia auricle in auricle reconstruction. OBJECTIVES: The aim of the study was to create an anatomical correct 3D rapid prototyping model for patients with microtia, to assist with the accurate fabrication and localization of a coastal cartilage framework for auricular reconstruction, and patients, who had undergone rib-cartilage reconstruction to treat a congenital auricular defect, were evaluated for aesthetic outcomes following ear reconstruction with a different template model...
September 15, 2016: Acta Oto-laryngologica
F Firmin, A Marchac
Reconstruction of complex auricular malformations is one of the longest surgical technique to master, because it requires an extremely detailed analysis of the anomaly and of the skin potential, as well as a to learn how to carve a complex 3D structure in costal cartilage. Small anomalies can be taken care of by any plastic surgeon, providing that he/she is aware of all the refinements of ear surgery. In this chapter, we analyze retrospectively 30 years of auricular reconstruction, ranging from small anomalies to microtia (2500 cases), excluding aesthetics variants such as prominent ears...
October 2016: Annales de Chirurgie Plastique et Esthétique
Alexis L Johns, Sheryl L Lewin, Daniel D Im
This study prospectively measured teasing and emotional adjustment before and after ear reconstruction in younger and older children with microtia. Participants with isolated microtia (n = 28) were divided into two groups by age at surgery, with a younger group aged 3-5 years (n = 13) with a mean age of 4.0 (0.71) years at the time of surgery and an older group aged 6-10 years old (n = 15) with a mean age of 7.87 (1.30) years. Children and their parents were interviewed preoperatively and a year after surgery about teasing and emotions about their ear(s)...
September 9, 2016: Journal of Plastic Surgery and Hand Surgery
Y Melgarejo-Ramírez, R Sánchez-Sánchez, J García-López, A M Brena-Molina, C Gutiérrez-Gómez, C Ibarra, C Velasquillo
The external ear is composed of elastic cartilage. Microtia is a congenital malformation of the external ear that involves a small reduction in size or a complete absence. The aim of tissue engineering is to regenerate tissues and organs clinically implantable based on the utilization of cells and biomaterials. Remnants from microtia represent a source of cells for auricular reconstruction using tissue engineering. To examine the macromolecular architecture of microtia cartilage and behavior of chondrocytes, in order to enrich the knowledge of this type of cartilage as a cell reservoir...
September 2016: Cell and Tissue Banking
Francesca Piceci, Silvia Morlino, Marco Castori, Elsa Buffone, Alessandro De Luca, Paola Grammatico, Valentina Guida
Microtia is a congenital defect affecting external ears, which appear smaller and sometimes malformed. Here we describe a five-generation family with isolated bilateral microtia segregating as an autosomal dominant trait. Similar features had been previously observed in an autosomal dominant family with non-syndromic microtia and hearing loss segregating with a HOXA2 nonsense variant. HOXA2 biallelic mutations were also described in an inbreed family with autosomal recessive microtia, hearing impairment and incomplete cleft palate...
August 9, 2016: Clinical Genetics
Jiayu Zhou, Bo Pan, Qinghua Yang, Yanyong Zhao, Leren He, Lin Lin, Hengyun Sun, Yupeng Song, Xiaobo Yu, Zhongyang Sun, Haiyue Jiang
BACKGROUND: During microtia reconstruction, the intraoperative design of the cartilage framework is important for the appearance and symmetry of the bilateral auricles. Templates (traditionally, the X-ray film template) are usually utilized to complete the task, which can provide cues regarding size, cranioauricular angle and positioning to the surgeons. With a combination of three-dimensional (3D) scanning and additive manufacturing (AM) techniques, we utilized two different ear-shaped templates (sheet moulding and 3D templates) during the fabrication of 3D-customized autologous cartilage frameworks for auricle reconstruction...
October 2016: Journal of Plastic, Reconstructive & Aesthetic Surgery: JPRAS
Datao Li, Feng Xu, Ruhong Zhang, Qun Zhang, Zhicheng Xu, Yiyuan Li, Cheng Wang, Tianya Li
BACKGROUND: Although a standard classification system and corresponding reconstruction methods are well described for microtia, establishing a classification system and corresponding surgical strategies for traumatic ear defects is difficult because the size, shape, and local skin conditions of each defect differ considerably. In this article, the authors describe a useful new classification system and corresponding surgical approaches. METHODS: Ear defects were classified into four types according to defect size and surrounding skin conditions...
August 2016: Plastic and Reconstructive Surgery
Ryan M Mitchell, Babette S Saltzman, Susan J Norton, Robert G Harrison, Carrie L Heike, Daniela V Luquetti, Kathleen C Y Sie
OBJECTIVE:   To evaluate the association between craniofacial phenotype and hearing loss in children with craniofacial microsomia. DESIGN:   Retrospective cohort study. SETTING:   Tertiary care children's hospital. PATIENTS:   Individuals with craniofacial microsomia. MAIN OUTCOME MEASURES:   Ear-specific audiograms and standardized phenotypic classification of facial characteristics...
July 26, 2016: Cleft Palate-craniofacial Journal
Stephanie Byun, Paul Hong, Michael Bezuhly
Microtia is associated with psychosocial burden and stigma. The authors' objective was to determine the potential impact of being born with microtia by using validated health state utility assessment measures. An online utility assessment using visual analogue scale, time tradeoff, and standard gamble was used to determine utilities for microtia with or without ipsilateral deafness, monocular blindness, and binocular blindness from a prospective sample of the general population. Utility scores were compared between health states using Wilcoxon and Kruskal-Wallis tests...
October 2016: Journal of Craniofacial Surgery
Kyong-Je Woo, Bo Young Kang, Jeong Jin Min, Jin-Woo Park, Ara Kim, Kap Sung Oh
BACKGROUND: Children with microtia complain of severe postoperative pain during early postoperative days after rib cartilage harvest for auricular reconstruction. The purpose of this study was to evaluate the effects of preventive donor site wound analgesia by intercostal nerve block (ICNB) and catheter-based infusion of local analgesics on postoperative pain after rib cartilage graft for auricular reconstruction in children with microtia. METHODS: In this prospective randomized study, 66 children underwent postoperative pain control using either preventive ICNB followed by catheter-based infusion (33 patients, study group) or intravenous (IV) analgesia alone (33 patients, control group)...
September 2016: Journal of Plastic, Reconstructive & Aesthetic Surgery: JPRAS
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