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.M inor anomalies of the external ear are found in 5-10 per 1000 newborn infants, with preauricular skin tags being the most common.1 2 Whereas there is a general consensus about the need to search for renal malformations in babies with gross or syndromic ear abnormalities, 3 4 the need for such evaluations in infants with isolated minor ear anomalies is controversial. 5The published studies are generally underpowered, often lack appropriate controls, and have given variable results, sometimes even from similar sociodemographic populations.2 4 6-10 Moreover, none of the evaluations report on the frequency of any extra abnormalities detected by such sonographic surveillance on a background of now routine prenatal sonography.We undertook this study to assess the yield of routine renal ultrasonography for detection of urinary tract abnormalities in infants with isolated minor external ear anomalies, in the era of routine fetal anomaly scanning. METHODSThe study included all infants born at the Royal Shrewsbury Hospital between 1 May 2000 and 31 December 2003. Infants in whom isolated minor anomalies of the external ear (preauricular skin tags, preauricular sinuses, ear pits, and misshapen pinnae) were detected on routine neonatal examination were eligible for inclusion in the study. These infants were offered renal ultrasonography, in addition to hearing assessment, and cosmetic surgery referral. All the postnatal sonographic examinations were performed by a team of a consultant radiologist and three experienced ultrasonographers, who were unaware of the results of prenatal screening. Infants with initial abnormal scans underwent further imaging as clinically indicated.During this period, a routine anomaly scan was offered to all pregnant women at around 20 weeks gestation. Fetuse...

The presence of isolated SUA is associated with increased risk of prematurity and fetal growth restriction. In this largest series of isolated SUA, there was no excess of significant renal malformations among infants with isolated SUA. Postnatal renal ultrasonography is not routinely warranted in such infants.

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