Nonsurgical Management of Congenital Auricular Anomalies

Lennon, Christen J.; Chinnadurai, Sivakumar

doi:10.1016/j.fsc.2017.09.001

Cited by 21 publications

(25 citation statements)

References 19 publications

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“…Congenital auricular anomalies are common; 50% of the congenital otorhinolaryngologic anomalies affect the ear. 1 Additionally, the auricle plays an important role in the staging of human embryos, as the Carnegie classification system (CCS) relies on the morphology of the auricle from Carnegie stage (CS)16 until CS18 (Table I). 2 However, little is known about the embryological development of the auricle.…”

Section: Introductionmentioning

confidence: 99%

The Developmental Origin of the Auricula Revisited

2019

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Objectives/Hypothesis Congenital auricular anomalies are common. Additionally, the auricle plays an important role in the staging of human embryos. However, little is known about the embryological development of the auricle. The most commonly reproduced developmental theory by His (1885) describes six hillocks; three on the first and three on the second pharyngeal arch. The aim of this study was to assess the validity of this theory by modern techniques and to expand the knowledge of the embryological development and morphology of the auricle. Study Design 22 human embryos from the Carnegie collection between Carnegie stage 13 and 23 (28–60 days) were selected based on their histological quality. Methods Histological sections of the selected embryos were examined. Three‐dimensional (3D) reconstructions were prepared. Additionally, literature research was performed. Results The hillocks were absent in most stages. Contrary to common knowledge, the auricle is almost entirely innervated by branches of the facial nerve. The branches of the trigeminal nerve only innervate the tragus and the anterior external auditory meatus (EAM). Consequently, this indicates that almost the entire auricle is derived from the second pharyngeal arch, with the exception of the tragus and the anterior EAM. Conclusions The 3D reconstructions show the anatomy and development of the auricle to be different from concepts presented in current textbooks. As a consequence, we propose that preauricular sinuses should be classified as first pharyngeal arch anomalies. Level of Evidence NA Laryngoscope, 130:2467–2474, 2020

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Section: Introductionmentioning

confidence: 99%

The Developmental Origin of the Auricula Revisited

2019

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“…1,3 Recently, nonsurgical management by ear molding has emerged as a favorable approach for newborn auricular deformities. [9][10][11][12]14 The most widely used ear molding systems in the world are the EarWell Infant Ear Correction System. It is an approved adhesive device that attaches to the skin of child to mold the malformed ear into a normal anatomical shape.…”

Section: Discussionmentioning

confidence: 99%

Comparison of 2 Ear Molding Systems for Nonsurgical Management of Newborn Auricular Deformities

Xiong

Wang

et al. 2020

Ear Nose Throat J

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Background: Congenital auricular deformities are common diseases in newborn infants. We compared the efficacy of 2 ear molding systems in the nonsurgical management of newborn auricular deformities in Chinese infants. Methods: A total of 462 newborns with auricular deformities were treated with either the EarWell or the LiangEar ear molding systems. The posttreatment outcome was graded as excellent, fair, and poor. The differences in effectiveness between the 2 ear molding systems and factors that may affect the posttreatment outcome were analyzed. Results: Both ear molding systems showed substantial efficacy in the treatment of newborn auricular deformities. The effective rate was comparable between the EarWell and the LiangEar systems for 4 types of auricular deformities (cryptotia, prominent ear, helical rim abnormality, and cup ear), while the costs for the LiangEar systems were half as much as that for the EarWell systems. Multivariate regression analysis showed that earlier time points at treatment initiation, less severe auricular deformities, treatment duration, and breastfeeding were the most significant predictive factors for a better outcome. Conclusion: Our findings demonstrate that using the EarWell and the LiangEar systems are both optimal nonsurgical approaches for treatment of most newborn auricular deformities.

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“…Although Matsuo K et al [8] in Japan found that different types of CADs have the tendency of natural improvement, there is still a lack of high-quality studies to demonstrate the degree of natural improvement. Therefore, it is suggested that treatment and correction should be carried out as early as possible [9][10][11].…”

Section: Introductionmentioning

confidence: 99%

Ear mould for congenital auricular deformities: a protocol for systematic review and meta-analysis

Huang

Zou

Yuan

et al. 2020

Preprint

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Background: Congenital auricle deformities (CADs) not only affect the appearance, but may also result in social inferiority or difficulties, influence the hearing and mental health of the children. Although some studies have pointed out CADs have a natural improvement trend, there is still a lack of high-quality research to demonstrate the degree of that. Therefore, related studies agree that early treatment are necessary. Ear mold correction is currently main non-surgical treatment for CADs, but the existing research often involves a small sample size, and the research conclusions are inconsistent. More importantly, there is still no systematic review on ear mold correction for CADs. This study aims to systematically evaluate the effectiveness and safety of ear mold correction for CADs, so as to provide an evidence base for further research.Methods: The study has been designed according to the Preferred Reporting program for Systems Evaluation and Meta-analysis Protocol (PRISMA-P). We will search electronic literature databases of PubMed, Embase, Cochrane Library, Web of science, CBM, CNKI, Wanfang and VIP from their initiative to 1 June 2020 for interventional studies on ear mould for children with CADs. The study selection, data extraction and quality assessment will be performed by two authors. Meta-analysis will be conducted on primary outcome effectiveness rate of physician assessment and secondary outcomes of effectiveness rate of parents’ assessment, effectiveness score, hearing assessment, and adverse reactions using relative ratio or mean difference and their 95% confidence intervals. The heterogeneity of the included studies will be tested using Chi square test and I2, and random-effects model will be used when significant heterogeneity was found, otherwise, fixed-effects model will be used. Sensitivity analysis will be performed using trials with high quality and using alternative [1]models (fixed-effects or random effects model). Publication bias will be tested using funnel plot and Egger’s test. Discussion: This study will be the first to systematically evaluate the effectiveness and safety of ear mold correction for CADs, to provide evidence base for clinical guideline making, clinical decision and future research. Systematic review registration : CRD42020190982.

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Nonsurgical Management of Congenital Auricular Anomalies

Cited by 21 publications

References 19 publications

The Developmental Origin of the Auricula Revisited

The Developmental Origin of the Auricula Revisited

Comparison of 2 Ear Molding Systems for Nonsurgical Management of Newborn Auricular Deformities

Ear mould for congenital auricular deformities: a protocol for systematic review and meta-analysis

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