The Newborn Butterfly Project

Doft, Melissa A.; Goodkind, Alison; Diamond, Shawn; DiPace, Jennifer; Kacker, Ashutosh; LaBruna, Anthony N.

doi:10.1097/prs.0000000000000999

Cited by 76 publications

(47 citation statements)

References 15 publications

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“…Our research indicated that the total treatment duration for constricted ears was 10.33 ± 3.44 weeks; this treatment period included the expanding duration (8.54 ± 2.98 weeks) and consolidation duration (1.67 ± 1.56 weeks), which were much longer than those required for other deformities. 9 , 14 , 15 This prolonged treatment duration is required mainly because constricted tension caused by skin and cartilage deficiencies necessitates a prolonged treatment duration for long-lasting expansion.…”

Section: Discussionmentioning

confidence: 99%

“…Complication rates of tissue excoriations and breakdown range from 3% to 7.6% for molding of ear abnormalities. 5,9,11,14 In our study, this rate was 9.8% and included skin excoriations and pressure ulcers. The relatively higher rate of tissue excoriations and dermatitis [11% (10 of 91)] may have been associated with the tissue tension and a relatively longer treatment time.…”

Section: Complicationsmentioning

confidence: 93%

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One-Year Outcomes of Ear Molding for Infants with Constricted Ear

Chen

Yang

et al. 2022

Plastic &Amp; Reconstructive Surgery

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Background: Ear molding is a noninvasive treatment that shows promising results for neonatal ear deformations. Little research has been reported evaluating 1-year outcomes or relapse after ear molding for ear malformations. Methods: One-year molding efficacy for constricted ear, a common malformation that affects the aesthetic appearance of the auricle, was assessed during a single-center, prospective study conducted over a 3-year period (from May of 2017 to April of 2020). Infants with constricted ears were recruited and treated with the EarWell Infant Ear Correction System. Constricted ear classification, age at treatment application, duration of treatment, complications, and parental satisfaction were analyzed. Photographic documentation of the ears was performed before treatment, at treatment termination, and 12 months after treatment to evaluate treatment efficacy and relapse. Results: Sixty patients with 91 constricted ears were recruited. The EarWell Infant Ear Correction System was initiated before 2 weeks of age for 75.0% of these patients. Successful correction was achieved in 85.8% of patients. Early molding initiation (before 14 days of age) resulted in a significantly higher success rate (P = 0.017). Class 1 and class 2 deformities achieved better outcomes than class 3 deformities (P = 0.001). Among the 91 auricles, 37 ears (40.7%) relapsed: 36.3% had mild relapse, 4.4% had moderate relapse, and 0% had severe relapse. The treatment duration for patients with relapse was shorter than for patients without relapse (P = 0.035). Conclusion: Early ear molding is an effective treatment for constricted ear. Sufficient molding duration and consolidation periods are crucial in maintaining treatment effects. Clinical question/level of evidence: Therapeutic, III.

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Section: Discussionmentioning

confidence: 99%

Section: Complicationsmentioning

confidence: 93%

One-Year Outcomes of Ear Molding for Infants with Constricted Ear

Chen

Yang

et al. 2022

Plastic &Amp; Reconstructive Surgery

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“…Nonsurgical methods, such as splinting or rigid ear molding, take advantage of the plasticity of auricular cartilage during the neonatal period, correcting the deformity over the first month of life 5 . Early identification of ear deformity is crucial for the success of non-invasive ear molding 7 . At birth, high levels of circulating maternal estrogens result in increased levels of hyaluronic acid in ear cartilage, which increases the ear’s malleability and plasticity.…”

Section: Introductionmentioning

confidence: 99%

Identifying Ear Abnormality from 2D Photographs Using Convolutional Neural Networks

Hallac

Lee

Pressler

et al. 2019

Sci Rep

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Quantifying ear deformity using linear measurements and mathematical modeling is difficult due to the ear’s complex shape. Machine learning techniques, such as convolutional neural networks (CNNs), are well-suited for this role. CNNs are deep learning methods capable of finding complex patterns from medical images, automatically building solution models capable of machine diagnosis. In this study, we applied CNN to automatically identify ear deformity from 2D photographs. Institutional review board (IRB) approval was obtained for this retrospective study to train and test the CNNs. Photographs of patients with and without ear deformity were obtained as standard of care in our photography studio. Profile photographs were obtained for one or both ears. A total of 671 profile pictures were used in this study including: 457 photographs of patients with ear deformity and 214 photographs of patients with normal ears. Photographs were cropped to the ear boundary and randomly divided into training (60%), validation (20%), and testing (20%) datasets. We modified the softmax classifier in the last layer in GoogLeNet, a deep CNN, to generate an ear deformity detection model in Matlab. All images were deemed of high quality and usable for training and testing. It took about 2 hours to train the system and the training accuracy reached almost 100%. The test accuracy was about 94.1%. We demonstrate that deep learning has a great potential in identifying ear deformity. These machine learning techniques hold the promise in being used in the future to evaluate treatment outcomes.

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“…The ear-molding technique was first described in the 1980s by Kurozumi et al [ 4 ], who reported the successful correction of constricted ear deformities by splinting the ear with foam. This technique has been shown to be effective for correcting ear deformities during the neonatal period [ 5 6 7 8 9 10 11 12 ]. The advantages of ear molding over otoplasty include fewer complications and a lower potential for psychological distress.…”

Section: Introductionmentioning

confidence: 99%

“…Byrd et al [ 5 ] contended that outcomes were clearly improved by initiating molding in neonates within the first 5–7 days, as results were suboptimal after 3 weeks of life. Doft et al [ 6 ] similarly found that the period of molding could be reduced to 2 weeks if initiated within the first week of life.…”

Section: Introductionmentioning

confidence: 99%

Correction of Congenital Auricular Deformities Using the Ear-Molding Technique

et al. 2016

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BackgroundStudies of the ear-molding technique have emphasized the importance of initiating molding early to achieve the best results. In the present study, we describe the immediate effects and long-term outcomes of this technique, focusing on children who were older than the ideal age of treatment initiation.MethodsPatients who visited our institution from July 2014 to November 2015 were included. Medical charts were reviewed to collect data on demographics, the duration of treatment, the types of deformities, and the manner of recognition of the deformity and referral to our institution. Parents were surveyed to assess the degree of improvement, the level of procedural discomfort at the end of treatment, any changes in the shape of the molded auricle, and overall satisfaction 12 months after their last follow-up visits.ResultsA review of 28 ears in 18 patients was conducted, including the following types of deformities: constricted ear (64.2%), Stahl ear (21.4%), prominent ear (7.1%), and cryptotia (7.1%). The average score for the degree of improvement, rated on a 5-point scale (1, very poor; 5, excellent), was 3.5 at the end of treatment, with a score of 2.6 for procedural discomfort (1, very mild; 5, very severe). After 12 months, the shapes of all ears were well maintained. The average overall satisfaction score was 3.6 (1, very dissatisfied; 5, very satisfied).ConclusionsWe had reasonable outcomes in older patients. After 1 year of follow-up, these outcomes were well maintained. Patients past the ideal age at presentation can still be candidates for the molding technique.

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The Newborn Butterfly Project

Abstract: Therapeutic, IV.

Cited by 76 publications

References 15 publications

One-Year Outcomes of Ear Molding for Infants with Constricted Ear

One-Year Outcomes of Ear Molding for Infants with Constricted Ear

Identifying Ear Abnormality from 2D Photographs Using Convolutional Neural Networks

Correction of Congenital Auricular Deformities Using the Ear-Molding Technique

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