Colesteatoma del conducto auditivo externo: Experiencia de 5 años Hospital del Salvador / External ear canal cholesteatoma: 5-year experience Hospital del Salvador

Introducción: El colesteatoma del conducto auditivo externo (CCAE) es una estructura quística revestida por epitelio escamoso estratificado queratinizado que tiene la capacidad de invadir y erosionar localmente al hueso temporal. Su incidencia es de 0,19 a 0,3/100.000 habitantes siendo 60 veces menos frecuente que el de oído medio. Objetivo: Describir las características epidemiológicas, clínicas, imagenológicas y tratamiento de los pacientes diagnosticados con CCAE en el Servicio de Otorrinolaringología Hospital del Salvador. Material y Método: Se presenta una serie de ocho casos clínicos recopilados durante el período 2017 y 2021. Se realizó revisión de fichas clínicas, biopsias y tomografías computadas de oídos (TC oídos). Se describen los hallazgos y tratamiento efectuado. Resultados: El promedio de edad fue de 65,6 años, correspondiente a 5 mujeres y 3 hombres con presencia de tabaquismo y diabetes en la mitad de los casos. Los síntomas y signos más frecuentes fueron otalgia e hipoacusia seguido de otorrea. 7 pacientes se presentaron con tímpano íntegro y el compromiso de la pared inferior del conducto se evidenció en 6 de 8 pacientes. La TC oídos mostró erosión ósea del conducto, con o sin compromiso de estructuras adyacentes, en todos los casos y el diagnóstico histológico fue efectuado en el 100% de los pacientes. Se privilegió el tratamiento conservador mediante curaciones óticas periódicas asociado a ácido salicílico al 3% y/o antibióticos tópicos en 6/8 pacientes. Conclusiones: El CCAE es una entidad poco frecuente sin signos ni síntomas patognomónicos por lo que el diagnóstico histológico junto con el estudio imagenológico es perentorio. El tratamiento conservador es una alternativa terapéutica válida que ofrece buenos resultados en pacientes con adecuada adherencia al tratamiento y posibilidad de seguimiento estricto.

Introduction: External ear canal cholesteatoma (EECC) is a cystic structure lined by keratinized stratified squamous epithelium that has the ability to locally invade and erode the temporal bone. Its incidence is 0.19 to 0.3 / 100,000 habitants, being 60 times less frequent than that of the middle ear. Aim: To describe the epidemiological, clinical, imaging and treatment characteristics of patients diagnosed with EECC in the Hospital del Salvador ENT department. Material and Methods: A series of eight clinical cases collected during the period 2017 and 2021 is presented. A review of clinical records, biopsies and computed tomography of the ear (ear CT) was carried out. The findings and treatment carried out are described. Results: The average age was 65.6 years corresponding to 5 women and 3 men with the presence of smoking and diabetes in half of the cases. The most frequent symptoms and signs were earache and hearing loss followed by otorrhea. 7 patients presented with an intact eardrum and compromise of the inferior wall of the canal was evidenced in 6 of 8 patients. Ears CT showed bone erosion of the canal with or without compromise of adjacent structures in all cases and the histological diagnosis was made in 100% of the patients. Conservative treatment with periodic ear dressings associated with 3% salicylic acid and / or topical antibiotics was favored in 6/8 patients. Conclusion: EECC is a rare entity without pathognomonic signs or symptoms, therefore the histological diagnosis together with the imaging study is peremptory. Conservative treatment is a valid therapeutic alternative that offers good results in patients with adequate adherence to treatment and the possibility of strict follow-up.

Un cuerpo extraño inusual de cianoacrilato en el oído. Presentación de un caso clínico y revisión de la literatura / An unusual cyanoacrylate foreign body in the ear. Presentation of a clinical case and literature review

El pegamento basado en cianoacrilato posee una gran capacidad de adherencia a los tejidos, representando un problema cuando se encuentra en el oído externo debido a sus características anatómicas particulares. Se presenta un caso clínico de cuerpo extraño de cianoacrilato que ocluye el conducto auditivo externo y el tímpano, alterando la audición. Se describen los hallazgos y los intentos de extracción utilizando las alternativas terapéuticas descritas en la literatura, sin obtener resultados positivos, debiendo recurrir a la extracción quirúrgica. Además, se presentan detalles del procedimiento y los resultados. El paciente recupera la audición y la normalidad anatómica.

Cyanoacrylate-based glue has a great capacity for adhering to tissue, which is a problem when it is placed in the ear canal due to the anatomy of this structure. A clinical case of a cyanoacrylate foreign body occluding the external auditory canal and the tympanic membrane is presented. The therapeutics alternatives described in the literature used in the case failed, so, it was surgically removed by drilling the glue. Details of the procedure and results are presented. The patient recovers the hearing and anatomical normality.

Descriptive study of goat external and middle ear through computed tomography and endoscopic evaluation, compared with the human ear

Abstract Objective: To describe the external and middle ear of goats, using computed tomography and endoscopic dissection, comparing them with the anatomy of the human ear, aiming to evaluate the viability of this animal model for training in otological endoscopic surgery. Methods: Images of the external and middle ear of goats were produced by computed tomography in the coronal and axial planes and analyzed. The radiological anatomy of the external and middle goat and human ear are described. Some measures of surgical interest were described, such as the length of the external auditory canal, external and internal cross-sectional area of the external auditory canal, middle ear depth, vertical angle of the external auditory canal, length of malleus and incus. After the tomographic study, we analyzed the importance of evaluations through the endoscopic dissection of the goat ear. Results: The bony canal is extremely tortuous and shows a bony prominence with significant elevation near the lower edge of the tympanic membrane. The middle ear has a large tympanic bulla in the hypotympanum region. The malleus is shaped similarly to that of the human, but its handle is located anterior to its head. The mastoid is not pneumatized. Compared to the human mastoid, there was a statistically significant difference in the external and internal cross-sectional area, at the depth of the middle ear, in the vertical angle of the canal and in the length of the incus. Conclusion: Goat morphometric anatomy showed that this model is suitable for surgical simulation in the initial training for endoscopic otological surgery. It is an important contribution to the development of skills to accelerate the subsequent endoscopic otological surgical training in humans, despite some differences found.

Quiste epidermoide en conducto auditivo externo: reporte de caso / Epidermoid cysts of the external auditory canal: case report

Resumen El quiste epidérmico es una lesión benigna y común de la piel. Se desarrolla por un bloqueo de la unidad pilosebácea, con la consecuente proliferación de células epiteliales y secuestro de queratina. El 7% se desarrollan en cabeza y cuello, sin embargo, son infrecuentes en canal auditivo externo. Su patrón de crecimiento es lento y progresivo durante años, siendo asintomáticos. Al aumentar de tamaño causan sintomatología variable, acorde a su localización; en el canal auditivo tienen un comportamiento obstructivo que genera síntomas como otalgia e hipoacusia. Se presenta caso de una paciente de 69 años, con acúfeno e hipoacusia progresiva derecha. Durante la otoscopia se observó una neoformación obstructiva del 100% de la luz del conducto. Se realizaron estudios de imagen que reportaron tumoración de características quísticas de conducto auditivo derecho, bien circunscrita, sin erosión ósea. Para el diagnóstico definitivo, se realizó resección quirúrgica y biopsia reportando quiste epidérmico. Durante el seguimiento posoperatorio sin hallazgos de recidiva.

Abstract The epidermal cyst is a common and benign lesion of the skin. It develops due to a blockage of the pilosebaceous unit, with the consequent proliferation of epithelial cells and keratin sequestration. Seven percent develop in the head and neck; however, they are infrequent in the external auditory canal. Its growth pattern is slow and progressive over the years, being asymptomatic. As they increase in size, they cause variable symptoms, according to their location. In the ear canal they have an obstructive behavior that generates symptoms such as earache and hearing loss. A case of a 69-year-old female with tinnitus and progressive right hearing loss is presented. At otoscopy, a 100% obstructive neoformation of the canal lumen was observed. Imaging studies showed a well circumscribed, cystic tumor of the right ear canal, without bone erosion. For the definitive diagnosis, a resection and biopsy were performed, reporting an epidermal cyst. During follow up there was no recurrence of tumor.

Uso de ácido tricloroacético para fechamento de lesão por alargadores em lóbulos de orelhas / Use of trichloroacetic acid for closure of lesion by extensors in lobules of ears

Introdução: O uso de alargadores de lóbulos de orelhas provoca um defeito circular cujo fechamento se torna um desafio para o cirurgião plástico. Existem múltiplas técnicas com mobilização de retalhos locais na tentativa de promover o fechamento e devolver o formato natural do lóbulo. Nossa proposta é apresentar o ácido tricloroacético (ATA) como alternativa para a correção dessas lesões. Métodos: Foram selecionados um total de 5 pacientes com lesões por alargadores nos lóbulos das orelhas e utilizado ATA 90% para o fechamento dos defeitos. Resultados: Após a aplicação do produto, observouse uma hiperemia ao redor da área onde foi aplicado o ácido nos primeiros dias, a área de frosting foi substituída por uma crosta, que foi se soltando com o passar dos dias, concomitante a redução do diâmetro da lesão com fechamento progressivo do defeito. Conclusão: Apesar de mais estudos serem necessários, a utilização de ATA 90% se mostrou uma opção simples e eficaz para o fechamento de lóbulos de orelhas alargados.

Introduction: The use of ear lobe extenders causes a circular defect whose closure becomes a challenge for the plastic surgeon. There are multiple techniques with mobilization of local flaps in an attempt to close and return to the natural shape of the lobe. We propose to present trichloroacetic acid (TCA) as an alternative for the correction of these lesions. Methods: A total of five patients with lesions by ear skin eyelets were selected, and 90% TCA was used to close the defects. Results: After applying the product, in the first days, there was a hyperemia around the area where the acid was applied. The frosting area was replaced by a crust, which loosened over the days, concomitantly reducing the diameter of the lesion with progressive closure of the defect. Conclusion: Although more studies are needed, the use of 90% TCA proved to be a simple and practical option for the closure of enlarged ear lobes.

Nova proposta cirúrgica para reparação de lóbulo de orelha após o uso de alargador / Proposal of a new surgical technique to repair gauge earlobe defect

As deformidades nos lóbulos das orelhas causadas por adornos e ornamentos são muito comuns. O uso de alargadores e piercings nessa topografia gera uma fenda parcial de grandes dimensões, além do alongamento, o que causa prejuízo estético e social quando no abandono de seu uso. Várias técnicas cirúrgicas já foram propostas para a correção de defeitos nos lóbulos das orelhas. Nesse relato de caso, foi descrita uma nova abordagem cirúrgica, simples, rápida e com resultado estético satisfatório nos casos de fenda parcial de grandes dimensões: a técnica em "L" adaptada

Earlobes deformities caused by adornments and ornaments are prevalent. The use of plugs and piercings in this topography generates a large partial cleft in the earlobes, which causes aesthetic and social damage when abandoning its use. The literature has already proposed several surgical techniques to correct defects in the earlobes. This case report describes a new, simple, and fast surgical approach, which had satisfactory aesthetic results in significant partial cleft cases: the adapted "L-plasty" technique

Criptotia em paciente ocidental adulto: relato de caso / Cryptotia in a Western adult patient: a case report

Criptotia é uma deformidade auricular congênita comum em orientais e rara em ocidentais, sendo a grande maioria dos estudos de técnicas cirúrgicas orientais e aplicados em crianças. Nesta patologia, a cartilagem do polo superior da orelha encontra-se alojada embaixo da pele na região temporal, o que impossibilita o uso de óculos, devido à falta de apoio e torna o polo superior sem definição estética. O presente estudo tem por objetivo relatar o caso de um paciente adulto com criptotia, submetido ao tratamento cirúrgico com retalho de pedículo subcutâneo mastóideo, revisando as principais técnicas descritas para o tratamento deste acometimento. O retalho de pedículo subcutâneo descrito por Yoshimura, mostrou-se adequado para a correção da criptotia em paciente ocidental e adulto.

Cryptotia is a congenital ear deformity common in Easterners and rare in Westerners, with most studies addressing Eastern surgical techniques applied to children. In this pathology, the cartilage of the upper pole of the ear is lodged subcutaneously in the temporal region, which prevents individuals from using glasses due to lack of support and prevents esthetic definition of the upper pole. The present study aimed to report the case of an adult patient with cryptotia undergoing surgical treatment using a mastoid subcutaneous pedicle flap and review the main techniques described for the treatment of this involvement. The subcutaneous pedicle flap described by Yoshimura proved to be adequate for correcting cryptotia in a Western adult patient.

Anthropometric Study Of External Ear In North Indian Population

Introduction: Anthropometry is a series of systematize measuring techniques that express quantitatively thedimensions of human body and skeleton which shows variation according to age, gender and race. Theidentification of an individual by age and sex possesses difficulty in revealing its identify. Various parametershave been used to establish the identification of individuals. Anthropometry of external features of the pinna isone of them.Objective: The aim of study to differentiate the morphometric features of external ear among males and femalesand also between the right and left ear in each gender.Materials and Methods: The study was conducted on 100 students which consist of 62 males and 58 female MBBSstudents with the age between 18-25 years in Rama Medical College, Hospital & Research Centre, Kanpur.Following anthropometric parameters used were: Height of ear (HE), Width of ear (WE), lobular height (LH),Lobular width (LW), Auricular index (AI) and Lobular index (LI).Results: In the present study, that all the parameters of right ear slightly greater than left ear among malepopulation except LW and LI. All the parameters of left ear slightly greater than right ear among female populationexcept HE and WE. The mean of HE,WE and AI of right ear slightly greater than left ear among combined (male +female) population whereas LH, LW and LI which were slightly lesser on right side than left side. All the parametersof external ear greater in males than female except LH on both sides which were greater in females than males.Conclusion: This anthropometric study is useful in the plastic reconstructive surgeries to correct the deformitiesand also useful in making the hearing aids or prosthesis, ear phones and head phones.

Retalho retroauricular ilhado para reconstrução parcial de orelha: relato de casos / Retroauricular island flap for partial ear reconstruction: case reports

Defeitos parciais de orelha podem ser tratados de diversas formas, dentre elas o fechamento primário, cicatrização por segunda intenção ou retalhos. Diversas opções técnicas foram descritas para a sua reconstrução de modo a manter o contorno natural da orelha, sem sacrificar tecido sadio ou alterar sua estética e função. Apresentamos neste artigo dois casos atendidos no Instituto do Câncer do Hospital de Base de São José do Rio Preto de reconstrução de defeitos condrocutâneos de orelha após ressecção de carcinoma basocelular em região central da orelha, com a confecção de retalho retroauricular ilhado transposto através de uma janela cartilaginosa e com o pedículo desepidermizado. Área doadora com fechamento primário. Tal procedimento constitui técnica segura, pois a região retroauricular é ricamente vascularizada, é de fácil execução, em único estágio e com resultado estético e funcional satisfatório.

Partial ear defects can be treated in several ways, including primary closure, healing by secondary intention, or flaps. Several surgical options have been described for reconstruction in order to maintain the natural contour of the ear, without sacrificing healthy tissues or changing the aesthetics and function. In this article, we present two cases of reconstruction of chondrocutaneous defects of the ear after resection of basal cell carcinoma in the central region of the ear, with the production of a retroauricular island flap transposed through a cartilaginous window with the de-epidermized pedicle. The donor area healed following a primary closure. This procedure can be performed in a single stage, yields satisfactory aesthetic and functional results, and is safe because the retroauricular region is richly vascularized.

Variation Of Ear Parameters Among Annang Ethnic Group Of Nigeria

The study was to establish the normative morphometric ear properties and height of Annang ethnic group of South–South Nigeria, highlight differences between sexes and changes with age. A total of 400 subjects (233 females and 167 males) of 16–80 years of age which met the inclusion criteria were used. Standardized measurement of human height, total ear height and width, concha height and width, lobar height and width and ear projection were taken. Data were analyzed using Statistical Package for Social Sciences (SPSS) Version 23. The mean human height was 1.61±0.08m. Total ear height, concha height and lobar height were 57.52±4.48mm; 26.2±12.89mm and 14.92±2.74mm, respectively. Total ear width, concha width, lobar width and ear projection were 34.19±3.55mm; 18.92±2.15mm; 14.01±3.61mm and 17.00±2.42mm, respectively. Ear parameters were higher in the males except for lobar width (p< 0.05). The total ear height, lobar height and width increased with age (p<0.05). Age positively correlated with right ear height with r value of 0.321 in males and 0.432 in females. The incidence of ear prominence was 7.5% in the general population. Among the Annang ethnic group, human height had a low positive correlation with total ear height.

Prevalência de apêndices préauriculares isolados em recémnascidos e resultados na triagem auditiva neonatal / Prevalence of isolated pre-auricular appendages in newborns and results in neonatal hearing screening

Introdução: os apêndices pré-auriculares, em conjunto com outras malformações craniofaciais e do osso temporal, estão associados à deficiência auditiva. Dentre as malformações do pavilhão auricular, encontram-se os apêndices pré-auriculares, formados por pele e cartilagem, e que podem estar presentes em qualquer ponto entre o trágus da orelha e o ângulo da boca, uni ou bilaterais. Objetivo: avaliar a resposta auditiva em 906 recém-nascidos sem indicadores de risco para deficiência auditiva e com apêndices pré-auriculares isolados (uni ou bilaterais) quanto a: prevalência de recém-nascidos com apêndices pré-auriculares; respostas de reflexo cócleo-palpebral; características das emissões otoacústicas; características do potencial evocado auditivo de tronco encefálico; e a incidência dessa causuística que apresente perda auditiva. Método: a identificação de indicadores de risco para deficiência auditiva foi realizada a partir da carteira do recém-nascido, do prontuário médico e de uma entrevista com os pais. Foram avaliados o meato acústico externo e a membrana timpânica através de otoscopia e espéculos auriculares. O reflexo cócleo-palpebral foi testado percutindo-se um agogô próximo ao recém-nascido. Pesquisa das emissões otoacústicas foi realizada com o aparelho ero scan etymotic research. Avaliou-se o potencial evocado auditivo do tronco encefálico. Resultado e discusssão: a prevalência de apêndices pré-auriculares foi de 1,1%. Todos apresentaram reflexo cócleo palpebral presente, passaram pelas EOA e o potencial evocado auditivo de tronco encefálico apresentou resposta eletrofisiológica dentro dos padrões de normalidade em todos os pacientes estudados. Conclusão: não houve correlação entre a perda auditiva e a presença de apêndices pré-auriculares

Introduction: pre-auricular appendages, together with other craniofacial malformations and temporal bone, are associated with hearing loss. Among the malformations of the auricle are the preauricular appendages, formed by skin and cartilage, and that can be present at any point between the tragus of the ear and the angle of the mouth, uni or bilateral. Objective: to evaluate the auditory response in 906 newborns without risk indicators for hearing loss and with isolated pre-auricular appendages (uni- or bilateral) for: prevalence of newborns with pre-auricular appendages; responses of cochlear-eyelid reflex; characteristics of otoacoustic emissions; characteristics of auditory brainstem evoked potential; and the incidence of this cause that presents hearing loss. Method: identification of risk indicators for hearing loss was carried out from the newborn's wallet, the medical record and the interview with the parents. The external acoustic meatus and the tympanic membrane were evaluated through otoscopy and atrial speculum. The cochlear-eyelid reflex was tested by percututing an agogot close to the newborn. Research on otoacoustic emissions was performed using the ero scan etymotic research apparatus. The auditory evoked potential of the brainstem was evaluated. Results and discussion: the prevalence of pre-auricular appendages was 1.1%. All of them presented a palpebral cochlear reflex present, passed through the OAE, and the auditory evoked potential of the brainstem presented an electrophysiological response within normality patterns in all patients studied. Conclusion: there was no correlation between hearing loss and the presence of pre-auricular appendages alone.

Correlation analysis of mandibular condyle volume and external ear volume in M2a type of hemifacial microsomia / 中华整形外科杂志

Objective@#To investigate the correlation between mandibular condyle volume and external ear volume in M2a type of hemifacial microsomia.@*Methods@#19 patients with M2a type of hemifacial microsomia diagnosed by CT scan in the Shanghai Ninth People′s Hospital from August 2017 to December 2018 were included, and the head CT data were obtained. At the same time, 19 healthy people were recruited as volunteers and obtain CT data of their heads as control. The Mimics 15.0 software was used for 3D reconstruction of CT data, measure the volume of mandibular condyle and external ear. SPSS 25.0 software was used to analyze the correlation between mandibular volume and external ear volume, as well as the difference between bilateral mandibular condyle volume (healthy side mandibular condyle volume-affected side mandibular condyle volume) and bilateral external ear volume difference (healthy side external ear volume-affected side external ear volume), and the correlation was obtained by spearman correlation coefficient analysis. P<0.05 indicates that the difference was statistically significant.@*Results@#The data of 19 cases of M2a type of hemifacial microsomia and 19 healthy volunteers were analyzed. The left and right volume of bilateral mandibular condyle in healthy volunteers was (1 309.23±420.63) mm3, (1 325.93±425.60) mm3(P=0.904), the left and right volume of external ear was (7 854.18±2 005.77) mm3, (7 862.63±1 994.02) mm3(P=0.990), bilateral development was synchronous, there was no statistical difference. There was a significant positive correlation between mandibular condyle volume and external ear volume in healthy volunteers (P=0.004, rs=0.772). The volume of healthy and affected mandibular condyle in the patients with M2a type of hemifacial microsomia was (1 160.89±549.07) mm3, (509.55±303.88) mm3 (P=0.006), and the volume of healthy and affected external ear was (7 418.19±2 434.93) mm3and (2 029.99±1 080.37) mm3 (P=0.007). The development is not synchronized in the mandibular condyle and external ear in M2a type of hemifacial microsomia, but the mandibular condyle volume is significantly positively correlated with the external ear volume(healthy side: P=0.008, rs=0.740; affected side: P=0.004, rs=0.709), and the affected part of the mandibular condyle and the external ear development (the volume difference between the mandibular condyle or the external ear volume) also has the same performance(P=0.006, rs=0.753).@*Conclusions@#There is a significant positive correlation between mandibular condyle volume and external ear volume in patients with M2a type of hemifacial microsomia.

Chondrocutaneous transposition flap for congenital tragal malformation with dystopic cartilage

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.

Helical Rim Advancement Flap with an Additional Postauricular Skin Flap: A Case Report

The auricle is a three-dimensional cartilaginous frame covered with thin overlying skin. Due to its complex features, reconstructing helical rim defects after the excision of an auricular mass is challenging. Shortage of subcutaneous tissue and the presence of a tightly bound epithelium further hamper the primary closure of lateral (anterior) auricular skin defects. We present herein a case in which we used a helical rim advancement flap along with an additional postauricular skin flap. We achieved a satisfactory esthetic result with minimal loss of helical diameter and a low risk of flap necrosis by preserving the vascular network of the flap. This technique is less traumatic and will facilitate faster healing as well as improved patient recovery.

Morphometric Study Of External Ear Of Medical Students

Introduction: Abnormalities of external ear either congenital or acquired needs correction to have an estheticappearance of face.Aim: to aid the surgeon in this process of correction we need to standardize the sizes of various parameters ofear in a particular ethnic group and age group.Materials and Methods: here we have taken photographs of face and measured various parameters of externalear by Image J technique.Results: in our study we got average sizes of ear as follows, Height of ear as 45.25±3.92, breadth of the ear at theupper attachment of pinna to the lateral surface of face as 21.29± 2.08, breadth of ear at tragus as 21.74±2.2,breadth of lobe 13.21±1.8, length of lobe as 17.22±2.24.Conclusion: these parameters which we have calculated for the sizes of external ear in the age group of 18-22 yrsin our region may be helpful for plastic surgeons in their work.

Otoplastia Combinada / Combined Otoplasty

Introdução: Orelha em abano é a deformidade congênita mais comum de cabeça e pescoço, cuja transmissão se dá por herança autossômica dominante, sem predileção por gênero. A orelha proeminente ou "em abano" ocorre quando há um excesso ou hipertrofia da concha auricular, apagamento da antélice, um ângulo escafoconchal maior que 90º ou uma combinação destes, ocorrendo uni ou bilateralmente. O objetivo é apresentar uma abordagem conservadora para correção de orelha em abano, com a associação de técnicas. Métodos: Foi utilizada uma variação cirúrgica para realização de otoplastia com o auxílio de uma abordagem anterior para ressecção da concha auricular associada ao enfraquecimento da antélice com incisões parciais na cartilagem também por via anterior e a realização de pontos de Mustardé por via posterior para melhor definição da antélice, sem a fixação da concha à mastoide. Foram operados 200 pacientes com idade média de 17 anos, entre janeiro de 1987 e janeiro de 2015, sendo 60% do gênero feminino. Resultados: Dos 200 pacientes, apenas 24 necessitaram revisões cirúrgicas discretas. Conclusão: O procedimento cirúrgico é simples, facilmente reprodutível, proporcionando bons resultados, com alto grau de satisfação e baixo índice de complicações/morbidade.

Introduction: Protruding ear is the most common congenital deformity of the head and neck, with an autosomal dominant inheritance and no predilection for sex. Protruding ear or prominent ear occurs when there is concha excess or hypertrophy, erasure of the antihelix, a scapho-conchal angle greater than 90°, or a combination of these factors, occurring unior bilaterally. The objective is to present a conservative approach to correct protruding ear, with a combination of techniques. Methods: The otoplasty surgical technique involved an anterior approach for resection of the auricular concha, which was associated with weakening of the antihelix, and partial incisions of the cartilage were performed through anterior access and of Mustardé sutures, through posterior access for better definition of the antihelix without fixation of the concha to the mastoid. Two hundred patients with a mean age of 17 years underwent operations between January 1987 and January 2015, 60% of whom were female. Results: Of the 200 patients, only 24 patients needed discrete surgical revisions. Conclusion: The surgical procedure is simple, easily reproducible, provides good results, and is associated with a high degree of satisfaction and a low rate of complications/morbidities.

A Case of Contrast Enhanced Cystic Mass of External Ear Canal Diagnosed as Engorged Hard Tick

A 58-year-old female complained earfullness and otalgia and came to the clinic. Dark gray colored cystic mass obstructing the left ear canal was observed during the endoscopic exam. Contrast enhanced CT image showed an oval shape soft tissue lesion in the mid part of the external auditory canal with a homogenous increased contrast uptake. The mass was removed under microscopic view at outpatient clinic. While dissecting the mass in the ear canal, a pod like structure was visualized. The external organism was densely adherent to the skin and turned out to be an engorged hard tick. Considering the final diagnosis, contrast uptake observed in the CT scan implicates the patient communication of blood between host and parasite. This unique image finding differs from a benign mass lesion in the ear canal was one of the differential diagnosis points for the lesion. This article is reporting the case of tick bite in the ear canal with a rare CT scan finding.

Refined Converse otoplasty with Ω shape for prominent ears / 中华整形外科杂志

Objective@#To investigate the feasibility and efficiency of refined Converse otoplasty with Ω shape for correcting prominent ears.@*Methods@#Refined Converse otoplasty with Ω shape was performed in 8 cases(3 cases of bilateral deformities)of prominent ears during January 2014 to September 2016. The postauricular fascial-perichondrial complex tissues were elevated through postauricular incision based on Converse otoplasty. The new antihelix was reformed by parallel mattress sutures though postauricular parallel cartilaginous incisions. The Ω shape appeared on the transverse section of the auricular cartilage after fascial-perichondrial sutures.@*Results@#Postoperative 6 month to one year follow-up presented satisfactory results in all 8 cases. The appropriate location and contour of the recreated antihelix was achieved. The included angle between fossae helicis and concha was decreased. The auricles were symmetric in both unilateral and bilateral patients of prominent ears. The scars were inconspicuous. Hematoma, infection, suture extrusion and secondary deformities were not seen in our series.@*Conclusions@#Natural and clear contour of the recreated antihelix was achieved by refined Converse otoplasty with Ω shape. Reoccurrence was not seen and complications were rare.

Early non-surgical treatment of congenital auricular deformity / 中华整形外科杂志

Objective@#To investigate the effect of auricle deformity corrector in non-surgical treatment of congenital auricular deformity.@*Methods@#The auricular deformity correctors were applied for non-surgical treatment of congenital auricular deformities. The patients were divided into three groups according to the treatment starting age (<1 month old, 1-3 months old, 3-6 months old), followed up for every month respectively after treatment. According to the improvement of auricle morphology, the treatment results were divided into four levels (e, g, f, p) and the effective rate (e+ g)% was calculated.@*Results@#From January 2014 to December 2016, there were 140 ears of congenital malformations in children aged less than 6 months who were treated and followed up. Among them, 33 ears had helical rim abnormalities, 29 with cup-shaped ears, 12 with prominent ears, 4 with Stahl′s ears, and 62 with cryptotia ears. The therapeutic efficacies (<1 month old, 1-3 months old, 3-6 months) of these ear malformations were: cryptotia ear (100%, 100%, 87.5%), helical rim abnormality (100%, 90.47%, 66.67 %), prominent ear (-, 100%, 50%), cup ear (100%, 78.57%, 53.33%), Stahl′s ear (-, 100%, 33.33%). Follow-up more than 6 months after treatment, up to a year and a half, no recurrence was found.@*Conclusions@#The auricular deformity corrector can be used as an effective approach for achieving natural outcomes and correcting cosmetic abnormalities. Rate of satisfaction is dependent on types of deformity, the neonatal age in which treatment started and also parents′ compliance to treatment methods and principals. The method is noninvasive, easy to wear and works well. Early proper treatment can avoid future operations and save social medical resources.

ЭХЭМҮТ-Н ХЗП-Н СОНСГОЛ ЗАСЛЫН КАБИНЕТААР ҮЙЛЧЛҮҮЛСЭН ГАДНА ЧИХНИЙ ГАЖ ХӨГЖИЛТЭЙ ХҮҮХДҮҮДИЙН ХЯНАЛТЫН СУДАЛГААНЫ ЗАРИМ ҮР ДҮН / Шинэ санаа Шинэ нээлт

@#BACKGROUND: Microtia is often associated with hearing loss and patients typically require treatment for hearing impairment and surgical ear reconstruction. The occurrence of microtia is of public health importance in part due to the psychosocial sequelae, including the stigma associated with malformations of the ear and the burden of undergoing multiple surgeries In addition, greater than 90% of individuals with microtia experience conductive hearing loss on the affected side. Although children with microtia-anotia are at a greater risk of delayed language development and attention deficit disorders. METHODS: Our study has a 173 childrens from the UB city and countryside. 23 children has a bilateral microtia and anotia. 6 patient wearing BAHA soft band from 6 months age. 150 patients have an unilateral microtia. Microtia was found more commonly in males, unilateral and right sided. Even children with bilateral microtia may have wearing BAHA soft band before 6 months age. RESULTS: External ear malformations are more commonly found in males. Sex ratio 2:1. From other studies right ear malformations are more common in male children. In our study children who have bilateral ear abnormalities wearing BAHA softband and language therapy from 6 months age to able to have normal language development. Children who had surgical treatment and using hearing aid can have normal social life and increased quality of life. CONCLUSION: Early screening in children who have external ear malformation, monitoring language development, wearing BAHA softband from 2 months age who have bilateral ear malformation and one ear affected other one is normal children wear BAHA softband increases children speech and language development.