[Non-invasive correction of congenital ear deformities with the EarWell Correction System: a prospective study]. / Nicht-invasive Korrektur angeborener Ohrfehlbildungen mit dem EarWell Infant Ear Correction System: Eine prospektive Studie.

BACKGROUND: Congenital ear deformities occur in 5 % of all newborns. Molding of the ear is possible during the first six weeks of life because of the maternal hormones which are still circulating in the newborns. For several years we have been using the EarWell™ Correction System, which allows us to correct ear deformities within the first weeks of life. PATIENTS AND METHODS: This prospective study included 19 newborns. The following ear deformities were treated: cup ear, lop ear, steel ear, helical rim abnormalities, antihelical rim abnormalities. The results of the EarWell™ system were reevaluated two years after the procedure. Two independent examiners evaluated the clinical results on the basis of preand postprocedural pictures. In addition, the following parameters were evaluated: time of application, complications, satisfaction of parents, cost comparison between the EarWell™ system and otoplasty. RESULTS: In all, 32 ears were treated with the EarWell™ system. 63 % were male and 37 % female. The system was placed in the first three weeks of life. The average treatment time was 12-28 days. The rate of complications was 1.3 %. The clinical results were rated as follows: 23 % very satisfactory, 35 % fully satisfactory, 30 % satisfactory, 3 % less satisfactory and 9 % not satisfactory. 95 % of the parents would use the EarWell™ system again. The costs of the EarWell™ system are EUR 660, those of otoplasty EUR 2826. CONCLUSION: Ear deformities are easily treated with the EarWell™ system during the first weeks of life. It reduces the need for surgical correction at a later age and prevents children from further stress. Another advantage is the low costs compared with the costs of otoplasty.

[Free latissimus dorsi muscle flap for scalp reconstruction in elderly patients with a squamous cell carcinoma]. / Freie M. latissimus dorsi Lappenplastik zur Defektdeckung des Capilitiums bei ausgedehnten Plattenepithelkarzinomen des alten Patienten.

BACKGROUND: Scalp defects resulting from the resection of a squamous cell carcinoma often require free tissue transfer. In these cases, a free latissimus dorsi muscle flap is a good possibility to cover scalp defects. Our aim was to evaluate the outcome of scalp coverage with free latissimus dorsi muscle flaps. METHODS: This retrospective analysis included 4 patients aged over 70 years (7082), who underwent scalp reconstruction with a free latissimus dorsi muscle flap and a split-skin graft after the resection of a squamous cell carcinoma. Patient characteristics, histological findings, recurrence rate, postoperative radiotherapy, duration of operation and in-patient stay were recorded. RESULTS: All 4 patients had recurrent tumours and the follow-up period was 12-48 months. Histological findings demonstrated R0 resection in all patients. A PALACOS® bone was necessary in two patients and duraplasty in one. All free flaps healed without major complications. There was no flap loss; minor complications included seromas and wound dehiscence. One patient died during follow-up and two were no longer treatable due to tumour progression. One patient is still alive and has had no recurrence for 22 months. CONCLUSION: Free latissimus dorsi muscle flap is a reliable method to reconstruct large scalp defects, even in elderly patients, due to its low complication rate and good tissue vascularity. Despite R0 resection with partial resection of the skullcap and duraplasty, there is a high risk for local recurrence. A multidisciplinary approach is necessary to achieve the best therapy concept for each patient.