Correction Of Ears Research Articles

Results of otoplasty by scoring anterior surface of auricular cartilage

A prominent ear, so called a protruding or 'lop' ear, is the most common congenital deformity of the external ear. This deformity persists when the mastoid-helix angle (MHA) is higher than 30 degrees. It is relatively common among the population with the incidence of about 5%. The aim of this study is to present surgical procedure and our results using otoplasty with scoring anterior surface of the auricular cartilage. To analyze objective and subjective surgical procedure effects. Between 2011 and 2014 we treated 28 patients. We found statistically high significance p<0.01 in value mastoid-helix angle (MHA) preoperative and postoperative. In patients with bilateral otoplasty the difference between left and right MHAs after surgical procedure is less than 4 degrees. The difference of head-helix distance (HHD) preoperative and postoperative is statistically important with high significance p<0.05. Preoperative satisfaction by personal appearance was better after surgical procedure p<0.05. Complications occurred in 9 cases (32.4%). Otoplasty by scoring anterior surface of auricular cartilage is safe procedure for correction of prominent ear with excellent results on patient satisfaction by personal appearance. Effect of reducing the MHA and HHD is long lasting.

T-bar reconstruction of constricted ears and a new classification

For the correction of constricted ears, many techniques are described in the literature, the majority based on Tanzer's classification of 1975. The improvements in ear reconstruction published by Brent, Nagata, Firmin and Park make better outcomes possible. It is therefore that a new classification for constricted ears is proposed, together with an alternative technique for correction of group IIA and IIB deformities, using a T-strut of costal cartilage to reconstruct the underdeveloped or missing superior crus of the antihelix.

Oncological outcomes in patients who underwent glansectomy and skin grafting for treatment of penile squamous cell carcinoma

Oncological outcomes in patients who underwent glansectomy and skin grafting for treatment of penile squamous cell carcinoma

Reduction of Antitragal Projection as an Adjunct to Correction of Prominent Ears

Level of Evidence IV This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of

Posterior scoring pinnaplasty for correction of prominent ears

EnAbstractAim of workIn this study, we present our experience with correction of prominent ears by posterior scoring only without elevation of the anterior perichondrium of the auricle.RationaleBy avoiding an anterior subperichondrial flap, we managed to reduce operative time, convalescence, and complications, with no effect on postoperative outcome.

Aesthetic Refinement of the Dog Ear Correction: The 90° Incision Technique and Review of the Literature

The closure of any circular or asymmetric wound results in puckering or excess of tissue known as dog ears. Tissue dynamics, wound geometry, surface contour, and surgical technique affect dog ear formation [1,2]. Despite good preoperative planning for skin management techniques including Burow's triangle, V-Y advancement flap, M-plasty [3], and S-plasty [4], and despite following intraoperative procedures including proper undermining of a shallow wound, proper 90° angle of the scalpel blade, precise suture placement, and removal of excess underlying fat, sometimes a dog ear occurs anyhow. Methods for correcting dog ears include excision of the excess tissue in the shape of a triangle, crescent or ellipse; excision of conical folds of tissue at the end of the wound in the same direction as the long axis of the original wound; and excision of the dog ear at a 120° angle to the long axis of the existing excision line in a shape resembling a hockey stick [5]. They are extensively described in the literature, but they all lead to wound extension. Only M-plasty allows for reduction in the scar's length but produces a double-tailed scar, so if the total length with the two tails is considered, the new scar is still longer than the original one. We have developed a new and easy technique for dog ear correction without extending the length of the original wound.

Avaliação de treinamento cirúrgico na graduação de medicina

To evaluate the effectiveness of training in surgical techniques in pig feet during medical school. We conducted a cross-sectional study with 87 volunteer medical students from different graduation semesters, who attended a basic workshop for incisions, sutures, biopsies, flaps, grafts, under direct supervision. Pre and post-training self-administered questionnaires were used. The teaching of sutures, biopsies and ear correction was effective for learning of the minimal skills required for the proposed techniques (p <0.005), as well as excisions and flaps, except grafting (p> 0 97). The methodological approach and monitoring of techniques' reproduction were adequate. The training offered complemented cutaneous surgical skills of undergraduate medicine students.

Personal Approach to the Correction of Prominent Ears

Personal Approach to the Correction of Prominent Ears

Orejas valgas: estabilización mediante colgajo dermo-graso-pericóndrico retroauricular

The treatment for the correction of prominent or valgus ears, is to create a normal distance (17-21 mm) between the mastoid and the helix and a normal appear...

Paying more for faster care? Individuals' attitude toward price-based priority access in health care

Increased competition in the health care sector has led hospitals and other health care institutions to experiment with new access allocation policies that move away from traditional expert based allocation of care to price-based priority access (i.e., the option to pay more for faster care). To date, little is known about individuals' attitude toward price-based priority access and the evaluation process underlying this attitude. This paper addresses the role of individuals' evaluations of collective health outcomes as an important driver of their attitude toward (price-based) allocation policies in health care.The authors investigate how individuals evaluate price-based priority access by means of scenario-based survey data collected in a representative sample from the Dutch population (N = 1464). They find that (a) offering individuals the opportunity to pay for faster care negatively affects their evaluations of both the total and distributional collective health outcome achieved, (b) however, when health care supply is not restricted (i.e., when treatment can be offered outside versus within the regular working hours of the hospital) offering price-based priority access affects total collective health outcome evaluations positively instead of negatively, but it does not change distributional collective health outcome evaluations. Furthermore, (c) the type of health care treatment (i.e., life saving liver transplantation treatment vs. life improving cosmetic ear correction treatment – priced at the same level to the individual) moderates the effect of collective health outcome evaluations on individuals' attitude toward allocation policies.For policy makers and hospital managers the results presented in this article are helpful because they provide a better understanding of what drives individuals' preferences for health care allocation policies. In particular, the results show that policies based on the “paying more for faster care” principle are more attractive to the general public when treatment takes place outside the regular working hours of a hospital.

Assessment of the degree of correction of prominent ears using a standardized treatment algorithm

Assessment of the degree of correction of prominent ears using a standardized treatment algorithm

Creating a Neoconchal Complex Using the Adjustable Conchal Sliding Technique in Prominent Ear Correction

An oversized aural concha plays a significant role in prominent ear deformities and should be taken into consideration during preoperative examination. In the current study, we present a procedure known as the conchal sliding technique as an alternative to more disruptive methods. Twenty-four patients (9 females and 15 males; 47 ears in total) underwent a conchal sliding procedure between 2006 and 2010. During the surgery, a wide subperichondrial dissection is performed after a posterior elliptical incision. After the concha is exposed as a hemisphere, it is split along its long axis to reveal the medial and lateral cartilage segments. These segments are gently scrolled upon each other. Transposition of the lateral segment posteriorly to the medial segment replaces the whole ear toward the posterior direction. Three mattress sutures (4-0 polypropylene) reliably secure the repositioned and setback conchal bowl. If needed, an antihelix can be formed using neoconchal-scaphal mattress sutures. Median follow-up period was 24.3 months (range, 6-48 mo). A unilateral hematoma developed in 1 patient and an anterior step deformity occurred in another. No recurrence, infection, necrosis of the skin, distortion of the auditory canal, or formation of keloid was observed in any of the patients. The median cephaloauricular angle was measured as 46 degrees before the surgery and 26 degrees after the surgery, whereas the distance between the helix and the mastoid was 23 mm before the surgery and 11 mm after the surgery. All the patients were satisfied with the results. This technique provides stable and natural results by creating a safe neoconchal complex. It may be a safe and reliable solution to an oversized aural concha, enabling natural-looking and positive cosmetic results.

Finesse in Otoplasty in Four Steps

This report describes the authors' personal experience with an otoplasty technique used to correct several deformities of the auricular cartilage in prominent ears using a single surgical procedure. This technique allows for correction of all alterations in prominent ears by acting on four basic sites of the auricular cartilage using incisions, microincisions, and microresections that shape the curvature of the auricular cartilage. This, combined with elliptical resection of the retroauricular skin, provides prompt reshaping of the ear, conferring a natural appearance. This technique was used for 897 patients ages 5 to 65 years for a period of 16 years (1994-2010). Of these patients, 304 had undergone previous otoplasty. The postoperative follow-up period for these patients was 1 to 14 years. This technique allowed for correction of prominent ears to achieve a natural appearance. It achieved complete satisfaction for 890 patients and a low rate of complications. Three cases of postoperative infection occurred, which were effectively controlled with antimicrobial treatment, and four cases of immediate postoperative hematoma occurred, which had no consequences because early drainage was used. There were no cases of keloids, hypertrophic scarring, or necrosis. This versatile and complete technique allows for correction of all deformities that constitute prominent ears. It is associated with a low rate of complications and relapses by preventing strain of the cartilage. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.

Chong-Chet Anterior Scoring Technique for the Correction of Prominent Ears: Results in 30 Patients

A lot ofotoplasty techniques have been developed during the past years. However, there is no single perfect technique which is worldwide accepted. We present our assessment of a Chong-Chet anterior scoring technique for the correction of prominent ears which we applied in 30 patients between 2005 and 2010. This study is a report of creating a natural fold of cartilage using Chong-Chet anterior scoring technique by cartilage incision at the border between the antihelix and scapha, with medial scoring of the scapha and lateral scoring of the antihelix. Sutures were used to maintain the created fold. There were no major complications at the 1-year follow-up evaluation. None of the patients developed a recurrence, or retro protrusion of the helix which required a second operation for correction. The procedure is a simple surgical technique. The reconstructed ear shows reliable results in stability, size and normal convolutions. Furthermore, sharp cartilaginous ridges and hidden helix are avoided.

Biomechanical Evaluation of Surgical Correction of Prominent Ear

Biomechanical Evaluation of Surgical Correction of Prominent Ear

Cartilage reshaping for protruding ears: A prospective long term follow‐up of 32 procedures

Correction of prominent ears is a common plastic surgical procedure. We introduced a new non-invasive laser-assisted cartilage reshaping (LACR) technique as an alternative to invasive surgical otoplasty. Since our first report in 2006, 32 LACR procedures in 17 patients have been performed at the Antoni De Gimbernat Foundation in collaboration with the French National Institute of Health and Medical Research (INSERM) U703. For 15 patients, the procedure was bilateral, for the remaining 2 patients LACR was performed only on one side. The treatment consisted of seven stacked pulses (3 ms, 2 Hz, 84 J/cm(2) cumulative fluence) applied using a 4-mm spot hand piece. Early and late complications were defined and reviewed for the whole series. Satisfaction was assessed by the patients using a visual analogue scale from 0 (unsatisfied) to 10 (highly satisfied). The superior and middle cephaloauricular distances were prospectively evaluated. Except for two cases of dermatitis, there were no early complications and no late complications (like keloids) in the series. The mean superior and middle cephaloauricular distances were, respectively, 12.3 ± 1.9 and 13.7 ± 1.6 mm compared to 17.8 ± 3.1 mm (p < 0.01) and 23.9 ± 1.9 mm (p < 0.01) before operation. Mean patient satisfaction was 8.6/10 with all patients reporting that they would be willing to undergo the procedure again, if required. LACR appears to be a safe and reproducible method for the treatment of protruding ears. Other applications of this technique, like laser assisted septal cartilage reshaping (LASCR) for septum deviation, have been recently described.

A New Skin Excision Pattern To Correct Protruding Earlobe Deformity in Prominent Ears

IntroductIon: Correction of the earlobe protrusion is challenging problem in prominent ear cases because of the dependence of only skin excision procedures instead of cartilage reshaping methods. Fish tail skin excision is usually performed, but the results don’t always satisfactory. We excised extra triangle shape skin islands to deal with this problem MethodS: We use this method in five prominent ear cases. We drew one or more triangle after planned of the skin excision line at the posterior aspect of the ear. The base of the triangle placed to the outer line of the elliptical excision or fish tail excision. We excised of this triangle shaped skin islands besides of the elliptical skin excision. reSultS: Results of the operations were satisfactory. We could obtain better earlobe position in the prominent ear cases. concluSIon: Surgical techniques for the correction of prominent ears can be grouped into operations that involve excision of cartilage, molding the ear with sutures, molding the ear with sculpting of cartilage, or a combination of any of the above. Anyone or combination of these methods usually correct the deformity of prominent ear. In most of the cases, elliptical skin excision is carried out at the postauricular region, thus excess skin is removed, and it helps to maintain the new position of the ear. However, fish tail skin excision is performed same time to correct of the earlobe protrusion. But, fish tail skin excision usually provides inadequate correction in protruding earlobes. Because there is plenty skin at the posterior aspect of the earlobe, and almost in all skin must be removed to successful set back. However we added one or more triangle shape skin excision which its apex to the helical margin with the fish tail excision, and we could obtain better earlobe position.

Effective scoring of scapha prevents helix irregularity in prominent ear correction — A biomechanical study

BackgroundAs the antihelix is created in the operation for prominent ear, the helix often presents irregularities. This biomechanical study aims to elucidate effective techniques to prevent these irregularities. MethodsFinite element models were produced simulating 10 prominent ears. The scaphas of the 10 models were thinned to simulate scoring or abrasion of the cartilage. The thinning was conducted in four fashions. In the first group, no thinning was conducted (Non-Scoring Models); in the second group, the upper half of the scapha was thinned (Upper-Scoring Models); in the third group, the lower half of the scapha was thinned (Lower-Scoring Models); in the fourth group, the whole scapha was thinned (Whole-Scoring Models). Mattress sutures were applied to create the antihelix to simulate Mustarde’s in-suture technique. Thereafter, transformation of the helix’s contour was evaluated. ResultsIrregularity developed on the upper region of the helix with Non-Scoring and Lower-Scoring Models; the degree of the upper-region’s irregularity was reduced with Upper-Scoring Models and Whole-Scoring Models. Although the edge of the helix moved in the posterior-medial direction with other type models, it moved in the anterior direction with Whole-Scoring Models. ConclusionIrregularity of the upper region of the helix can be prevented by performing scoring or abrasion of the upper part of the scapha. The prominence of the helix and width of the auricle are adjustable by varying the areas of the scapha receiving scoring or abrasion. These findings are useful in improving operative outcomes in the treatment of prominent ears.

Conchal Setback without Resection in Prominent Ear Deformity

Prominent ear deformity is a congenital anomaly characterized by the absence of an adequate antihelical fold, an increased conchal-mastoid angle, and conchal hypertrophy. In order to overcome the conchal hypertrophy and increased conchal-mastoid angle, either conchal cartilage excision or conchal-mastoid suture placement or posterior auricular muscle manipulations are currently used. The authors present an assessment of a combined technique for the correction of prominent ears with conchal hypertrophy. In this technique through a cartilage incision, a setback is obtained by overlapping the cartilage segments, and the antihelix is formed by Mustarde’s sutures. The conchal setback combined with other techniques may be used as a standard procedure in the surgical treatment of prominent ears with predominance of the conchal component.

A New Skin Excision Pattern to Correct Protruding Earlobe Deformity in Prominent Ears

IntroductIon: Correction of the earlobe protrusion is challenging problem in prominent ear cases because of the dependence of only skin excision procedures instead of cartilage reshaping methods. Fish tail skin excision is usually performed, but the results don’t always satisfactory. We excised extra triangle shape skin islands to deal with this problem MethodS: We use this method in five prominent ear cases. We drew one or more triangle after planned of the skin excision line at the posterior aspect of the ear. The base of the triangle placed to the outer line of the elliptical excision or fish tail excision. We excised of this triangle shaped skin islands besides of the elliptical skin excision. reSultS: Results of the operations were satisfactory. We could obtain better earlobe position in the prominent ear cases. concluSIon: Surgical techniques for the correction of prominent ears can be grouped into operations that involve excision of cartilage, molding the ear with sutures, molding the ear with sculpting of cartilage, or a combination of any of the above. Anyone or combination of these methods usually correct the deformity of prominent ear. In most of the cases, elliptical skin excision is carried out at the postauricular region, thus excess skin is removed, and it helps to maintain the new position of the ear. However, fish tail skin excision is performed same time to correct of the earlobe protrusion. But, fish tail skin excision usually provides inadequate correction in protruding earlobes. Because there is plenty skin at the posterior aspect of the earlobe, and almost in all skin must be removed to successful set back. However we added one or more triangle shape skin excision which its apex to the helical margin with the fish tail excision, and we could obtain better earlobe position.