Normal Pinna Research Articles

A case of microtia with bilateral conductive hearing loss with unusual findings

Microtia refers to a group of congenital auricle malformations that range in severity from minor partial structural abnormalities to full auricle absence (anotia). A 17-year-old female, who was also a known case of left ear microtia presented to OPD with chief complaint of reduced hearing from both ears since 4 years. Examination showed Left ear microtia with narrow canal with retracted tympanic membrane while right ear had a normal pinna and canal with grade 3 retraction present in the tympanic membrane. In pure-tone audiometry (PTA) a conductive hearing loss of 57 dB in the right ear and 52 dB in the left ear, and impedance audiometry showed a curve of "Ad" and bilaterally ipsilateral reflexes were found to be absent. During exploratory tympanotomy, intraoperatively facial nerve was found to be low lying over the promontory, showing an abnormal course. A piece of cartilage was placed over the posterosuperior region. Temporalis fascia graft was placed over it. Any such case that has a congenital anomaly like microtia should not be planned for any kind of surgical intervention as they might have abnormal findings like an aberrant course of the facial nerve, and any kind of intraoperative manipulation with the ear might further increase the complications of the patient like facial nerve paresis. These patients should be properly assessed and counselled to directly go for a hearing aid rather than undergo any kind of surgical risk or complication.

Ability to Identify External Ear Deformities and Normal External Ear Anatomy Based on Year and Specialty of Medical Training

The aim of this study was to analyze a potential association between resident training level/specialty type and correct identification of external ear deformities/external ear anatomy. A Qualtrics survey was distributed via email to all pertinent residency programs in the United States. The survey captured specialty type (Otolaryngology, Pediatrics, and Plastic Surgery) and level of training (PGY 1-2 and PGY 3+). The assessment asked residents to identify 10 clinically relevant external ear deformities and 10 normal pinna anatomic subunits. Chi-square tests were used to examine the association between the level of training/specialty type and performance on individual survey items. To examine group performance on overall mean scores of the external ear deformity/external ear anatomy survey, a t-test and factorial analysis of variance (ANOVA) were used. Responses from 105 residents were analyzed. Senior residents (PGY 3+) performed significantly better in correctly identifying Microtia Grade 3, Question Mark ear, and Cryptotia as compared to junior residents (PGY 1-2). Senior residents performed significantly better in the identification of external ear deformities ( P = .002) and normal pinna anatomical subunits ( P < .001). Otolaryngology and Plastic Surgery residents performed significantly better in the identification of external ear deformities ( P < .001) and normal pinna anatomical subunits ( P < .001) than Pediatrics. There were no significant interaction effects between the level of training and the specialty type on either ear deformity or normal pinna anatomy identification. Residents had a 34.5% success rate of identifying ear deformities and showed improved confidence in identification when exposed to a digital-based examination. Improved education methods for detection will help with timely correction of ear deformities.

Pinna injuries management at tertiary care center

Introduction: Ear is one of the most important parts of the face along with the nose and eyes, as normal pinna is projected outward, it is highly vulnerable to injury by road traffic accident (RTA) and other causes. Aim of Study: The aim of the study was to evaluate various etiology, management, and treatment outcomes of pinna injury. Materials and Methods: Fifty cases of pinna injuries were treated medically and surgically over a period of 1 year at Sir T Hospital, Government Medical College, Bhavnagar, India. Results: It was observed that RTA (46%) was the most common cause of pinna injury. Conclusion: RTA is the most common cause of injury to pinna, followed by assault, thermal injury, human bite, and animal bite. To lessen the risk of perichondritis, aseptic precautions are most important thing.

Bilateral Cricoarytenoid Joint Ankylosis with a Perplexing Etiology

Bilateral Cricoarytenoid Joint Ankylosis with a Perplexing Etiology

Mirror ear—surgical correction of this rare external ear anomaly: A case series

Background Mirror ear, also known as polyotia, is an infrequently reported form of external ear malformation characterized by morphologic and dimensional similarity to a normal pinna. The condition has been described in association with various syndromes, and in isolation. However, as the data with specific relevance to polyotia is sparse, not only are the precise causative processes of mirror ear unknown, but the paucity of documented cases also lends the operative approach to be daunting.

High-resolution CT findings in children with a normal pinna or grade I microtia and unilateral mild stenosis of the external auditory canal.

A subset of patients presents with unilateral conductive hearing loss, a normal pinna or grade I microtia, and mild external auditory canal stenosis. The physical findings of microtia and a small external canal are commonly absent or subtle in this group of patients, who are being commonly referred for imaging to evaluate isolated conductive hearing loss. We present a case series of patients with unilateral conductive hearing loss and characteristic ossicular abnormalities, commonly anterior fixation of the malleus. All patients had a significantly increased distance from the cochlear promontory to the handle of the malleus and an abnormal incudostapedial angle, indicative of an abnormal ossicular position and/or morphology. Successful surgical reconstruction of the ossicular chain was attempted and accomplished in 3 patients.

Sonographic Measurement of Fetal Pinna Length in Normal Pregnancies

Many studies have emphasized on fetal pinna measurements and morphologic features to use this structure as an additional marker for fetal chromosomal anomaly. To assess relationship between fetal pinna length and gestation age and develop a nomogram. To assess relationship between fetal pinna length and head circumference and biparietal diameter. Fetal pinna measurements from the tip of helix to the end of lobe were obtained prospectively in 850 singleton pregnant women between 15 and 40 weeks gestation Normal case was defined as normal sonographic findings during examination and normal infant examination at birth or both. Final study population was 787. The relationship between gestational age in weeks to pinna length in millimeters was analyzed by simple linear regression. Correlation of fetal ear length measurements with gestational age, biparietal diameter and head circumference were also obtained. Linear relationships were found between fetal pinna length and gestational age [Pinna Length (mm)=1.044xGestational age (weeks) -3.857]. A nomogram of normal pinna length was obtained. High correlation was found between pinna length and gestational age (r=0.942; p less than 0.001), pinna length and head circumference (r=0.931; p less than 0.001). Significant correlation was found between pinna length and biparietal diameter (r=0.934; p=0.004) The results of this study provide a nomogram for fetal pinna. The study also provides relationship and good correlation between pinna length and other biometric measurements.

Original article: Study of congenital anomalies of pinna and the ecological influence on it's development.

Pinna is present in mammals only and not found in any other living species. Various congenital anomalies of Human pinna often mimic the appearance of normal pinna of many mammals of lower order. Ecology has been observed to play a role in the development of pinna. Anomalous pinna though frustrating for both patients and clinicians, are mostly amenable to treatment.

The effect of head rotations on vertical plane sound localization.

Current understanding gives predominant weight to stationary cues for auditory localization. Two experiments were conducted to investigate the possible existence of a dynamic cue. The first experiment involved localization of concealed sources in the upper median vertical plane (MVP) and showed, as expected, that elevation was not detectable with motionless listening when high-frequency energy was absent or when normal pinna function was distorted. Elevation under such conditions did become detectable with horizontal head rotations, provided low-frequency energy was present in the signal. This indicates that the basis of the dynamic cue is variation in the rate of transformation of low-frequency interaural time/phase differences. The second experiment involved localization of sources arrayed throughout upper and lower regions of the MVP and in the left lateral vertical plane (LVP); it showed that upper hemisphere sources can be distinguished somewhat from those in the lower hemisphere, even in motionless listening conditions, but more so with rotation. The greatest benefit for localization from rotation of the head appears to be gained for sources positioned in the front MVP.

Sphaerostephanos (Thelypteridaceae) in Asia, excluding Malesia

Sphaerostephanos J. Sm. (in Hook., Gen. Fil. t. 24, 1839) was based on a single species characterized by elongate sori, the structure of which was incorrectly observed, as subsequently noted by its author who later admitted that it is 'scarcely distinct from Nephrodium' (Hist. Fil.: 210, 1875) in which genus, as N. javanicum, it was placed by Hooker (Spec. Fil. 4: 67, 1862). Most subsequent authors, however, maintained it (or its substitute Mesochlaena R. Br.) as a genus solely distinct in its elongate sori; as so constituted it is a mixture of species not closely allied nor sharply distinct from species with circular sori. When I proposed a new system of genera in the family Thelypteridaceae in 1971 (Blumea 19: 39) I found that Sphaerostephanos was the oldest generic name for a large group of mainly Malesian species, most of them with sori not elongate, and re-defined it accordingly. The 17 species in the Pacific were described in 1977 (Allertonia 1, No. 3); the c. 160 species in Malesia will be dealt with in a forthcoming issue of Flora Malesiana Series II; the present paper is concerned with the 13 species of Asia excluding Malesia, six of which are also Malesian in distribution. Nearly all species are plants of forest with erect or short-creeping caudex, and most are of restricted distribution; an exception is the widelydistributed S. unitus which grows in open places and has a long-creeping caudex. A character of almost all species is the presence of small sessile spherical yellow glands which in S. arbuscula occur on both surfaces of pinnae and on indusia and sporangia (Plates 9 & 10). In Malesia a series of species can be traced showing gradual loss of these glands, and there is a considerable minority in which no glands occur, though in other ways they appear to belong to the genus. In mainland Asia S. hirtisorus belongs to this group and appears to be closely allied to the widely-distributed S. invisus (Forst. f.) Holttum of Eastern Malesia and the Pacific. The most distinctive field-character of the genus, which it shares with Pneumatopteris, is the presence of much-reduced basal pinnae, usually with a sharp transition from normal to reduced. The number, size and shape of these reduced pinnae, and the shape of lower normal pinnae, provide important diagnostic characters. Old herbarium specimens often lack the base of fronds, and early authors failed to recognize the distinctive characters of lower pinnae, often also ignoring the presence of glands. This led to

Pinna Anomalies Associated With Congenital Conductive Hearing Loss

This paper compares the normal pinna with the abnormal congenitally malformed pinna. Then the abnormal pinna is related to case histories where a hearing loss was found due to a congenital malformation of the middle ear ossicles. Careful examination of the pinna, therefore, may be a simple diagnostic sign of an underlying potentially surgically correctable hearing loss. An abnormal pinna is more often associated with a middle ear anomaly than with any other congenital malformation including a urinary tract anomaly.

External auditory atresia and the deleted chromosome.

AbstractFour patients presented with suspected hearing loss and growth and motor retardation. Hearing loss was confirmed, and in three patients was conductive in nature, associated with bilateral atresia or hypoplasia of the bony external auditory canal and essentially normal pinnae. One patient had normal ear canals and mixed hearing loss. The patients had a variety of somewhat subtle associated defects. These included epicanthic folds, strabismus, microcephaly, hypertelorism, hypoplasia of the mid‐face, carpshaped mouth, short stature, foot anomalies, congenital heart disease and absent IgA. Chromosome analysis showed deletion of the long arm or a ring formation of chromosome 18, which defects are potentially transmissible to the next generation. Petrous pyramid polytomography showed atresia plates in the region of the tympanic membrane in the three patients with abnormal external auditory canals. The middle ears appeared normal. Polytomography was entirely normal in the fourth patient with patent canals and a mixed hearing loss.The patient with “isolated” auditory atresia, retardation, relatively minor facial abnormalities and either previously surgically corrected or previously undetected other abnormalities (e.g., congenital heart disease, club foot), should be suspect for this disorder. The diagnosis is confirmed by karyotype. Complete workup also includes audiometry and petrous pyramid polytomography. Karyotypes should be performed on the parents to rule out a balanced translocation. Otologic management is basically the same as that in other children with external auditory atresia, but may be contingent on the control of other health problems.

Destruction of the pinnae of white mice by high intensity air-borne sound.

The pinnae of white mice, when exposed to high intensity airborne sound waves, exhibit an immediate inflammation followed by degeneration. Treated pinnae were compared histologically with normal pinnae, with pinnae treated with high temperatures, and with pinnae of mice which were depilated around the ears and treated with sound so that no heat could be produced by absorption of sound in the fur. The results showed that the major factor in destruction of the pinnae is heating in the fur, but some of the effects produced by sound are probably the results of mechanical agitation or a combination of heating and mechanical agitation.

Destruction of the Pinnae of White Mice by High Intensity Air-Borne Sound

The pinnae of white mice, when exposed to high intensity airborne sound waves, exhibit an immediate inflammation followed by degeneration. Treated pinnae were compared histologically with normal pinnae, with pinnae treated with high temperatures, and with pinnae of mice which were depilated around the ears and treated with sound so that no heat could be produced by absorption of sound in the fur. The results showed that the major factor in destruction of the pinnae is heating in the fur, but some of the effects produced by sound are probably the results of mechanical agitation or a combination of heating and mechanical agitation.