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Nonsurgical Creation of an Auriculocephalic Sulcus in Children With Congenital Auricular Deformities
Hitomi Matsutani1,2, Susam Park1, Yohei Ishikawa1
1Department of Plastic Surgery, Shizuoka Children's Hospital, Shizuoka.
Insights
Early ear molding significantly improves nonsurgical correction of congenital auricular deformities, especially for the auriculocephalic sulcus. Treatment before 6 months of age is recommended for optimal outcomes in cases of cryptotia and certain constricted ears.
Area of Science:
- Plastic Surgery
- Pediatric Otolaryngology
- Medical Device Technology
Background:
- Congenital auricular deformities impact aesthetics and function, affecting glasses/mask wear.
- The auriculocephalic sulcus is a crucial structure for proper ear contour.
- Nonsurgical correction is effective in newborns, but factors influencing outcomes require investigation.
Purpose of the Study:
- To identify factors influencing the success of nonsurgical and surgical correction of the auriculocephalic sulcus.
- To evaluate the efficacy of ear molding for specific auricular deformities like cryptotia and constricted ears.
- To determine the optimal age for initiating ear molding treatment.
Main Methods:
- Retrospective chart review of 80 ears (63 children) treated between October 2010 and September 2019.
- Utilized ear splinting with a metallic paper clip and thermoplastic resin.
- Compared clinical characteristics, deformity types (cryptotia crus involvement, Tanzer classification), and treatment outcomes (nonsurgical vs. surgical).
Main Results:
- A significant correlation was found between the age of treatment initiation and outcome (P < 0.001).
- Optimal age for initiating ear molding treatment was identified as before 7 months.
- Inferior crus cryptotia responded well to splinting; however, all Tanzer group IIB constricted ears required surgery.
Conclusions:
- Nonsurgical ear molding is effective for creating the auriculocephalic sulcus in ears with cryptotia and Tanzer group IIA constricted ears.
- Earlier intervention, preferably before 6 months of age, is recommended for better nonsurgical outcomes.
- Nonsurgical methods cannot correct inadequate skin or antihelix defects.
Abstract:
Nonsurgical correction of congenital auricular deformity is known to be effective in newborns. In this study, the authors investigated factors influencing the outcome of nonsurgical or surgical correction of the auriculocephalic sulcus, an important auricular structure and one that is necessary for wearing glasses or a mask. A total of 80 ears (63 children) were splinted using a metallic paper clip and thermoplastic resin in our outpatient clinic between October 2010 and September 2019. The ears were divided into a group, in which the auriculocephalic sulcus was formed nonsurgically (n =5 6) and a group, in which surgery was needed (n = 24). The authors compared the clinical characteristics of the deformities, whether cryptotia affected the superior or inferior crus, and whether constricted ears were Tanzer group IIA or IIB between the two study groups by retrospective chart review. There was a significant correlation between the age, at which ear-molding treatment was initiated and outcome ( P < 0.001). The optimal cutoff value for age, before which ear-molding treatment should be initiated was 7 months. Inferior crus-type cryptotia was corrected adequately by splinting, but all Tanzer group IIB constricted ears needed surgical treatment. Earlier initiation of ear-molding treatment is recommended, preferably before 6 months of age. Nonsurgical treatment is an effective intervention for the creation of the auriculocephalic sulcus in ears with cryptotia and Tanzer group IIA constricted ears but cannot correct for an inadequate amount of skin over the auricular margin or a defect in the antihelix.
