(1984) Nonsurgical correction of congenital auricular deformities in the early neonate: a preliminary report. Hong P (2012) Reconstruction of congenital inverted conchal bowl deformity: Our experience in two of four children. CONGENITAL DEFORMITIES OF EXTERNAL EAR 10. The cohort consisted of 10 new-borns who presented with congenital convex concha at our clinic in 2018-2019. ©2020 Olshinka A. Osmani OA, Matthews R (2016) An original technique for the correction of congenital inverted conchal bowl deformity in an adult. To improve the appearance, the crus of the helix is advanced out of the concha and into the helical rim, as in the Antia-Buch procedure, and standard otoplasty techniques are used in addition. Subjects and methods: The cohort included 10 new-borns treated for congenital convex concha in 2018-2019. Tan ST, Abramson DL, MacDonald DM, Mulliken JB (1997) Molding therapy for infants with deformational auricular anomalies. The conchal crus is an abnormal fold of cartilage crossing the mid portion of the concha cymba essentially dividing the ear in half. Although the anterior scar is rarely visible after an anterior approach, the surface of the anterior cavum concha became rough. The size selected (medium or large) was based on the size of the auricle. The aim of the present report was to describe the deformity and the use of the novel non-invasive treatment protocol for its management. If this time window has passed, then surgical excision of the conchal bulge can give good results in the adult. The convex- concha deformity is an unfamiliar deformation, which is not only aesthetic but may also interrupt with hearing and usage of hearing-aids. Plast Reconstr Surg. The aim of the present report was to describe the deformity and the use of the novel non-invasive treatment protocol for its management. Most of the auricular deformities such as prominent ear, lop ear, and Stahl’s ear include helix and antihelix anomalies. Most auricular deformities involve the helix and the antihelix (Stahl's bar, lop and prominent ear); an isolated conchal deformity is uncommon in an otherwise normal ear.6 We present two such cases and their treatment. If diagnosed early, the majority of ear deformations can be treated conservatively [3,5] by molding or splinting, with satisfactory results [6]. The system consists of four interlocking components: a large posterior shell that fits around the ear and is held to the scalp with adhesive tape; a conchal former that shapes the conchal bowl of the ear; small soft rubber retractors that gently shape the ear to the desired position; and a snap-on outer lid of soft breathable rubber that holds the components securely in place. Otorhinolaryngol Head Neck Surg 5: doi: 10.15761/OHNS.1000229. Whereas malformations can be amended only surgically, deformations, if diagnosed early, are correctable non-surgically, with molding/splinting techniques. Question mark ear (Cosman ear) deformity, a rare congenital malformation, is characterized by a cleft between the helix and the ear lobe and marked prominence of the auricles. Figure 3. Accepted date: February 25, 2020 Most of the auricular deformities such as prominent ear, lop ear, and Stahl’s ear include helix and antihelix anomalies. Concha bullosa is best diagnosed with a CT scan and is estimated to be found in 16 to 53 out of 100 cases. Mean duration of treatment by age (in weeks) at application. 3. Treatment with the EarWell® system was continued until an appropriate conchal concavity was reached. Therefore, it is important that it be addressed particular attention. PMID: 8559828 [Indexed for MEDLINE] Publication Types: Case Reports; MeSH terms. Figure 4. Check out;SnapChat; teddieandzombieInstagrams;_carys_is_a_unicorn_Twitter; @CarysPrice7TikTok; @carysprice54 Among the conchal anomalies, the most abundantly described is conchal crus malformation, which is characterized by an abnormal fold of cartilage that crosses through the center of the conchal bowl. Most auricular deformities involve the helix and the antihelix (Stahl's bar, lop and prominent ear); an isolated conchal deformity is uncommon in an otherwise normal ear. When improvement was delayed beyond 2 weeks of treatment, treatment was continued for an additional 2 weeks after which the EarWell® was replaced with silicone molding (Figure 4) for 1-2 weeks (Figure 5) followed by posterior taping for an additional 2 weeks. All rights reserved. The average duration of treatment was 5.2 weeks. Furnas DW (1999) Nonsurgical treatment of auricular deformities in neonates and infants. Conchal crus ear deformity is when there is there is an abnormal extra fold of cartilage crossing through the middle of the ear. Many tend to have ear deformities without even knowing. Right ear before and after treatment of a convex concha deformation, Figure 7. Figure 2. (2012) Neonatal molding in deformational auricular anomalies. This article gives us the opportunity to better understand the effectiveness of nonsurgical options for the treatment of ear anomalies in young patients (5–14 years). The cases need to be referred for treatment as soon as possible in order to spare patients unnecessary invasive procedures and ease parental anxiety [10]. Board certified plastic surgeon Dr. Shareef Jandali specializes in non-surgical correction of newborn ear deformities with ear molding. Ullmann Y, Blazer S, Ramon Y, Blumenfeld I, Peled IJ (2002) Early nonsurgical correction of congenital auricular deformities. Our ears in a way defines our face. Newsletter. These can be corrected simultaneously with the EarWell® system. However, if there is an enlarged concha, it can force the outer ear away from the scalp. However, concha bullosa typically doesn’t cause ear and jaw pain, mucus drainage, or other associated symptoms. The concha is large with poorly developed antihelix and scapha. Menu Menu Location (917) 708-0018 Contact . The anteverted concha causes not only aesthetic but also functional problems. Ear deformities are not paid much heed to. This 2 week old infant shows a Helical Rim & Conchal Crus Deformity, during their initial visit and after 7 weeks of ear molding treatment. Although some authors claim conservative means may be applied up to age 3 months [17], it is known that estrogen is responsible for the malleability and plasticity of the auricular cartilage through increased levels of hyaluronic acid, and that hyaluronic acid levels peak within 72 hours from birth, followed a gradual decrease to baseline 4 days later. A gross ear deformity is created by the total resection of the conchal cartilage. Case report 1 A 3 month old baby boy presented with a normal left ear and an anteverted concha of the right ear (Figure 1). It’s important ear cancer is caught early. Convex concha treatment algorithm. It may be unilateral or bilateral. While deformation is characterized by fully developed auricular components (full pinna) and can be manually corrected into normal shape; malformations are due to abnormal embryologic development of the auricle and may affect the inner or outer ear (missing or excess anatomic structures, otherwise anomalous pinna) [2]. To our opinion, this should be categorized as an anatomical variant rather than an anomaly because it has only aesthetic consequences. All were treated with the EarWell® system within the first 3 weeks of life (Figure 6); the average patient age at treatment initiation was 2 weeks (Figure 6). When a convexity rather than a concavity of the concha is present, it can be defined as “anteverted concha”. In the inverted concha deformity (ICD), the conchal cartilage has an anterior convexity rather than a concavity. We present two such cases and their treatment. This 2 week old infant shows a Helical Rim & Conchal Crus Deformity, during their initial visit and after 7 weeks of ear molding treatment. What structures develop from the three hillocks of the second branchial arch? Closure of Our Dental Department . The conchal crus is an abnormal fold of cartilage crossing the mid portion of the concha cymba essentially dividing the ear in half. Shetty SC, Gupta S, Hasan S, Cherian M, Joseph V, et al. Subjects and methods: The cohort included 10 new-borns treated for congenital convex concha in 2018-2019. OA Text’s journals are led by prominent researchers, each embracing the concept that basic knowledge can foster sustainable solutions for society. The convex- concha deformity is an unfamiliar deformation, which is not only aesthetic but may also interrupt with hearing and usage of hearing-aids. Dr. Jones can use revision otoplasty to restore the conchal contour or perform a conchal reduction. But isolated concha anomaly is a very rare condition. Congenital convex concha is one of the less common cartilaginous auricular framework deformities [11], especially as an isolated anomaly [6] (Figure 1). Byrd HS, Langevin CJ, Ghidoni LA (2010) Ear molding in newborn infants with auricular deformities, Daniali LN, Rezzadeh K, Shell C, Travato M, Ha R, et al. 1989 Apr;83(4):641-54. Silicone mold applied at the second stage on the right ear, Figure 5. Surgery is associated with higher rates of complications and recurrence than conservative treatment and higher costs [19]. In contrast, convex concha deformation, besides its aesthetic repercussions, may also result in functional impairments due to auditory canal stenosis and interfere with the use of hearing aids owing to its location [12,13].