| Abstract [eng] |
Background: Prominent ears are the most common congenital ear deformity, affecting about 5% of the populations in the Western World. The most common cause of prominent ears is an underdeveloped antihelix or its complete absence. Another reason is a too deep concha cavity (lat. concha cavum), due to which the antihelix is formed irregularly. In most cases, protruding ears are caused by both reasons. Protruding ears usually do not cause any hearing problems, but prominent ears are one of the most common causes of bullying at school, which leads to psychosocial damage, low self-esteem, and social isolation. Corrective surgery for prominent ears is one of the most common cosmetic surgeries performed in pediatrics. Objective: To review the results of conservative and operative treatment of prominent ears. Material and methods: Scientific literature search was performed in Pubmed, ScienceDirect databases. The review includes 8 articles published in 2018 – 2023. The review of the literature on conservative and operative treatment of prominent ears includes specific research descriptive and review articles printed in English. The following keywords were used to search for articles: prominent ears, protruding ears, ear molding, „EarWell”, prominent ear correction. The following data were evaluated: the effect of prominent ears on the child's development (health), children's age at the start of conservative treatment, treatment results (complications, pain after surgery, satisfaction with the results, long-term results), surgery results (complications, quality of life, satisfaction with the result). Results: Early recognition of prominent ears can be followed by the „EarWell” Ear Bonding System. According to different authors, the duration of treatment varies greatly. According to many studies, the ideal time to start the ear molding method is within the first month after birth, according to other authors - up to 6 months of age. When ear taping is started within the first 2 weeks after birth, the treatment is 100% effective and gradually decreases as ear taping is started later. Studies show that the duration of treatment can be from 3 to 6 weeks. For prominent ears, the initial treatment result is very good and reaches 100%, but the successful long-term results were only 66.7%. subjects (p=0.042). Ear plastic can be applied from the age of 5, but according to research data, these operations are usually performed a little later - for children aged 7-10 years. Most often, ear operations are performed under general anesthesia - 70.3%, while local anesthesia is used much less often, and it is applied to older patients. Depending on the number of ears affected, the duration of the operation varies from 75 to 120 minutes for otoplasty for both ears and from 39 to 62 minutes for correcting one ear. Hematomas are the most common early complications (6.4%). Most of the patients and the surgeons who performed the operation were satisfied with the results (97%) and would recommend the operation to others. The most common late complications were keloid and hypertrophic scars, the removal of which required additional surgery. In two studies, there were recurrences of prominent ears (1.3% and 7.4%) requiring reoperation. Conclusions: Very good results can be achieved with a conservative ear taping method, but treatment should be started very early, preferably within the first 4 weeks after birth. The most common complications of conservative treatment are skin rash or redness. Surgical treatment of prominent ears can be performed from the age of 5. The final results are very encouraging, but late complications such as skin hypertrophy, keloid formation or recurrence are common. Keywords: prominent ears, protruding ears, ear molding, „EarWell“, prominent ear correction, otoplasty. |
