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PubMed · 9046617

Otoplasty techniques.

P A Adamson·H D Strecker
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Abstract

Otoplasty has undergone a number of important developments over the course of the past 150 years. While cartilage-incision techniques were favored earlier in the century, suture-only techniques are now favored. Prominauris, a condition that affects 5% of the Caucasian population, is inherited as an autosomal dominant trait. Protruding ears commonly are due to a combination of two defects: under-development of antihelical folding, and overdevelopment of the conchal wall. Utilizing a graduated approach, consistently superior results can be obtained. Our approach includes: fusiform skin excision; concha-mastoid sutures; scapha-conchal sutures; and refinement of the scapha, helix, and lobe. The aesthetic results are well retained and significant complications are rare.

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CicatrixEar Deformities, AcquiredEar, ExternalEstheticsHistory, 19th CenturyHistory, 20th CenturyHumansSurgery, PlasticSurgical Wound InfectionHistorical ArticleJournal Article

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BibTeXRIS

P A Adamson, H D Strecker. 1995. Otoplasty techniques.. https://doi.org/10.1055/s-2008-1064545

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We aimed to investigate, by means of dimercaptosuccinic acid (DMSA) scan, the relations between vesicoureteral reflux (VUR) and its degree, pyelonephritis during infancy, and renal parenchymal findings. Seventy-four infants with pyelonephritis, 44 girls and 30 boys (mean age at their first pyelonephritic episode 4.12 months, median 3 months), were enrolled in the study. Voiding cystourethrography (VCU) and ultrasonography (US) were performed within 6 weeks following the infection. DMSA was performed at least 4 months after the urinary tract infection (UTI). The renal parenchymal pathology was defined as focal or multifocal defects or as a split renal uptake of less than 45%. DMSA scintigraphy revealed that 19% (14/74) of the children had renal damage. Renal parenchymal findings were observed only when VUR was present, and its grade was above 3/5. No abnormality was found in 51 renal units without reflux, 9 with VUR grade 1/5, and 54 with grade 2/5. Renal pathology was observed in 9/24 renal units with VUR grade 3, 3/8 with grade 4, and 2/2 with grade 5. No correlation was found between renal parenchymal defects and clinical presentation of the pyelonephritis, type of the microorganism, presence of bacteremia, or the number of recurrent infections. In adequately treated infants, renal damage is probably due to a reflux-associated, preexisting, congenital renal parenchymal pathology and not to the inflammatory process. We suggest that DMSA scintigraphy should not be performed routinely in every infant with UTI and should be reserved primarily for children with VUR grade 3 and above.

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