congenital ear anomalies

  • 文章类型: Case Reports
    2号染色体短臂上p11.2区域的染色体异常与发育迟缓有关,智力残疾,面部异常,耳朵异常,骨骼和生殖器畸形。在这里,我们描述了在p11.2-p12区域的2号染色体短臂上有从头间质杂合微缺失的患者。他表现出面部畸形,其特征是鼻子的根部宽且低,耳朵突出。随访期间的临床检查显示先天性摆动性眼球震颤,视力下降和精神运动发育障碍,包括智力障碍。通过阵列CGH(比较基因组杂交)分析表征杂合5Mb微缺失。在过去的二十年里,已经通过阵列CGH分析确定了9例该区域微缺失的患者,并在文献中进行了报道.所有这些患者均表现为精神运动发育障碍和外耳和/或内耳异常。此外,大多数患者患有轻度至重度智力残疾,并表现出面部畸形。我们使用基因/基因座名称作为搜索词回顾了PubMed和OMIM的文献,试图确定位于杂合微缺失内的基因与患者临床表型之间的相关性。为了定义2p11.2p12微缺失综合征的可识别表型。我们讨论了并非所有患者都系统存在的其他症状,并导致这种微缺失综合征的异质性临床表现。
    Chromosomal abnormalities on the short arm of chromosome 2 in the region p11.2 have been associated with developmental delay, intellectual disability, facial anomalies, abnormal ears, skeletal and genital malformations. Here we describe a patient with a de novo interstitial heterozygous microdeletion on the short arm of chromosome 2 in the region p11.2-p12. He presents with facial dysmorphism characterized by a broad and low root of the nose and low-set protruding ears. Clinical examinations during follow-up visits revealed congenital pendular nystagmus, decreased visual acuity and psychomotor development disorder including intellectual disability. The heterozygous 5 Mb-microdeletion was characterized by an array CGH (Comparative Genomic Hybridization) analysis. In the past two decades, nine patients with microdeletions in this region have been identified by array CGH analysis and were reported in the literature. All these patients show psychomotor development disorder and outer and/or inner ear anomalies. In addition, most of the patients have mild to severe intellectual disability and show facial malformations. We reviewed the literature on PubMed and OMIM using the gene/loci names as search terms in an attempt to identify correlations between genes located within the heterozygous microdeletion and the clinical phenotype of the patient, in order to define a recognizable phenotype for the 2p11.2p12 microdeletion syndrome. We discuss additional symptoms that are not systematically present in all patients and contribute to a heterogeneous clinical presentation of this microdeletion syndrome.
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  • 文章类型: Journal Article
    背景:耳部成型是一种安全的,非手术方法治疗新生儿先天性耳畸形。在这项研究中,我们旨在调查耳成型治疗的长期美学结果和看护者满意度。
    方法:2018年至2020年对在我们机构接受耳部成型治疗的婴儿进行了回顾性图表审查。收集患者人口统计学和治疗相关变量。对看守者的经历进行了调查,期望,以及治疗后1年(短期)和3年(长期)的美学结果。独立医师评估治疗效果。反应转换为李克特量表(1-5),5代表最理想的。
    结果:总体而言,42例患者中有38例(90%)参加了我们的长期研究,共62耳。平均随访时间为治疗完成后3.31±0.50年。治疗时的平均年龄为23.2±19.7天,平均治疗持续时间为21.7±7.7天。看护者对耳廓外观的满意度仍然很高(短期:4.18vs.长期:4.17,p=0.54),预期的社会痛苦随着时间的推移而减少。医生的美学评价在“有点有效”和“非常有效”之间是有利的,并且随着时间的推移保持一致(短期:3.46vs.长期:3.31,p=0.31)。此外,对于畸形(p=0.04)和在30日龄开始治疗的儿童(p=0.04),医师对畸形的评价较高.
    结论:长期随访后,看护者对耳部成型治疗的满意度仍然很高,和社会的痛苦从他们的孩子的耳朵的感知减少随着时间的推移。医生的美学评级证实了疗效,在畸形中观察到比在畸形中更好的结果。
    方法:本期刊要求作者为每篇文章分配一定程度的证据。对于这些循证医学评级的完整描述,请参阅目录或在线作者说明www。springer.com/00266.
    BACKGROUND: Ear molding is a safe, non-surgical approach to treat newborns with congenital ear anomalies. In this study, we aimed to investigate long-term aesthetic outcomes and caretaker satisfaction from ear molding therapy.
    METHODS: A retrospective chart review from 2018 to 2020 was conducted for infants who underwent ear molding treatment at our institution. Patient demographics and treatment related variables were collected. Caretakers were surveyed regarding their experience, expectations, and aesthetic outcome at 1 year (short-term) and 3 years (long-term) from treatment. Independent physicians evaluated treatment efficacy. Responses were converted to a Likert scale (1-5), with 5 representing most desirable.
    RESULTS: Overall, 38 of 42 patients participated in our long-term study (90%) for a total of 62 ears. Average follow-up was 3.31 ± 0.50 years after completion of treatment. Mean age at treatment was 23.2 ± 19.7 days with a mean treatment duration of 21.7 ± 7.7 days. Caretakers\' satisfaction regarding auricular appearance remained high (short-term: 4.18 vs. long-term: 4.17, p = 0.54) and anticipated social distress decreased over time. Physician aesthetic evaluations were favorable between \"somewhat effective\" and \"very effective\" and remained consistent over time (short term: 3.46 vs. long-term: 3.31, p = 0.31). Furthermore, physician evaluations were higher for deformations than malformations (p = 0.04) and in children who began treatment by 30 days old (p = 0.04).
    CONCLUSIONS: Caretaker satisfaction from ear molding therapy remained high after long-term follow up, and social distress from the perception of their child\'s ears decreased with time. Physician aesthetic ratings confirmed efficacy, with better outcomes seen in deformations than in malformations.
    METHODS: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
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  • 文章类型: Journal Article
    在这项研究中,我们的目的是分析先天性中耳畸形患者中耳手术的听力测量结果。
    在这项单中心回顾性队列研究中,从患者档案中提取听力学结果.包括2015年6月至2020年12月在三级转诊中心手术治疗的先天性中耳异常患者。比较术前和术后短期和长期听力测量数据(分别为≥3和≥10个月)以分析听力结果。
    18耳(15例患者)采用鼓室探查切开术进行手术治疗。在短期随访中,发现空气传导阈值和空气-骨间隙有统计学上的显着改善。94.4%(17/18)的手术耳朵听力得到改善。成功的结果,定义为手术后20dB以内的空气-骨间隙闭合,达到44.4%(8/18)。在55.6%(10/18)达到了可用的听力(空气传导≤30dB)。1例患者出现阴性结果(听力显着恶化):在该耳中耳炎中,发生在术后过程中。在长期随访中,可用于50%的队列,5耳听力保持稳定,1耳改善,3耳恶化,均接受翻修手术。手术引起的感觉神经性听力损失,或其他并发症,没有遇到。
    中耳手术被发现是改善先天性中耳异常患者听力的有效治疗选择。大多数患者都达到了获得空气传导阈值和可用听力水平的手术目标,而没有发生任何医源性感觉神经性听力损失。
    UNASSIGNED: In this study, we aim to analyze audiometric outcomes of middle ear surgery in patients with congenital middle ear anomalies.
    UNASSIGNED: In this single center retrospective cohort study, audiological outcomes were extracted from patient files. Patients with a congenital middle ear anomaly treated surgically in a tertiary referral center between June 2015 and December 2020 were included. Pre- and postoperative short- and long-term audiometric data (at ≥3 and ≥10 months respectively) were compared to analyze hearing outcomes.
    UNASSIGNED: Eighteen ears (15 patients) were treated surgically with an exploratory tympanotomy. At short term follow up statistically significant improvements in air conduction thresholds and air-bone gaps were found. Hearing improved in 94.4% (17/18) of operated ears. Successful outcome, defined as an air-bone gap closure to within 20 dB after surgery, was reached in 44.4% (8/18). Serviceable hearing (air conduction ≤30 dB) was reached in 55.6% (10/18). Negative outcome (any significant deterioration in hearing) occurred in 1 patient: in this ear otitis media occurred during the postoperative course. At long term follow up, available for 50% of the cohort, hearing remained stable in 5 ears, improved in 1 ear and deteriorated in 3, all of which underwent revision surgery. Sensorineural hearing loss due to surgery, or other complications, were not encountered.
    UNASSIGNED: middle ear surgery was found to be an effective treatment option to improve hearing in this cohort of patients with congenital middle ear anomalies. Surgical goals of obtained gain in air conduction thresholds and serviceable hearing levels were met by most patients without the occurrence of any iatrogenic sensorineural hearing loss.
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  • 文章类型: Evaluation Study
    OBJECTIVE: Describe anatomical and radiological findings in 742 patients evaluated for congenital aural atresia and microtia by a multidisciplinary team. Develop a new classification method to enhance multidisciplinary communication regarding patients with congenital aural atresia and microtia.
    METHODS: Retrospective chart review with descriptive analysis of findings arising from the evaluation of patients with congenital atresia and microtia between January 2008 and January 2012 at a multidisciplinary tertiary referral center.
    RESULTS: We developed a classification method based on the acronym HEAR MAPS (Hearing, Ear [microtia], Atresia grade, Remnant earlobe, Mandible development, Asymmetry of soft tissue, Paralysis of the facial nerve and Syndromes). We used this method to evaluate 742 consecutive congenital atresia and microtia patients between 2008 and January of 2012. Grade 3 microtia was the most common external ear malformation (76%). Pre-operative Jahrsdoerfer scale was 9 (19%), 8 (39%), 7 (19%), and 6 or less (22%). Twenty three percent of patients had varying degrees of hypoplasia of the mandible. Less than 10% of patients had an identified associated syndrome.
    CONCLUSIONS: Patients with congenital aural atresia and microtia often require the intervention of audiology, otology, plastic surgery, craniofacial surgery and speech and language professionals to achieve optimal functional and esthetic reconstruction. Good communication between these disciplines is essential for coordination of care. We describe our use of a new classification method that efficiently describes the physical and radiologic findings in microtia/atresia patients to improve communication amongst care providers.
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