Indian Journal of Dental Research

TECHNICAL NOTE
Year
: 2015  |  Volume : 26  |  Issue : 2  |  Page : 220--221

A simple ear splint for microtia patients


CJ Venkata Krishnan1, SM Balaji2, Ashish R Jain3,  
1 Research Scholar, Bharath University, Consultant, Balaji Dental and Craniofacial Hospital, Chennai, Tamil Nadu, India
2 Director, Balaji Dental and Craniofacial Hospital, Chennai, Tamil Nadu, India
3 Consultant, Balaji Dental and Craniofacial Hospital, Chennai, Tamil Nadu, India

Correspondence Address:
Prof. C J Venkata Krishnan
Research Scholar, Bharath University, Consultant, Balaji Dental and Craniofacial Hospital, Chennai, Tamil Nadu
India

Abstract

Microtia is a congenital anomaly of the ear can occur as an isolated birth defect or as part of a spectrum of anomalies or as a syndrome. Microtia is often associated with impaired hearing and or total loss of hearing. Such patients typically require treatment for surgical ear reconstruction and for hearing impairment. Maintenance of ear projection and post auricular sulcus in staged ear reconstruction in microtia is a trying problem. So also is the maintenance of the patency of the external auditory meatus following recanalization and meatoplasty.This case report describes a simple effective way of fabrication of ear splint prosthesis.



How to cite this article:
Venkata Krishnan C J, Balaji S M, Jain AR. A simple ear splint for microtia patients.Indian J Dent Res 2015;26:220-221


How to cite this URL:
Venkata Krishnan C J, Balaji S M, Jain AR. A simple ear splint for microtia patients. Indian J Dent Res [serial online] 2015 [cited 2020 Dec 1 ];26:220-221
Available from: https://www.ijdr.in/text.asp?2015/26/2/220/159177


Full Text

Correction of the Microtia is one the complex facial esthetic treatment. Microtia is a spectrum of external ear deformities that spreads from a gross miniature ear to complete absence of the auricle. There are several methods to classify the disorder, and so are the surgical methods to correct the deformity. [1],[2] Of all such procedures, a staged reconstruction of the auricle with grafts and flaps is the most daunting procedure. [1] The requirement of the maintenance of the ear projection in the initial phases and the preservation of the postauricular sulcus from re-epithelization, causing obliteration of the vestibule in cases of ear reconstruction in microtia is a known problem. [3]

In a reconstructed ear, the shallow retro-auricular sulcus fails to retain stable dressings. Application of inappropriate, excessive pressure is detrimental as it compresses an already shallow sulcus. During the initial phases of healing, it is vital to keep the sulcus depth, so as to keep the projection of the auricle in its desired position. The primary objective of such stents is to prevent the physical re-epithelization and thereby the obliteration of the sulcus. Secondarily, the splint would need to counteract the contracting forces of the skin-graft. When the skin flap stabilizes, more rigid stent can be applied. [4]

Numerous splints and ear guards have been described in the literature with each having its own merit and demerit. Several methods that utilize rubber tubes, silicon splints, Foley's catheter and dressings have been reported in the literature. [4]

Several of these designs are limited owing to the ease of availability of the materials, economic, difficulty in compliance, expertise in fabrication and the necessity to replace daily under medical supervision. Besides these, few splints are bulkier and cumbersome wearing of which is relatively difficult. [3]

We have added a new type of splint which limits the disadvantages and enhances the advantages of the ear splints.

This is heat-cure acrylic resin based splintPost-surgically a moulage hydrocolloid impression of the reconstructed auricle is made as atraumatic as possibleStudy models are prepared using dental stoneUsing an 18 Gauge Stainless Steel wire, a coil with retentive loop is made extending from the dorsal to the ventral surface of the reconstructed ear [Figure 1]{Figure 1}Acrylic resin pads cover the retentive loops, and a "C-shaped" resin tag is adapted along the surgical site which prevents reattachment until epithelization occurs [Figure 2] and [Figure 3].{Figure 2}{Figure 3}

The advantages of this novel splint are (a) esthetically acceptable as the extrinsic stains are added to acrylic in get a close match to patients skin tone, (b) loops can be adjusted for better retentiveness, (c) small, compact and easy to clean and disinfect, (d) reduced number of postoperative visits.

References

1Wong W. Microtia-How i do it? Hong Kong Med Diary 2009;14:5-7.
2Khondoker MS, Awwal R, Sarker MM, Khundkar SH. Microtia reconstruction: Our experiences of first 10 cases in Bangladesh. Bangladesh J Plast Surg 2010;1:14-9.
3Karanth SK, Mokal NJ. Silicone Foley′s catheter: A useful splint in ear surgeries. Indian J Plast Surg 2008;41:51-4.
4Puri V, Kare N, Venkateshwaran N. A simple method of applying ear dressing in microtia patients. Indian J Otol 2012;18:154-5.