RESUMEN
BACKGROUND: "Prominent ear" remains one of the most common referrals to pediatric plastic surgery. The perceived deformity has been corrected using a multitude of techniques for over a century, and significant variation in practice still exists. Recent studies suggesting that cartilage-scoring techniques are associated with more major complications than suture techniques may have led to an adverse international perception of the technique. Thus, waning use of anterior scoring prominent ear correction appears to be occurring. For appropriate cases, the authors have used anterior scoring for over 20 years, with high patient satisfaction and low complication rates. They present a review of all cases and outcomes from 2005 to 2015. The authors believe this is the largest case series of anterior scoring otoplasty published to date. METHODS: All pediatric cases undergoing prominent ear correction from 2005 to 2015 were included in this retrospective case note analysis and follow-up study. Patient demographics, operative details including early and late complications, and postoperative results were analyzed. METHODS: Over a 10-year period, 1199 otoplasties were performed (1134 bilateral, 65 unilateral), for a total of 2333 ear corrections. A total of 1575 ears were corrected using the anterior scoring technique. The remaining cases underwent correction by means of suture only, cartilage reduction, or combination techniques. There was a significantly lower all-cause reoperation rate for anterior scoring compared to suture-only techniques ( P = 0.0039; significant at P < 0.025). There were no reported cases of cartilage necrosis. CONCLUSIONS: This study demonstrates that in appropriately selected patients, anterior scoring otoplasty is a low-morbidity procedure. In the authors' institution, when compared to suture techniques, it was associated with a lower rate of complications and reoperation rate than suture-only techniques. CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, IV.
Asunto(s)
Oído Externo , Satisfacción del Paciente , Humanos , Niño , Estudios de Seguimiento , Estudios Retrospectivos , Oído Externo/cirugía , Técnicas de Sutura , Cartílago Auricular/cirugía , Resultado del TratamientoRESUMEN
The performance of Type I industrial helmets for fall protection is not required to be tested in standardized tests. The current study analyzed the fall protection performance of Type I industrial helmets and evaluated if the use of a chin strap and the suspension system tightness have any effect on protection performance. Head impact tests were performed using an instrumented manikin. There were 12 combinations of test conditions: with or without chin strap usage, three levels of suspension system tightness, and two impact surfaces. Four representative helmet models (two basic and two advanced models) were selected for the study. Impact tests without a helmet under all other applicable test conditions were used as a control group. There were four replicates for each test condition-a total of 192 impact tests with helmets and eight impact tests for the control group. The peak acceleration and the calculated head impact criteria (HIC) were used to evaluate shock absorption performance of the helmets. The results showed that all four helmet models demonstrated excellent performance for fall protection compared to the barehead control group. The fall protection performance of the advanced helmet models was substantially better than the basic helmet models. However, the effects of the use of chin straps and suspension system tightness on the helmets' fall protection performance were statistically not significant.