BACKGROUND: Protruding ears are the most common congenital ear deformity, with a frequency of 13.5%. Since 1845 and the first works of Dieffenbach, over 170 classical surgical methods have been proposed to correct it. We introduced laser-assisted cartilage reshaping (LACR) in 2004 as an alternative to invasive surgical otoplasty. METHODS: Between January 2008 and June 2008, 24 patients underwent LACR for treatment of bilateral ear protrusion. Fourteen adults and ten children were treated (mean age = 16.0 years, range = 6-45 years). No anesthesia was used. Both sides of the entire helix and the concha were irradiated using a 1540-nm laser connected to a 4-mm spot handpiece with integrated cooling. Fluences varying from 70 up to 84 J/cm(2) were applied. Immediately after the irradiation, silicone elastomer was inserted inside the helix to give it the desired shape. After 3 minutes a solid mold was obtained. Patients were asked to keep this mold in place at all times with a bandage wrapped around the head for the first 3 weeks and then for an additional 3 weeks only during the night. A non-steroidal anti-inflammatory drug (NSAID) was prescribed to the patients for 3 days. At 1, 30, 60, and 90 days after the procedure, ears were checked and photographs were taken. Clinical follow-up at 1 year was obtained via direct patient contact or over the telephone. RESULTS: The treatment was well tolerated. No hematomas or skin necrosis occurred. Contact dermatitis was observed in four children and two adults as a result of inappropriate mold design. These patients stopped wearing the mold and the shape of their ear did not improve. For the remaining 18 patients (6 children and 9 adults), the expected ear reshaping was obtained (fluence was 84 J/cm(2)). For three other adults, incomplete reshaping of the ears was observed and can be correlated to a lower fluence (70 J/cm(2)). CONCLUSION: LACR, performed without any anesthesia, is a safe and less morbid approach to surgical otoplasty.
BACKGROUND: Protruding ears are the most common congenital ear deformity, with a frequency of 13.5%. Since 1845 and the first works of Dieffenbach, over 170 classical surgical methods have been proposed to correct it. We introduced laser-assisted cartilage reshaping (LACR) in 2004 as an alternative to invasive surgical otoplasty. METHODS: Between January 2008 and June 2008, 24 patients underwent LACR for treatment of bilateral ear protrusion. Fourteen adults and ten children were treated (mean age = 16.0 years, range = 6-45 years). No anesthesia was used. Both sides of the entire helix and the concha were irradiated using a 1540-nm laser connected to a 4-mm spot handpiece with integrated cooling. Fluences varying from 70 up to 84 J/cm(2) were applied. Immediately after the irradiation, silicone elastomer was inserted inside the helix to give it the desired shape. After 3 minutes a solid mold was obtained. Patients were asked to keep this mold in place at all times with a bandage wrapped around the head for the first 3 weeks and then for an additional 3 weeks only during the night. A non-steroidal anti-inflammatory drug (NSAID) was prescribed to the patients for 3 days. At 1, 30, 60, and 90 days after the procedure, ears were checked and photographs were taken. Clinical follow-up at 1 year was obtained via direct patient contact or over the telephone. RESULTS: The treatment was well tolerated. No hematomas or skin necrosis occurred. Contact dermatitis was observed in four children and two adults as a result of inappropriate mold design. These patients stopped wearing the mold and the shape of their ear did not improve. For the remaining 18 patients (6 children and 9 adults), the expected ear reshaping was obtained (fluence was 84 J/cm(2)). For three other adults, incomplete reshaping of the ears was observed and can be correlated to a lower fluence (70 J/cm(2)). CONCLUSION: LACR, performed without any anesthesia, is a safe and less morbid approach to surgical otoplasty.
Authors: Amy Y Y Yau; Cyrus Manuel; Syed F Hussain; Dmitry E Protsenko; Brian J F Wong Journal: JAMA Facial Plast Surg Date: 2014 Jul-Aug Impact factor: 4.611
Authors: Edward C Kuan; Ashley A Hamamoto; Victor Sun; Tony Nguyen; Cyrus T Manuel; Dmitry E Protsenko; Brian J F Wong; J Stuart Nelson; Wangcun Jia Journal: Lasers Surg Med Date: 2014-11-18 Impact factor: 4.025
Authors: Edward C Wu; Victor Sun; Cyrus T Manuel; Dmitriy E Protsenko; Wangcun Jia; J Stuart Nelson; Brian J F Wong Journal: Lasers Med Sci Date: 2013-01-10 Impact factor: 3.161