Enlisting newborn hearing screenersto help identify common ear deformities allows doctors to easily correct thecondition without surgery before a baby leaves the hospital, according to a newstudy by researchers at the Perelman School of Medicine at the University ofPennsylvania. The new study is published onlineahead of print in the International Journal of Pediatric Otorhinolaryngology.
“We’ve known for some time that by simply splinting the earsof newborns with congenital auricular deformities, we’re able to effectivelyreshape the impaired cartilage to prevent the need for future surgery,” saidthe study’s senior author, Oren Friedman, MD, director of Facial Plastic Surgery associate professor ofOtorhinolaryngology: Head and Neck.
“But we need to get to these newbornswithin the first three days after birth. It made perfect sense to enlist thehelp of hearing screeners in this endeavor, as they typically perform anin-hospital exam on babies within 24 to 48 hours. It is an ideal opportunity toidentify these deformities and allow doctors to take action quickly.”
Congenital auricular deformities arebirth defects affecting the shape and position of the ear. The soft cartilagearound the ear and other structures that affect both the function andappearance of the ear may be involved. The incidence of these deformitiesvaries based on the type and between racial and ethnic groups, howeverstudies have found that up to 30 percent of children have some type of eardeformity at birth. If left untreated, some of these deformities can causesignificant functional and social impairment, requiring major surgicalintervention at a future date.
In the new study, newborn hearingscreeners received education on evaluation of congenital auricular deformitiesby a team of otolaryngologists and were provided an easy to use sheet to keepwith them at all times of photos and illustrations of the most common eardeformities. When the newborn hearing screeners identified infants withcongenital auricular deformities during a standard hearing exam, the infant’sprimary care medical team was alerted. The primary care team then notified thefamily that an otolaryngologist would evaluate the infant’s ears.
During the study timeframe, teninfants with 19 affected ears amenable to treatment were treated with a simplesplint. All ears were assessed by physical examination and photographicdocumentation prior to splinting and at follow-up visits. Splinting wasinitiated prior to the infant's discharge from the hospital. All of thepatients exhibited improvement from the original deformity after one to fourweeks of splinting and there were no instances of skin irritation or breakdown.
“In addition to the results fromthis study, this technique has been used with great success for many newbornsat Pennsylvania Hospital in the last year,” said Friedman. “We have employedexcellent screening methods utilizing a multi-disciplinary team of experts atthe busiest birthing hospital in Philadelphia to ensure our patients get thebest possible care.”
Friedman and his co-authors notethat over time, this approach may prove to be a cost-effective, minimalistmethod to manage the vast majority of congenital auricular deformities. It mayalso prove to enhance the psychosocial functioning of children during theformative years, which can improve their life-long well-being.