[Nonsurgical attachment possibilities for bone conduction hearing aids : Comparison of coupling using external pressure versus an adhesive plate].

Background: Bone conduction hearing systems are used for patients with conductive or combined hearing loss who cannot be adequately treated with air conduction hearing aids or surgery. These hearing systems can be surgically implanted or reversibly attached using bone conduction eyeglasses or a rigid or soft headband. A nonsurgical and pressure-free alternative is fixation via an adhesive plate.

Otoplasty and Auricular Reconstruction.

Due to the variety of abnormalities, surgery of the auricle is one of the most complex challenges in facial plastic surgery. They reach from mild protruding ears or isolated abnormalities of the supporting structures, mainly the helical rim and antihelix, over cup ear deformities and miniears all the way to severe microtia and anotia. In this article, the authors present a short overview of auricular abnormalities and malformations and their treatment options based on their experiences gained over three decades of special service for patients with auricular malformations.

International Consensus Recommendations on Microtia, Aural Atresia and Functional Ear Reconstruction.

The aim of this report is to provide international recommendations for functional ear reconstruction in patients with microtia and aural atresia. All patients with microtia and external auditory atresia should be seen in the setting of a multidisciplinary team and agreed treatment outcomes should be measured, so that techniques, approaches, and results can be compared. The methods are expert opinion from the members of the International Microtia and Atresia Workgroup (IMAW).

Periosteal Flap Technique for Elevation of the Pinna in Microtia.

Importance: For optimal aesthetic construction of the auricle in patients with severe microtia, it is important to construct an exquisite framework and place it in the correct natural position. In addition to its accurate vertical and sagittal positioning, normal elevation is of utmost importance because this determines the auricular width from the common anterior view in interpersonal communication. Many techniques have been described to stabilize the constructed auricle in the elevated position.

Malformation and plastic surgery in childhood.

Malformations of the head and neck show a huge variety of clinical symptoms with functional and esthetic consequences. Often times its rehabilitation requires multi-staged and multi-disciplinary procedures and concepts. These must consider eating, speech, mimic expression, hearing and "esthetics" or at least "normality".

Auricular reconstruction: surgical innovations, training methods, and an attempt for a look forward.

The construction of an auricle from autologous tissue is highly complex and demanding for a reconstructive surgeon. Depending on the characteristics of the underlying malformation, there are various surgical techniques available, which in specialized hands, promise regularly achievable attractive and stable results. To achieve this goal, a long-term training in super specialized centers is required.

Reconstruction of the avulsed auricle after trauma.

Severe auricular trauma is a rare injury. In addition to the type of injury, the location and the extent of the involved auricular structures have an important influence on the selection of an appropriate replantation or reattachment technique. A satisfactory primary reconstruction is not always possible to obtain and the remaining defects must be reconstructed secondary.

A new semi-implantable transcutaneous bone conduction device: clinical, surgical, and audiologic outcomes in patients with congenital ear canal atresia.

Introduction: Patients with air-bone-gaps that cannot be corrected successfully by tympanoplasty or with mixed hearing loss may be treated with bone conducting hearing aids. Their disadvantages are the obvious external fixation components or the biological and psychosocial problems of open implants. We have developed a new partially implantable Bone Conduction Hearing Device (BCHD) without a percutaneous abutment and have been using them clinically for over 6 years.

Sulcus construction in microtia repair: a retrospective comparison of different techniques.

Objective: To compare the auricular projection results across 3 different techniques of sulcus construction in microtia repair (using a temporoparietal fascial flap, a retroauricular fascial flap from the mastoid region, or a superficial muscular aponeurotic system advancement flap).

Methods: All the patients had been photographed at least 3 months after the second stage (construction of the retroauricular sulcus) in auricular reconstruction for microtia. The auricular projection of each patient was measured, and the results of 3 different techniques were compared.

Partially implantable bone conduction hearing aids without a percutaneous abutment (Otomag): technique and preliminary clinical results.

Introduction: Patients with air-bone gaps who cannot be corrected successfully by tympanoplasty or with mixed hearing loss may be treated with bone conduction hearing aids. Their disadvantages are the obvious external fixation components or the biological and psychosocial problems of open implants. We have developed new partially implantable bone conduction hearing aid without a percutaneous abutment and have been using them clinically for 4 years.

Combined reconstruction of congenital auricular atresia and severe microtia.

Objectives: Due to their embryological development, auricular atresia and severe microtia are, in most cases, combined malformations. The aims of this study were firstly to develop a surgical technique for combined esthetic and functional reconstruction with a minimum of operations and secondly to evaluate its results.

Study Design: Prospective clinical evaluation.

Special reconstruction techniques for special circumstances.

Auricular reconstruction is a challenging, mostly multistaged procedure that requires many different techniques. Whereas standard techniques have been developed for the standard severe, third-degree dysplasia, we are often confronted with severely scarred patients due to excess trauma or prior operations. These special situations need a variety of special techniques; some of those are described here to be considered as alternative options.

Reducing the morbidity involved in harvesting autogenous rib cartilage.

Although the use of autogenous cartilage is the gold standard in auricular reconstruction, its main disadvantage is the morbidity due to harvesting the cartilage. This includes postoperative pain, visible scar, and possibly asymmetry and reduced stability of the thorax. To reduce all of these drawbacks, we describe some modifications that reduce pain to a low tolerable level, hide the scar invisibly in the submammary fold in females, and induce regeneration as well reestablish stability of the rib defect.

Basic techniques in autogenous microtia repair.

Although several techniques can be used for microtia repair, some standard procedures have been developed over the past few decades. In specialized centers, these techniques are performed most frequently. They include two to four operative steps using autogenous rib cartilage for the framework and local skin for its tegument.

[Localization of lacrimal drainage system obstruction by diaphanoscopy].

Endonasal dacryocystorhinostomy is the standard treatment for obstruction of the lacrimal drainage system. Localization of the stenosis can be difficult intraoperatively, especially in chronic sclerosing dacryocystitis or re-operations. We present a technique of intraoperative diaphanoscopic localization of the stenosis with the use of a special small light fiber that is inserting through the lacrimal points down to the stenosis.

Fully implantable hearing aids in patients with congenital auricular atresia.

Introduction: Patients with congenital auricular atresia suffer from a conductive hearing loss (HL) with an air-bone gap of 50 to 60 dB. Conventional bone conducting or bone anchored hearing aids are treatment options with several disadvantages and a biophysical limitation of almost no sound attenuation in the skull bone. Surgical construction of the sound conducting apparatus has been performed by others and modified by us into a three-step procedure with in vivo prefabrication of the external ear canal and the tympanic membrane.

Reconstruction of the auricle.

Reconstructive and aesthetic surgery of the auricle is one of the most challenging and diverse tasks in plastic head and neck surgery. Injuries, defects and malformations require multiple different techniques, some of which are standardized, other situations require huge experience and artistic creativity. It is a specialty that will never become monotone.

Correction of the lobule.

Many techniques have been described for the correction of protruding ears. Most of them concentrate on correcting the form and position of auricular cartilage. The lobule is a soft tissue structure.

The modified converse technique in combination with cavum rotation.

We report our experiences in 210 patients with protruding ears who underwent a surgical correction of their deformity using a modified "Converse technique." The technique combines a posterior incomplete cartilage incision with permanent cartilage sutures and a cavum rotation if necessary. The described technique provides a good anterior width and normal relief, with shaped anthelix and crus superior, can be achieved.

Combined reconstruction of congenital auricular atresia and severe microtia.

Objectives: Due to their embryologic developments, auricular atresia and severe microtia are in most cases combined malformations. The aims of this study were to develop a surgical technique for combined esthetic and functional reconstruction with a minimum of operations and to evaluate the results.

Study Design: Prospective clinical evaluation.

Comparison of the efficacy and safety of faropenem daloxate and cefuroxime axetil for the treatment of acute bacterial maxillary sinusitis in adults.

In this multicentre, multinational, comparative, double-blind clinical trial, outpatients with both clinical signs and symptoms and radiographic evidence of acute sinusitis were randomly assigned to receive for 7 days either a twice-daily oral regimen of faropenem daloxate (300 mg) or a twice daily oral regimen of cefuroxime axetil (250 mg). Among 452 patients considered valid for clinical efficacy, faropenem daloxate treatment was found to be statistically equivalent to cefuroxime axetil (89.0% vs.