- Email: [email protected]
Response to the Letter to the Editor regarding “A long-term analysis of auricular position in pediatric patients who underwent post-auricular approaches”
Accepted Manuscript Title: Response to the Letter to the Editor regarding “A Long-Term Analysis of Auricular Position in Pediatric Patients Who Underwent Post-Auricular Approaches” Author: Paul Hong PII: DOI: Reference:
S0165-5876(14)00270-5 http://dx.doi.org/doi:10.1016/j.ijporl.2014.05.002 PEDOT 7121
To appear in:
International Journal of Pediatric Otorhinolaryngology
Received date: Accepted date:
28-4-2014 3-5-2014
Please cite this article as: Paul Hong, Response to the Letter to the Editor regarding “A Long-Term Analysis of Auricular Position in Pediatric Patients Who Underwent Post-Auricular Approaches”, International Journal of Pediatric Otorhinolaryngology http://dx.doi.org/10.1016/j.ijporl.2014.05.002 This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.
ip t
Response to the Letter to the Editor regarding “A Long-Term Analysis of Auricular Position in Pediatric Patients Who Underwent Post-Auricular Approaches”
Paul Hong1,2 M.D. 1
cr
Division of Otolaryngology-Head and Neck Surgery, Department of Surgery, Dalhousie University, Halifax, Nova Scotia, Canada
us
2
an
School of Human Communication Disorders, Dalhousie University, Halifax, Nova Scotia, Canada
Ac ce pt e
d
Dr. Paul Hong IWK Health Centre 5850/5980 University Avenue PO Box 9700 Halifax, Nova Scotia B3K 6R8 Canada Phone: (902) 470-0841 Fax: (902) 470-8929 Email: [email protected]
M
Corresponding author contact information:
Financial Disclosure: None Conflict of Interest: None
Keywords: post-auricular; mastoidectomy; auricular position; and post-operative
1
Page 1 of 3
INTRODUCTION We would like to express our gratitude to Dr. D.H. Lee for his interest in our study [1], and we appreciate his thoughtful comments. We do agree that measuring anterior-
ip t
posterior and vertical position of the auricle after post-auricular approaches would be valuable and interesting. However, as mentioned in our article, these measurements are not
cr
easy to obtain in the clinical setting. Consistent photographs along with computer-aided
us
measurements may be necessary, which was not practical to perform in our pediatric otolaryngology clinic. Further, we are uncertain whether anterior-posterior measurements
an
would be an important dimension to document. That is, there are no studies to indicate that horizontal dimensions or positions of the auricle or their changes are associated with any
M
real significance. On the contrary, lateral protrusion of the auricle has been linked to psychosocial and functional problems [2,3].
d
Changes to the vertical position of the auricle may lead to problems such as ill-
Ac ce pt e
fitting eyeglasses [4]. However, there is no good evidence to support this claim. In our study, none of the patients or their caregivers reported noticing any changes in the appearance of their ears. As well, the patients who wore eyeglasses did not report any changes after their operation, suggesting that the vertical position of the ear was not significantly altered [1].
Although Dr. Lee presented his method of post-auricular wound closure in four
layers to prevent anterior auricular displacement, there is no data or evidence to substantiate this claim. Since our closure technique does not seem to result in significant long-term positional changes in our patients, we are unclear if there are advantages to the four-layer closure technique.
2
Page 2 of 3
Again, Dr. Lee insightfully concluded his letter by stating that the anterior-posterior and vertical position of the auricle is more important than lateral protrusion after postauricular approach. Our conjecture is that all dimensions may be of importance but the
cr
practical and aesthetically valuable dimension to document.
ip t
focus of our study was the lateral prominence of the auricle. We believe that this was a
us
References
1. Hong P, Arseneault T, Makki F. A long-term analysis of auricular position in
an
pediatric patients who underwent post-auricular approaches. Int J Pediatr Otolaryngol 2014;78:471-473.
M
2. McNeil ML, Aiken SJ, Bance M, Leadbetter JR, Hong P. Can otoplasty impact hearing? A prospective randomized controlled study examining the effects of pinna
Ac ce pt e
2013;42:10.
d
position on speech reception and intelligibility. J Otolaryngol Head Neck Surg
3. Hao W, Chorney JM, Bezuhly M, Wilson K, Hong P. Analysis of health-related quality of life outcomes and their predictive factors in pediatric patients who undergo otoplasty. Plast Reconstr Surg 2013;132:811-817.
4. Ali MS. Unilateral secondary (acquired) postmastoidectomy low-set ear: postoperative complication with potential functional and cosmetic implications. J Otolaryngol Head Neck Surg 2009;38:240-245.
3
Page 3 of 3
S0165-5876(14)00270-5 http://dx.doi.org/doi:10.1016/j.ijporl.2014.05.002 PEDOT 7121
To appear in:
International Journal of Pediatric Otorhinolaryngology
Received date: Accepted date:
28-4-2014 3-5-2014
Please cite this article as: Paul Hong, Response to the Letter to the Editor regarding “A Long-Term Analysis of Auricular Position in Pediatric Patients Who Underwent Post-Auricular Approaches”, International Journal of Pediatric Otorhinolaryngology http://dx.doi.org/10.1016/j.ijporl.2014.05.002 This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.
ip t
Response to the Letter to the Editor regarding “A Long-Term Analysis of Auricular Position in Pediatric Patients Who Underwent Post-Auricular Approaches”
Paul Hong1,2 M.D. 1
cr
Division of Otolaryngology-Head and Neck Surgery, Department of Surgery, Dalhousie University, Halifax, Nova Scotia, Canada
us
2
an
School of Human Communication Disorders, Dalhousie University, Halifax, Nova Scotia, Canada
Ac ce pt e
d
Dr. Paul Hong IWK Health Centre 5850/5980 University Avenue PO Box 9700 Halifax, Nova Scotia B3K 6R8 Canada Phone: (902) 470-0841 Fax: (902) 470-8929 Email: [email protected]
M
Corresponding author contact information:
Financial Disclosure: None Conflict of Interest: None
Keywords: post-auricular; mastoidectomy; auricular position; and post-operative
1
Page 1 of 3
INTRODUCTION We would like to express our gratitude to Dr. D.H. Lee for his interest in our study [1], and we appreciate his thoughtful comments. We do agree that measuring anterior-
ip t
posterior and vertical position of the auricle after post-auricular approaches would be valuable and interesting. However, as mentioned in our article, these measurements are not
cr
easy to obtain in the clinical setting. Consistent photographs along with computer-aided
us
measurements may be necessary, which was not practical to perform in our pediatric otolaryngology clinic. Further, we are uncertain whether anterior-posterior measurements
an
would be an important dimension to document. That is, there are no studies to indicate that horizontal dimensions or positions of the auricle or their changes are associated with any
M
real significance. On the contrary, lateral protrusion of the auricle has been linked to psychosocial and functional problems [2,3].
d
Changes to the vertical position of the auricle may lead to problems such as ill-
Ac ce pt e
fitting eyeglasses [4]. However, there is no good evidence to support this claim. In our study, none of the patients or their caregivers reported noticing any changes in the appearance of their ears. As well, the patients who wore eyeglasses did not report any changes after their operation, suggesting that the vertical position of the ear was not significantly altered [1].
Although Dr. Lee presented his method of post-auricular wound closure in four
layers to prevent anterior auricular displacement, there is no data or evidence to substantiate this claim. Since our closure technique does not seem to result in significant long-term positional changes in our patients, we are unclear if there are advantages to the four-layer closure technique.
2
Page 2 of 3
Again, Dr. Lee insightfully concluded his letter by stating that the anterior-posterior and vertical position of the auricle is more important than lateral protrusion after postauricular approach. Our conjecture is that all dimensions may be of importance but the
cr
practical and aesthetically valuable dimension to document.
ip t
focus of our study was the lateral prominence of the auricle. We believe that this was a
us
References
1. Hong P, Arseneault T, Makki F. A long-term analysis of auricular position in
an
pediatric patients who underwent post-auricular approaches. Int J Pediatr Otolaryngol 2014;78:471-473.
M
2. McNeil ML, Aiken SJ, Bance M, Leadbetter JR, Hong P. Can otoplasty impact hearing? A prospective randomized controlled study examining the effects of pinna
Ac ce pt e
2013;42:10.
d
position on speech reception and intelligibility. J Otolaryngol Head Neck Surg
3. Hao W, Chorney JM, Bezuhly M, Wilson K, Hong P. Analysis of health-related quality of life outcomes and their predictive factors in pediatric patients who undergo otoplasty. Plast Reconstr Surg 2013;132:811-817.
4. Ali MS. Unilateral secondary (acquired) postmastoidectomy low-set ear: postoperative complication with potential functional and cosmetic implications. J Otolaryngol Head Neck Surg 2009;38:240-245.
3
Page 3 of 3