An auricular splint (AS) or ear splint is a custom-made medical device that is used to maintain auricular projection and dimensions following second stage auricular reconstruction. The AS is made from

ethylene-vinyl acetate Ethylene-vinyl acetate (EVA), also known as poly (ethylene-vinyl acetate) (PEVA), is the copolymer of ethylene and vinyl acetate. The weight percent of vinyl acetate usually varies from 10 to 40%, with the remainder being ethylene. There are th ...

(EVA), which is typically used to make custom-made mouthguards and was developed by a team from

Great Ormond Street Hospital Great Ormond Street Hospital (informally GOSH or Great Ormond Street, formerly the Hospital for Sick Children) is a children's hospital located in the Bloomsbury area of the London Borough of Camden, and a part of Great Ormond Street Hospital ...

in the

United Kingdom The United Kingdom of Great Britain and Northern Ireland, commonly known as the United Kingdom (UK) or Britain, is a country in Europe, off the north-western coast of the continental mainland. It comprises England, Scotland, Wales and North ...

History

The auricle is typically reconstructed using autogenous

cartilage Cartilage is a resilient and smooth type of connective tissue. In tetrapods, it covers and protects the ends of long bones at the joints as articular cartilage, and is a structural component of many body parts including the rib cage, the neck an ...

, which is the most reliable material for producing the best results with the least complications. Cartilage from the

knee In humans and other primates, the knee joins the thigh with the leg and consists of two joints: one between the femur and tibia (tibiofemoral joint), and one between the femur and patella (patellofemoral joint). It is the largest joint in the hu ...

and contralateral auricular cartilage from the concha have also been reported but

costal cartilage The costal cartilages are bars of hyaline cartilage that serve to prolong the ribs forward and contribute to the elasticity of the walls of the thorax. Costal cartilage is only found at the anterior ends of the ribs, providing medial extension. ...

is typically used as it is the only donor site that provides sufficient tissue to fabricate the complete auricular framework. The four main elements to consider when assessing the final reconstructed auricle are: * The

symmetry Symmetry (from grc, συμμετρία "agreement in dimensions, due proportion, arrangement") in everyday language refers to a sense of harmonious and beautiful proportion and balance. In mathematics, "symmetry" has a more precise definit ...

of size of the auricle * The projection of the auricle * The adequacy of the temporoauricular sulcus (the depression behind the auricle next to the head) * The contour of the different subunits of the reconstructed auricle In order to prevent compression during sleep and to prevent the grafted skin from contracting, the use of a

Foley catheter In urology, a Foley catheter (named for Frederic Foley, who produced the original design in 1929) is a flexible tube that a clinician passes through the urethra and into the bladder to drain urine. It is the most common type of indwelling urina ...

, Reston™ Foam,

silicone foam Silicone foam is a synthetic rubber product used in gasketing, sheets and firestops. It is available in solid, cured form as well as in individual liquid components for field installations. Uses *Gaskets *Sheets *High temperature tubes for autoc ...

polysiloxane A silicone or polysiloxane is a polymer made up of siloxane (−R2Si−O−SiR2−, where R = organic group). They are typically colorless oils or rubber-like substances. Silicones are used in sealants, adhesives, lubricants, medicine, cooking ...

and dental impression compound have been described. The auricular splint was developed with the aim of overcoming the drawbacks associated with these methods.

Technique

The auricular splint (AS) is easy to fit and remove, self-retaining, lightweight and easy to camouflage due to its transparency. The AS is made from

(EVA), which is inert and non-toxic, non-absorbent, sufficiently elastic to allow it to fitted and removed but sufficiently rigid to avoid breakage. The concept was first presented at the 2nd Congress of the International Society for Auricular Reconstruction in

Beijing } Beijing ( ; ; ), alternatively romanized as Peking ( ), is the capital of the People's Republic of China. It is the center of power and development of the country. Beijing is the world's most populous national capital city, with over 21 ...

China China, officially the People's Republic of China (PRC), is a country in East Asia. It is the world's most populous country, with a population exceeding 1.4 billion, slightly ahead of India. China spans the equivalent of five time zones and ...

in September 2017 and published in the

Annals of Plastic Surgery ''Annals of Plastic Surgery'' is a monthly peer-reviewed medical journal covering all aspects of plastic and reconstructive surgery. It is published by Lippincott Williams & Wilkins and the editor-in-chief is William C. Lineaweaver (Joseph M. Sti ...

the following year. The first stage involves taking an impression of the reconstructed auricle with Soft Putty Elastomer, which is cast in dental stone to make a model of the reconstructed auricle. The splint is made by

thermoforming Thermoforming is a manufacturing process where a plastic sheet is heated to a pliable forming temperature, formed to a specific shape in a mold, and trimmed to create a usable product. The sheet, or "film" when referring to thinner gauges and cert ...

a 4mm sheet of transparent

(EVA) over the stone model. The edges of the splint are trimmed and polished using the outline on the model as a guide. The splint has been found to maintain auricular projection and other key dimensions up to the six-month post-operative follow-up.

References

{{DEFAULTSORT:Auricular splint 2017 in science 2017 introductions Congenital disorders of ears Ear Ear procedures Ear surgery Medical devices Plastic surgery