Evaluation of 4 Outcomes Measures in Microtia Treatment: Exposures, Infections, Aesthetics, and Psychosocial Ramifications.

BackgroundIn craniofacial microsomia, microtia and canal atresia pose formidable reconstructive challenges. We review our institutional experience in treating microtia and atresia to identify variables associated with 4 outcomes measures: complications, surgical revisions, aesthetic outcomes, and psychosocial function.MethodsCraniofacial microsomia patients treated at the University of California Los Angeles Craniofacial Clinic between 2008 and 2014 greater than 13 years of age (n = 68) were reviewed for microtia and atresia treatment and outcomes.ResultsIn total, 91.2% of patients diagnosed with craniofacial microsomia presented with microtia, affecting 75 ears. Both a male and right-sided predominance were observed. Fifty-six patients (90.3%) underwent autologous external ear reconstruction at an average age of 8.5 years. Age, type of incision, and size of cartilage framework did not predict total number of surgeries or complications. Severity of ear anomalies correlated with increased number of surgeries (P < 0.001) and decreased aesthetic outcomes (P < 0.001) but not complications. In total, 87.1% of patients with microtia had documented hearing loss, of which the majority were conductive and 18.5% were mixed sensorineural and conductive. Hearing deficits were addressed in 70.4% of patients with external hearing aids, bone anchored hearing aids, or canaloplasty. Of all variables, improvement of psychosocial function was correlated only to hearing loss treatment of any type (P = 0.01).ConclusionsOn evaluation of surgical and patient characteristics, severity of microtia predicted the total number of surgical revisions performed and aesthetic ratings. In addition, we found that the only factor that correlated with improved patient and parent-reported psychosocial outcomes was treatment of hearing loss

Change of Electronic Structure Induced by Magnetic Transitions in CeBi

The temperature dependence of the electronic structure of CeBi arising from two types of antiferromagnetic transitions based on optical conductivity ($\sigma(\omega)$) was observed. The $\sigma(\omega)$ spectrum continuously and discontinuously changes at 25 and 11 K, respectively. Between these temperatures, two peaks in the spectrum rapidly shift to the opposite energy sides as the temperature changes. Through a comparison with the band calculation as well as with the theoretical $\sigma(\omega)$ spectrum, this peak shift was explained by the energy shift of the Bi $6p$ band due to the mixing effect between the Ce $4f \Gamma_8$ and Bi $6p$ states. The single-layer antiferromagnetic ($+-$) transition from the paramagnetic state was concluded to be of the second order. The marked changes in the $\sigma(\omega)$ spectrum at 11 K, however, indicated the change in the electronic structure was due to a first-order-like magnetic transition from a single-layer to a double-layer ($++--$) antiferromagnetic phase.Comment: 4 pages, to be published in J. Phys. Soc. Jpn. 73 Aug. (2004