Two-dimensional and three-dimensional ultrasonographic diagnosis of congenital auricular anomalies

Huanyu WangKe LvXining WuYixiu Zhang^*Yunshu OuyangYan LvYulin JiangYue FanXiaowei ChenHua Meng^*

• Peking Union Medical College Hospital (CAMS), Beijing, China

Objective: To evaluate the role of prenatal ultrasound and three-dimensional ultrasound in the diagnosis of fetal congenital auricular malformations anomalies.The ultrasonographic features of 14 fetuses diagnosed with auricular malformations at Peking Union Medical College Hospital between diagnosed in PUMCH from May 2019 to and May 2024 were retrospectively reviewed, and pregnancy outcomes were followed up.The median gestational age at which congenital auricle deformities were detected by ultrasound was 24 weeks 5 days. Of the 14 cases, 5 had bilateral deformities, 5 had right-sided deformities, and 4 had left-sided deformities. Auricle deformities detected by ultrasound include: microtia, low ear position, accessory auricle, abnormal ear helix, question mark ear, etc., which are consistent with postnatal follow-up observation or induced labor pathological examination results.The auricular abnormalities detected included microtia, low set ears, accessory auricles, abnormal ear helix and question mark ear, all of which were confirmed by postnatal follow-up or pathological examination after termination. Ten patients fetuses underwent three-dimensional ultrasound examination of the external ear, providing which provided additional diagnostic informationdetails. Eight fetuses presented with other systemic deformities: three had facial deformities such as micrognathia, nasal bone absence, and facial cleft,; two had diaphragmatic hernia, or pelvic kidney, two had cardiac structural abnormalities; two had spina bifida or polydactyly; and one had intrauterine growth restrictionwhile five had additional structure anomalies including diaphragmatic hernia, cardiac anomalies, spina bifida and polydactyly. Genetic testing was performed in nine cases: one fetus had complete trisomy 18, one had Xp22.31 duplication, and seven had normal results.Six patients underwent induced laborpregnancies were electively terminated, and 8 were born;while eight fetuses were carried to term. Among the newborns, four had no significant hearing impairment, four others (three with microtia and one with a question mark ear) had hearing loss and required further reconstructive treatment.Conclusions: Congenital auricle auricular deformities exhibit characteristic ultrasound features, and in most cases, prenatal diagnosis and evaluation can be achieved through ultrasound. This provides valuable information to support clinical decision-making and prenatal counseling. examination, providing effective reference information for clinical decision-making for patients.