耳畸形整形术

Repair of ear deformity: a study of different methods

目的探讨和评价不同耳畸形的手术方法、效果及其影响因素.方法根据耳畸形的不同情况,利用自体肋软骨,对379例(401耳)采用双叶皮瓣法、29例(29耳)采用耳后沟皮瓣行耳廓再造及耳道成形术.对84例(84耳)气化型乳突患者同时行耳道成形术和鼓室成形术.结果335例(82%)术后随访3个月以上,其中273例(67%)随访0.5～5年,手术效果满意,再造耳形态逼真,颅耳角满意;358例(380耳)先天性小耳畸形术后复查听力,335耳术后听力有不同程度提高,其中84耳同时行耳道成形术和鼓室成形术,听力改善更明显;45耳术后听力无明显改善(＜10 dB).结论自体肋软骨是耳再造的理想材料,双叶皮瓣及耳后沟皮瓣行耳再造效果满意,听力有所提高.

Objective To evaluate the surgical effects and influencing factors of ear malformation. Methods 408 cases were reviewed, including surgical methods and its effect in different condition of malformation, in which autogenous rib cartilage was used in reconstruction of ear. Meanwhile, 349 cases （401 ears） double-lobe skin flap and 29 cases （29 ears） retroauricular groove flap were designed according to different condition of malformation. All the patients were treated with eanalplasty, and 84 cases （84 ears） with mastoid process of pneumatic type were treated with tympanoplasty and eanalplasty. Results months and more follow-up obtained in 335 cases （82%）, and 6 months to 5 years follow-up in 273 cases （67%）. Surgical effect was satisfactory, the shape of reconstructive ear was verisimilitude, and skull auricle angle was suitability; hearing was improved after operation in 335 ears, especially in 84 ears with canalplasty and tympanoplasty, but hearing was not improved after operation in 45 ears （-〈10dB）. Conclusion Autogenous rib cartilage is an ideal material for ear reconstruction, the effect is good by doublelobe skin flap and retroaurieular groove flap, and the hearing is also improved after operation.