骨整合义耳修复全耳廓缺损的远期疗效观察

Long-term therapeutic effects of repairing the whole auricular defects with osseointegrated prosthetic ears

目的 探讨骨整合义耳修复全耳廓缺损的远期疗效.方法 回顾性分析中山大学附属第二医院耳鼻咽喉头颈外科自2002年1月至2005年12月行骨整合义耳修复耳廓缺损患者62例（63耳）,随访5～8年,中位随访时间6.5年.就其固位义耳种植体的稳定性、脱出率,种植体周围组织感染,配戴义耳时间和外观满意度,义耳更换频率和周期及有无全身并发症进行分析.结果 63耳一次全部治愈,义耳形态逼真,配戴稳定,色泽自然.63耳均出现种植体与周围组织感染,但对种植体稳定性无影响.63耳126颗种植体一次植入成活稳定,有4颗种植体脱出都为外伤所致.所有63耳配戴义耳时间超过8 h/d.义耳更换中位时间3.0年,主要原因是义耳褪色和撕裂.无全身及颅内并发症.结论 骨整合义耳安全可靠,长期效果稳定,是全耳廓缺损修复可选择的方法.

Objective To evaluate the long-term therapeutic effects of repairing the whole auricular defects with osseointegrated prosthetic ears. Methods From January 2002 to December 2005, 62 patients （63 ears） with the whole auricular defects were treated with osseointegrated prosthetic ears and followed up for 5- 8 years （median 6.5 years） after operations. In all cases, the following items were analyzed： stability and dislocation rate of the implants fixing prosthetic ears, infection of tissues surrounding implants, time and appearance satisfaction of wearing prosthetic ears, rate and time length of replacement of prosthetic ears, and presence of systemic complications or not. Results All 63 ears were healed with one surgery, with the appearances of life like shapes, stable fixation, and natural color. Infection of implants and their surrounding tissues occured in all cases, but didn＇t influence the stability of the implants. All 126 implant particles in 63 ears survived after one surgery, execpt that 4 implant particles were dislocated by trauma. In all cases, the time of wearing prosthetic ears was more than 8 hours per day. Because of color fading and breakage, average time length of replacement of prosthetic ears was 3.0 years. There were no intracranial or systemic complications. Conclusions Osseointegrated prosthetic ears can be used in the treatment of the patients with the whole auricular defects, because of its safety and reliability, the stability of long-term therapeutic effects, and the good satisfaction of the patients.