新生儿耳郭畸形发生率调查及表型分析

Investigation on the incidence of auricular malformations in newborn infants and its phenotypic analysis

目的明确新生儿中不同耳郭畸形的发生率及流行病学特点,并对表型规律进行分析。方法收集复旦大学附属妇产科医院2018年11月~2020年1月出生的新生儿出生资料,重点关注耳郭形态特点,按照统一模式多个角度对耳郭形态进行拍照并归档,由双人盲法进行评判,争议部分由专家组讨论判定。之后对不同类型的耳郭畸形发生率进行总结,并结合文献对耳郭畸形的表型规律进行分析。结果共计4688例新生儿纳入本研究,其中31.97%(1499/4688)的新生儿表现为耳郭畸形。将4688例新生儿的9376耳进行分析,共有2076耳表现为耳郭畸形,耳郭畸形的发生率为22.14%(2076/9376)。耳郭畸形发生率从高到低依次为:垂耳8.05%、猿耳4.97%、耳轮畸形3.98%、杯状耳2.18%、环缩耳0.92%、复合耳畸形0.91%、耳甲异常凸起0.49%、招风耳0.29%等。结合耳郭畸形诊疗新进展与耳模矫正等临床新技术的应用,提出新的综合性耳郭畸形分类分型分度系统。结论新生儿中各类耳郭畸形的发生率高,其中垂耳、猿耳、耳轮畸形、杯状耳等最为常见。新的综合性耳郭畸形分类分型分度系统的提出,将进一步指导和规范耳郭畸形的精细化诊疗,推动耳畸形领域专科化整形的不断发展。

Objective To clarify the incidence of different auricular malformations in newborns and to analyze the phenotypic rules.Methods We collected data of the newborns of Obstetrics and Gynecology Hospital of Fudan University between November 2018 and January 2020,focusing on the morphological characters of auricular and taking pictures of the auriculars from multiple angles in unified mode.The phenotypic was judged by a two-person blind method,and the disputed parts were judged by expert group.Afterwards,the incidence of different types of auricular malformations and the epidemiological characteristics of auricular malformations were summarized,and the phenotypic rules of auricular malformations were analyzed in combination with literature.Results A total of 4688 newborns were included in this study,and 31.97%(1499/4688)of the newborns showed auricular deformities.Analyzing 9376 ears of the 4688 newborns,a total of 2076 ears were affected and showed auricular malformations.The incidence of auricular malformation was 22.14%(2076/9376).According to the incidence of auricular malformation,the order was lop ear 8.05%,ape ear 4.97%,helix malformation 3.98%,cup ear 2.18%,constricted ear 0.92%,compound ear malformation 0.91%,ear concha abnormal protrusion 0.49%,wind ear 0.29%and so on.Combining the new advances of auricular malformations and the application of new clinical techniques such as ear mold correction,a new comprehensive classification and grading system for auricular malformations was proposed.Conclusions The incidence of various auricular malformations in newborns is high,among which lop ear,ape ear,helix malformation,and cup ear are the most common.The proposal of the new comprehensive classification system of auricular malformations will further guide and standardize the refined diagnosis and treatment of auricular malformations,and promote the continuous development of specialized plastic surgery in the field of ear malformations.