1岁以内婴幼儿耳郭形态畸形矫正效果评价

A clinical observation on effect of auricle deformity type and age on outcomes of auricle correction in 1-year-old infants

目的 探讨耳郭形态畸形的类型及矫正时的年龄对治疗效果的影响,为临床耳郭形态畸形无创矫正提供参考。方法 选取2017年9月至2019年9月,以耳鼻咽喉头颈外科门诊确诊为耳郭形态畸形的1岁以内患儿作为研究对象。按开始矫正的年龄分为两组,<42 d为小月龄组,>42 d为大月龄组。同时根据形态畸形的类型分为招风耳组、杯状耳组、垂耳组和隐耳组。采用改良版耳郭形态畸形无创矫正视觉模拟评分法(MVAS-NAC)对小月龄组和大月龄组患儿的矫形效果进行对比分析。结果 小月龄组平均提升效果优于大月龄组(P<0.05),患儿矫正年龄与矫正效果呈负相关,小月龄组和大月龄组矫正时长差异无统计学意义(P>0.05),不同耳郭形态畸形组之间平均提升效果差异无统计学意义(P>0.05)。家长评分与医生评分差异无统计学意义(P>0.05),家长和医生评分斯皮尔曼等级相关系数r=0.810。小月龄组皮肤并发症发生率低于大月龄组(P<0.05)。结论 年龄是影响矫正效果的主要因素,超过6个月的患儿,不再推荐进行矫正治疗,隐耳可适当放宽矫正年龄。临床可采用MVAS-NAC进行矫正效果的评估。

Objective To explore the influence of auricle deformity type and age at the time of correction on the outcomes in order to provide references for clinical non-surgical correction of the auricle. Methods Infants with auricle deformity diagnosed in the ENT department between September 2017 and September 2019 were selected as the subjects. They were divided into two groups based on the age within 1 year. Infants less than 42 days were in the younger group, and infants more than 42 days were in the older group. The type of auricle deformity was divided into prominent ears, cup ears, lop ears, and cryptotia. The modified visual analogue scale in non-surgical auricle correction(MVAS-NAC) was used to evaluate the outcomes. Results The outcomes of the younger group were better than those of the older group(P<0.05). The relationship between the age at correction and the outcome was generally negative(P<0.05). The difference in the duration of treatment between the younger group and the older group was not statistically significant(P>0.05). No significant difference was found in the outcome among the different type of deformity groups(P>0.05). No statistical difference was seen between parents? score and doctor?s score(P>0.05). The Spearman rank correlation coefficient between the parents and the doctor was 0.810. The incidence of skin complications in the younger group was lower than that in the older group(P<0.05). Conclusion The age of correction is the main factor affecting the effect of correction. Infants with age above 6 months must not be recommended for auricle correction;for infants with cryptotia, the age limitation can be relaxed. MVAS-NAC can initially be used to evaluate the effect of non-invasive correction of auricle deformities in infants.