3D耳模在自体肋软骨移植耳廓再造术中的应用效果探讨

Application of 3D Earmould in the Auricular Reconstruction of Autologous Costal Cartilage Transplantation

目的:探讨3D耳模在自体肋软骨移植耳廓再造术中的应用效果。方法:选取2018年12月-2020年12月笔者医院整形外科收治的68例耳廓再造患儿为观察对象,根据耳模制作方法不同分为3D耳模组和标准耳模组,各34例。两组均进行术前检查并给予针对性护理,在此基础上3D耳模组行3D打印技术辅助耳廓再造术,标准耳模组行二维标准耳模术辅助耳廓再造术。比较两组再造耳廓整体形态、心理状态、术后并发症发生情况、美学效果满意度及模型应用效果。结果:术后6个月,3D耳模组再造耳廓的三维轮廓、对称性、颅耳角和亚解剖结构还原度评分均高于标准耳模组,差异有统计学意义(P<0.05);大小和位置评分与标准耳模组比较差异无统计学意义(P>0.05)。两组患儿各种心理状态评分均较术前显著降低,且3D耳模组和标准耳模组比较差异有统计学意义(P<0.05)。3D耳模组术后并发症总发生率(5.88%)低于标准耳模组(11.76%),但组间比较差异无统计学意义(P>0.05)。3D耳模组对再造耳廓的三维轮廓、对称性、颅耳角和功能美学效果满意度评分均高于标准耳模组,差异有统计学意义(P<0.05);对大小、位置和稳定性满意度评分与标准耳模组比较差异无统计学意义(P>0.05)。耳廓再造医生对3D耳模组模型各方面应用效果评分均高于标准耳模组,差异有统计学意义(P<0.05)。结论:在自体肋软骨移植耳廓再造术中应用3D耳模可有效辅助精细解剖结构的重建提升再造耳廓整体形态,改善患儿心理状态,减少术后并发症发生,提高美学效果满意度,且有助于医生更好地实施耳廓再造术,值得推广应用。

Objective To explore the cosmetic effect of 3D earmould in the auricular reconstruction of autologous costal cartilage transplantation.Methods 68 children with auricular reconstruction who were admitted to our hospital from December 2018 to December 2020 were selected as the observation subjects,and were divided into the 3D earmould group and the standard earmould group according to different earmould making methods,with 34 cases in each group.Both groups of patients underwent preoperative examination and were given surgical targeted nursing,and on this basis,the 3D earmould group applied 3D printing technology to assist auricular reconstruction and the standard earmould group was given two-dimensional standard earmould to assist auricular reconstruction.The overall shape of reconstructed auricles,psychological status,occurrence of postoperative complications,cosmetic effect satisfaction and model application effect of the two groups of patients were compared.Results 6 months after operation,the scores of three-dimensional profile,symmetry,cranioauricular angle and sub-anatomical structure reduction degree of reconstructed auricles in the 3D earmould group were all higher than those of the standard earmould group,the differences were statistically significant(P<0.05).And there were no statistical differences in the scores of size and location compared with those of the standard earmould group(P>0.05).The scores of various psychological states of children in two groups were significantly lower than those before operation(P<0.05).The differences between the 3D earmould group and the standard earmould group were significant(P<0.05).The total incidence rate of postoperative complications in the 3D earmould group was lower than that in the standard earmould group(5.88%vs 11.76%),but there was no significant difference between two groups(P>0.05).The cosmetic effect satisfaction scores of three-dimensional profile,symmetry,cranioauricular angle and function of reconstructed auricles of patients in the 3D earmould group were higher than those in the standard earmould group(P<0.05).There were no statistically significant differences in the satisfaction scores of size,location and stability compared to the standard earmould group(P>0.05).The application effect scores of various aspects by auricular reconstruction doctors in the 3D earmould group were higher than those in the standard earmould group(P<0.05).Conclusion The application of 3D earmould in the auricular reconstruction of autologous costal cartilage transplantation can effectively assist the reconstruction of fine anatomical structure to enhance the overall shape of reconstructed auricles,improve the psychological status,reduce the occurrence of postoperative complications,enhance the cosmetic effect satisfaction,and help doctors better implement auricular reconstruction,thus it is worthy of popularization and application.