无创矫正小儿先天性耳廓畸形453例疗效分析

Analysis of Therapeutic Effect of Non-invasive Correction of 453 Children with Congenital Auricle Deformity

目的:探讨耳廓无创矫形器治疗小儿先天性耳廓畸形的临床效果,分析矫正后复发的相关影响因素。方法:纳入2019年11月-2021年12月在笔者医院耳鼻咽喉头颈外科接受EarWell耳廓矫正器治疗的先天性耳廓畸形患儿292例共453耳。所有患儿均严格佩戴矫正器2~8周;根据患儿月龄分为≤2月龄组、3~5月龄组、6~8月龄组;另根据耳廓畸形种类区分垂耳组、杯状耳组、招风耳组、耳廓畸形组。评估各组矫正结束3个月后的矫正效果,随访1年观察畸形复发情况,对比复发组和未复发组的临床资料,采用Logistic回归分析影响耳廓畸形矫正后复发的相关因素。结果:矫正过程中有4例(6耳)患儿因各种原因退出治疗,最终完成矫正的共288例患儿(447耳)。≤2月龄组矫正成功率为90.21%(258/286)高于3~5月龄组74.26%(75/101)和6~8月龄组53.33%(32/60),差异有统计学意义(P<0.05);不同类型耳廓畸形中,垂耳矫正成功率高于杯状耳、耳廓畸形和招风耳(94.05%>80.00%>59.76%>41.67%),差异有统计学意义(P<0.05);随访1年,矫正成功的365例耳廓畸形中有47例复发,复发率为12.88%;多因素Logistic回归分析显示,初始矫正月龄(OR=1.832)、矫正器佩戴时长(OR=0.741)是无创矫正后复发的影响因素(P<0.05)。结论:耳廓畸形患儿接受无创矫正治疗的效果与患儿月龄及耳廓畸形类型有关,初始矫正月龄和矫正器佩戴时长与矫正成功后复发有关。

Objective To explore the clinical effect of non-invasive auricle orthosis in the treatment of congenital auricle malformations in children,and analyze the relevant factors affecting recurrence after correction.Methods A total of 453 ears of 292 children with congenital auricle deformities who received EarWell's auricle correction device treatment in our hospital's otolaryngology head and neck surgery from November 2019 to December 2021 were included;All children were strictly wearing braces for 2-8 weeks.Distinguish the≤2-month-old group,3-5 month-old group,and 6-8-month-old group based on the age of the child;According to the types of auricle deformities,the groups of pendulous ears,cup-shaped ears,flaring ears,and auricle deformities can be distinguished.Evaluate the corrective effect of each group 3 months after the completion of correction;Follow up for 1 year to observe the recurrence of deformities,compare the clinical data of the recurrent group and the non recurrent group,and analyze the relevant factors affecting the recurrence of auricular deformities after correction using logistic regression analysis.Results During the correction process,4 children(6 ears in total)withdrew from treatment due to various reasons,and 288 children(447 ears in total)completed the correction.The success rate of correction in the≤2-month-old group was 90.21%(258/286),which was higher than 74.26%(75/101)in the 3-5 month-old group and 53.33%(32/60)in the 6-8-month-old group,with a statistically significant difference(P<0.05).Among different types of auricular deformities,the success rate of correction of the hanging ear is higher than that of cup-shaped ear,auricular deformities,and flaring ear(94.05%>80.00%>59.76%>41.67%),and the difference is statistically significant(P<0.05).Following up for one year,out of 365 cases of successfully corrected auricular deformities,47 cases recurred,with a recurrence rate of 12.88%.Multivariate logistic regression analysis showed that the initial correction age(OR=1.832)and the length of appliance wear(OR=0.741)were independently correlated with recurrence after non-invasive correction(P<0.05).Conclusion The effectiveness of non-invasive correction treatment for children with auricular malformations is related to the age of the child and the type of auricular malformation.The initial correction age and the duration of appliance wear are related to recurrence after successful correction.