耳软骨舒展术在轻中度耳甲腔型小耳畸形中的应用

Application of auricle radial cartilage incision in mild to moderate type of concha-type microtia patients

目的评价耳软骨舒展术替代肋软骨部分耳郭再造术在耳甲腔型小耳畸形中的应用。方法自2023年5月至2023年12月,中国医科大学附属第一医院整形外科收治5例轻中度耳甲腔型小耳畸形患者,采用耳软骨舒展术配合耳甲腔软骨移植及游离皮片移植治疗,测量术后即刻耳宽、耳周长,并对术后耳细微结构进行评分,并与术前患耳进行对比。记录了患者对再造耳的满意度及术后有无并发症发生。结果术后即刻患耳宽平均提高约31%,耳周长平均提高约28%、耳细微结构评分平均提高约35%。患耳手术前后比较,术后耳宽及耳周长均有提高,差异有统计学意义(P<0.01);术后耳细微结构评分也有提高,差异有统计学意义(P<0.05)。所有患者均对再造耳外形满意,无并发症发生。结论耳软骨舒展术配合耳甲腔软骨移植,游离皮片移植等方法可在轻中度耳甲腔型小耳畸形患者中作为肋软骨切取部分耳郭再造术的良好替代方法。

Objective To evaluate the auricle radial cartilage incision as for a method for the alternative to treat mild to moderate type of concha-type microtia.Methods As for an example of five patients aged between 6 to 35 and who were diagnosed with mild to moderate type of concha-type microtia,in a period between 2023 May to 2023 Dec.the Department of Plastic Surgery of The First Hospital of China Medical University applied auricle radial cartilage incision with autologous cartilage form auricle concha and skin graft for treatment.The auricle width,perimeter and the scores of detailed structures of the affected ear were recorded and evaluated preoperatively and postoperatively.The satisfaction and the complication of the operation were followed and recorded.Results The average improvement of the width and the perimeter of the affected ear is about 31 percent and 28 percent respectively,measured immediately after surgery.The average score of ear fine structure increased by about 35%.The width and the perimeter of the affected ear have been both improved and the improvements have been proved to have significant differences(P<0.01).The scores of detailed structures of the affected ear has also been improved and the improvement has been proved to have difference(P<0.05).Conclusion The auricle radial cartilage incision assisted with autologous cartilage form auricle concha and skin graft is a promising alternative to the method costal cartilage graft for the purpose of auricle reconstruction in mild to moderate type of concha-type microtia patients.