自体耳甲软骨移植矫正“贴面耳”

Autogenous concha cartilage graft for correction of"lying ear"

目的探讨自体耳甲软骨移植矫正“贴面耳”的手术方法和临床效果。方法自2021年6月至2023年1月,南京医科大学友谊整形外科医院对12例“贴面耳”患者行自体耳甲软骨移植矫正手术。均采用开放切口,充分游离松解对耳轮背侧的皮下组织及肌肉,在对耳轮背侧软骨上划痕释放软骨应力,将自体耳甲软骨移植至对耳轮背侧,增加颅耳角及耳甲-耳舟角角度,术后使用热塑板固定外耳形态。对手术前后颅耳角改变及耳部外形视觉模拟(visual analogue scale,VAS)进行评分,并记录术后并发症。结果12例患者术后切口均一期愈合。所有患者术后获随访6个月,“贴面耳”得到矫正,颅耳角增加。所有患者术后效果均满意,无并发症发生。术前颅耳角为(26.25°±6.72°),术后为(40.08°±4.52°),差异具有统计学意义(P<0.01);患者自评耳部外形VAS评分术前为(2.17±1.11)分,术后为(7.75±1.29)分,差异具有统计学意义(P<0.01)。医师评耳部外形VAS评分术前为(2.82±1.25)分,术后为(7.83±0.94)分,差异具有统计学意义(P<0.01)。结论自体耳甲软骨移植矫正“贴面耳”畸形,术后佩戴外固定支架,可明显矫正“贴面耳”,是一种安全有效的整形手术方法。

Objective To investigate the surgical method and clinical effect of autogenous concha cartilage graft for correction of“lying ear”.Methods From June 2021 to January 2023,Department of Plastic Surgery,The Affiliated Friendship Plastic Surgery Hospital of Nanjing Medical University performed autogenous concha cartilage graft on 12 patients with“lying ear”to correct the lying ear deformity.In all cases,open incisions were used to fully free and loosen the subcutaneous tissue and muscle on the dorsal side of the antihelix.A scratch on the dorsal cartilage of the antihelix was made to release cartilage stress,and autogenous concha cartilage was grafted to the dorsal side of the antihelix to increase the cephaloauricular angle and the angle between the ear concha and the ear navicular angle.The external ear was fixed with a thermoplastic plate after the operation.The changes of cephaloauricular angle and visual analogue scale of ear shape before and after the operation were scored,and postoperative complications were recorded.Results The incision healed in 12 patients.All patients were followed up for 6 months.The"lying ear"was corrected and the cephaloauricular angle angle was increased.All patients were satisfied with postoperative results and no complications occurred.The cephaloauricular angle was(26.25°±6.72°)before surgery and(40.08°±4.52°)after surgery,the difference was statistically significant(P<0.01).Patient evaluation the VAS score of ear contour was(2.17±1.11)before surgery and(7.75±1.29)after surgery,the difference was statistically significant(P<0.01).Physician evaluation the VAS score of ear contour was(2.82±1.25)before surgery and(7.83±0.94)after surgery,the difference was statistically significant(P<0.01).Conclusion Autogenous concha cartilage graft for correction of"lying ear"deformity,with wear external stent after operation is a safe and effective plastic surgery method to correct the"lying ear".